Farmers’ and Consumers’ Beliefs About Community-Supported Agriculture in Australia: A Qualitative Study

This study aimed to examine the level of knowledge about community-supported agriculture (CSA) (a form of direct marketing of produce) and perceived benefits and barriers among farmers and consumers. Twenty consumers and 12 farmers in Victoria, Australia, were interviewed. Knowledge of CSA was limited. For consumers, one potential benefit of involvement with CSA was the food being fresh, while barriers included lack of produce choice. For farmers, one potential benefit was financial, while barriers included concerns about risk-sharing. If CSA is to develop further in Australia, the concept needs to be more heavily promoted to raise the population’s awareness.     

A Qualitative Study of Mothers’ Perspectives on Enrolling and Engaging in an Evidence-Based Nurse Home Visiting Program

Prevention Science - Prevention programs like Nurse-Family Partnership® (NFP) must enroll and retain clients of the intended population to maximize program impact. NFP is an evidence-based...     

African–American Solo Grandparents Raising Grandchildren: A Representative Profile of Their Health Status

The objective of this study is to document the health profile of 252 African-American grandparents raising their grandchildren solo, compared with 1552 African-American single parents. The 2012 Behavior Risk Factor Surveillance System is used to compare the specific physical and mental health profiles of these two family groups. The findings suggest solo grandparents have prevalence of many health conditions, including arthritis (50.3?%), diabetes (20.1?%), heart attack (16.6?%) and coronary heart disease (16.6?%). Logistic regression analyses suggest that solo grandparents have much higher odds of several chronic health disorders in comparison with single parents, but this difference is largely explained by age. Although solo grandparents have good access to health care insurance and primary care providers, a substantial percentage (44?%) rate their health as fair or poor. Practice interventions to address African American solo grandparents’ health needs are discussed.     

Exploring Mothers’ Influence on Preschoolers’ Physical Activity and Sedentary Time: A Cross Sectional Study

Objectives Physical activity patterns can track from childhood into adulthood; therefore, establishing active behaviors early is imperative. Given the multidimensional nature of a mother’s influence on their children, there is a need to utilize more comprehensive measures to assess the relationship between mother and child activity behaviors. Specifically, mothers have been identified as influencing preschoolers’ activity behaviors and are often in control of organizing a family’s opportunities to be active. The purpose of this study was to explore maternal influence on preschoolers’ physical activity and sedentary time. Methods Preschoolers (n?=?24) and their mothers (n?=?24) wore Actical? accelerometers for 7 consecutive days (e.g., 5 weekday, 2 weekend days), and mothers completed the adapted Environmental Determinants of Physical Activity in Preschool Children—Parent Survey. Direct entry regression analyses were conducted to explore maternal influence (e.g., role modeling through mothers’ activity levels, maternal support, and enjoyment of being active) on preschoolers’ activity levels. Results Maternal support was found to be a significant predictor of preschoolers’ light and moderate–vigorous physical activity, and sedentary time (p?<?.05); accounting for 37.3–46.7% of the variation. Conclusions for Practice Mothers supportive behaviors influenced preschoolers’ physical activity and sedentary time. Future research is needed to investigate facilitators/barriers that mothers with preschoolers encounter with regard to providing support to be active or modeling active behaviors themselves.     

Correlates of Mothers’ Perception of Their Communities’ Social Capital: A Community-Based Study

Psychosocial issues have been recognized as important factors in children’s health for decades. This study documents the relation among several important psychosocial variables (e.g., mothers’ depressive symptoms) and a new instrument that assesses parents’ perception of their communities’ social capital. Mothers were recruited from their children’s primary care (PC) pediatricians’ offices within the Southwestern Ohio Ambulatory Research Network or from a children’s hospital developmental clinic (DC). Mothers completed a questionnaire that included the Social Capital Scale (SCS), Children with Special Health Care Needs Screener (CSHCNS), Pediatric Quality of Life Inventory, Maternal Social Support Index and the Center for Epidemiologic Studies Depression Scale (CES-D). Mothers were sorted into three subgroups based on site of recruitment (PC or DC) and results of the CSHCNS. The sample (N = 620) was also sorted into terciles based on SCS scores. Mean SCS was about 73 for each of the three subgroups. Compared to mothers in the highest SCS tercile, mothers in the lowest SCS tercile reported lower education, lower income and higher CES-D median scores. The SCS subscale “sense of belonging” had an inverse correlation with CES-D scores (r = ?.248, p < 0.001). Mothers from primary care and sub-specialty clinics had similar perceptions about their communities’ social capital. Compared to mothers in the highest one third of SCS scores, mothers in the lowest one third were more likely to report less education and income as well as more depressive symptoms. A decreased sense of belonging in their communities was also correlated with more depressive symptoms. The SCS is a new useful tool for investigators and clinicians who work with children and their families.     

Elderly Women’s Views About Sexual Desire During Old Age: A Qualitative Study

Due to the embarrassment and discomfort elderly women feel, there is insufficient information about elderly Iranian women’s sexual desires. Therefore, 15 elderly married women over 60 years of age were studied. The participants all lived with their husbands and were interested in expressing the sexual desire they felt. Using qualitative content analysis, we identified three categories of sexual desire among the studied participants: a dictated role, acquired management, and glorified spirituality. In all three categories, both religious and traditional dimensions are also observed. In addition to socio-cultural and psychological factors, the evaluation of sexual desire in older women requires considering a full range of spiritual and religious issues.     

Stories of Postpartum Depression: Exploring Health Constructs and Help-Seeking in Mothers’ Talk

This article explores behavioral constructs derived from the Integrative Model of Behavioral Prediction (Fishbein, 2009) that emerged from unsolicited, online stories from 30 mothers about their experiences with postpartum depression. Five constructs (i.e., social norms; severity; barriers to help-seeking; facilitators to, and cues to action for, help-seeking; and self-efficacy) were prevalent and were connected with help-seeking behaviors in the stories that were analyzed after a single data collection in March 2011. Recommendations are offered for how the findings can be integrated into postpartum depression-related health promotion interventions.     

Hispanic Parents of Overweight and Obese Children and Their Outcome Expectations for Children’s Television Viewing: A Qualitative Study

ObjectiveExplore parental outcome expectations (OE) regarding children’s television (TV) viewing among parents of overweight or obese children.MethodsQualitative study using semi-structured interviews with 20 parents of 5- to 8-year-old overweight or obese children.ResultsParent’s positive OE for allowing TV viewing were the convenience of using TV for entertainment or as a babysitter. Hispanic parents would limit children’s TV viewing to improve their children’s health, restrict content, and promote other activities. Negative OE such as children misbehavior and the loss of positive OE for allowing TV emerged as reasons parents may not limit TV.Conclusions and ImplicationsAlthough Hispanic parents expected to improve their child’s health by limiting TV, the negative OE may prevent them from doing so. Interventions targeting children’s TV viewing, as a strategy to fight childhood obesity, may be more effective if they promote parent’s positive OE and address parent’s negative OE for children’s TV viewing.     

Knowledge Translation and Evidence-Based Practice: A Qualitative Study on Clinical Dietitians’ Perceptions and Practices in Switzerland

BackgroundKnowledge translation (KT) in health care is essential to promote quality of care and reduce the knowledge-to-practice gap. Little is known about KT among dietitians, and a better understanding of how this process pans out is fundamental to support their clinical practice.ObjectiveTo explore clinical dietitians’ perceptions and practices concerning preferences and access to information sources in clinical practice, KT activities, research in nutrition and dietetics, and evidence-based practice (EBP).Design, participants, and settingEight interviews and two focus groups involving a total of 15 participants were conducted in 2013 among members of the Swiss Association for Registered Dietitians in the French- and German-speaking regions of Switzerland.Analysis performedThematic analysis drawn from a constructivist grounded theory approach.ResultsInformation from colleagues and experts of the field were favored when facing unfamiliar situations in clinical practice. Critically selecting evidence-based information was considered challenging, but dietitians declared they were at ease to integrate patients’ preferences and values, and their clinical expertise and judgment, in decision making, which are fundamental elements of EBP. A major reported barrier to KT was the perception that time to identify and read scientific literature was not expected during working hours and that instead, this time should be spent in clinical activities with patients. On the other hand, dietitians identified that their frequent involvement in educational activities such as knowledge dissemination or tailoring favored the integration of evidence into practice. Finally, dietitians struggled more to identify evidence-based information about counseling and communication than about biomedical knowledge.ConclusionsDietitians mentioned being involved in each step of the KT process (ie, synthesis, dissemination, exchange, and ethically sound application of knowledge). Barriers and facilitators identified in this study need to be explored in a larger population to develop strategies to facilitate KT and EBP in dietetics practice.     

Concern Explaining Nonresponsive Feeding: A Study of Mothers’ and Fathers’ Response to Their Child's Fussy Eating

Objective

To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families.

Barriers to Unmarried Father Involvement During Infancy: Qualitative Study from Professionals’ Perspectives

Introduction Unmarried fathers in the U.S. face barriers to establishing a relationship with their newborn children that married fathers do not confront. Our study was implemented to determine how systems and services could be modified to better support the engagement of unmarried fathers. Methods We conducted interviews with 35 professionals who interact with primarily low-income unmarried mothers and fathers to elicit their perceptions of such barriers. We developed a social ecological model to inform the study design and used purposive sampling with chain referrals to ensure a wide breadth of perspectives. Themes and subthemes categorizing personal and environmental factors were placed within five nested categories corresponding to different levels of influence on unmarried fathers’ behaviors: public policy, community, institutions, interpersonal relationships, and intrapersonal characteristics, and their intersections. Results Participants challenged as inaccurate the stereotype of unmarried fathers as disengaged and uninterested in being involved with their children. Rather, they described the marginalization and devaluing of unmarried fathers by government policies and family service systems and programs and also the dearth of resources available to them. They called on decision makers to adjust policies and services to be more inclusive of unmarried fathers, to promote father engagement more actively, and to urge direct service providers to respond to fathers as valued individuals. Discussion Adapting to the common reality of nonmarital childbearing will entail a systematic shift in the integration of ways in which we value, understand, include, and serve fathers.

     

Health Workers’ Perceptions of Italian Female Adolescents: A Qualitative Study About Sexuality,Contraception, and Caring Practices in Family Health Centers

Our aim was to explore health workers’ perceptions of providing sexuality and contraception care for female adolescents within family health centers. We interviewed 26 volunteer health workers and analyzed the interviews using thematic analysis. We identified three main themes: (a) “adolescents and sexuality,” with the subthemes “initiation rite,” “me like the others,” and “just for fun”; (b) “adolescents and contraception,” with the subthemes “omnipotent adolescents,” “aware adolescents,” and “women's responsibility”; and (c) “health workers and adolescents,” with the subthemes “to put in order,” “to catch,” and “to teach to take care of themselves.” Our results provided an interesting picture of health workers’ perceptions of their work with Italian female adolescents regarding sexuality and contraception.     

Ambivalence and Stigma Beliefs About Medication Treatment Among Young Adults With Opioid Use Disorder: A Qualitative Exploration of Young Adults’ Perspectives

PurposeYoung adults with opioid use disorder (OUD) have low engagement in treatment with medication for opioid use disorder (MOUD). The objective of this study is to explore the beliefs and attitudes about MOUD among young adults.MethodsWe conducted a single-site qualitative study of 20 young adults ages 18–29 years with a diagnosis of OUD receiving care at an outpatient program and who spoke English. We used a flexible interview guide with the following domains: experience with MOUD, sources and impact of stigma, and interactions with family, healthcare professionals, and social networks. We conducted a thematic analysis based on deductive codes related to the domains and emergent codes from the interviews.ResultsWe identified three themes. First, participants perceived being on MOUD as stigmatizing. They regarded MOUD as lifesaving but ultimately as a “crutch” hindering their full recovery. Second, young adults expressed ambivalence, distinct from stigma, about MOUD. This ambivalence was related to fear of withdrawal symptoms and concerns about their ability to live independent lives, side effects, and unknown treatment duration. Third, participants felt that MOUD was more than just a means to reduce risk of overdose, it was a means to become fully functioning in their lives.DiscussionIn this study of young adults in treatment for OUD, we found that stigma and ambivalence concerning MOUD could explain young adults’ low engagement in care. Interventions addressing concerns about the stigmatizing effects of MOUD and the ambivalence young adults experience related to MOUD could improve engagement and retention of young adults.