Use of online health information to manage children’s health care: a prospective study investigating parental decisions

Background

The use of the internet to access information is rapidly increasing; however, the quality of health information provided on various online sites is questionable. We aimed to examine the underlying factors that guide parents’ decisions to use online information to manage their child’s health care, a behaviour which has not yet been explored systematically.

Methods

Parents (N?=?391) completed a questionnaire assessing the standard theory of planned behaviour (TPB) measures of attitude, subjective norm, perceived behavioural control (PBC), and intention as well as the underlying TPB belief-based items (i.e., behavioural, normative, and control beliefs) in addition to a measure of perceived risk and demographic variables. Two months later, consenting parents completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their use of online information to manage their child’s health care during the previous 2 months.

Results

We found support for the TPB constructs of attitude, subjective norm, and PBC as well as the additional construct of perceived risk in predicting parents’ intentions to use online information to manage their child’s health care, with further support found for intentions, but not PBC, in predicting parents’ behaviour. The results of the TPB belief-based analyses also revealed important information about the critical beliefs that guide parents’ decisions to engage in this child health management behaviour.

Conclusions

This theory-based investigation to understand parents’ motivations and online information-seeking behaviour is key to developing recommendations and policies to guide more appropriate help-seeking actions among parents.

     

Antenatal psychosocial risk status and Australian women’s use of primary care and specialist mental health services in the year after birth: a prospective study

Background

Poor mental health in the perinatal period can impact negatively on women, their infants and families. Australian State and Territory governments are investing in routine psychosocial assessment and depression screening with referral to services and support, however, little is known about how well these services are used.The aim of this paper is to report on the health services used by women for their physical and mental health needs from pregnancy to 12 months after birth and to compare service use for women who have been identified in pregnancy as having moderate-high psychosocial risk with those with low psychosocial risk.

Methods

One hundred and six women were recruited to a prospective longitudinal study with five points of data collection (2–4 weeks after prenatal booking, 36 weeks gestation, 6 weeks postpartum, 6 months postpartum and 12 months postpartum) was undertaken. Data were collected via face-to-face and telephone interviews, relating to psychosocial risk factors, mental health and service use. The prenatal psychosocial risk status of women (data available for 83 of 106 women) was determined using the Antenatal Risk Questionnaire (ANRQ) and was used to compare socio-demographic characteristics and service use of women with ‘low’ and ‘moderate to high’ risk of perinatal mental health problems.

Results

The findings indicate high use of postnatal universal health services (child and family health nurses, general practitioners) by both groups of women, with limited use of specialist mental health services by women identified with moderate to high risk of mental health problems. While almost all respondents indicated that they would seek help for mental health concerns most had a preference to seek help from partners and family before accessing health professionals.

Conclusion

These preliminary data support local and international studies that highlight the poor uptake of specialist services for mental health problems in postnatal women, where this may be required. Further research comparing larger samples of women (with low and psychosocial high risk) are needed to explore the extent of any differences and the reasons why women do not access these specialist services.

     

Global governance and the broader determinants of health: A comparative case study of UNDP’s and WTO’s engagement with global health

This comparative case study investigated how two intergovernmental organisations without formal health mandates – the United Nations Development Programme (UNDP) and the World Trade Organization (WTO) – have engaged with global health issues. Triangulating insights from key institutional documents, ten semi-structured interviews with senior officials, and scholarly books tracing the history of both organisations, the study identified an evolving and broadened engagement with global health issues in UNDP and WTO. Within WTO, the dominant view was that enhancing international trade is instrumental to improving global health, although the need to resolve tensions between public health objectives and WTO agreements was recognised. For UNDP, interviewees reported that the agency gained prominence in global health for its response to HIV/AIDS in the 1990s and early 2000s. Learning from that experience, the agency has evolved and expanded its role in two respects: it has increasingly facilitated processes to provide global normative direction for global health issues such as HIV/AIDS and access to medicines, and it has expanded its focus beyond HIV/AIDS. Overall, the study findings suggest the need for seeking greater integration among international institutions, closing key global institutional gaps, and establishing a shared global institutional space for promoting action on the broader determinants of health.     

Contrasting children and women’s health and the determinants of health in a small-sized city

Contrasts that exist in urban infrastructure and accessibility of public health and social services between suburban and urban districts of mega-cities have been well defined. There has been less research in small-sized cities (population under 500,000). This cross-sectional study was done on 1,728 ever-married reproductive-aged women living in Manisa, Turkey, in the year 2000. The probability proportion to size cluster sampling approach was used in the sample selection. Data were collected for women and 7,016 inhabitants of the interviewed households. The data were collected from the women by face to face interviews. Suburban areas (illegally occupied public land called “Gecekondu” dwellings) in Manisa differ from other urban regions (legal settlements of the city) on socioeconomic factors including household occupancy, adult literacy, social class, rates of religious marriages, unemployment, health insurance coverage, migration, cultural segregation, and social status of women. Some traditional practices were also highly prevalent in gecekondu families, where poverty is more common. Although gross fertility rate (GFR), total fertility rate (TFR), and percent decrease of the TFR were higher for gecekondu women than urban women, total wanted fertility rate (TWFR) was lower. In urban neighborhoods, prevalence of contraceptive use was higher, and the infant and child mortality rates were lower; however, when rates were adjusted for mother’s age, education and number of births, the differences turned out to be nonsignificant. Women living in urban areas receive better antenatal care, child immunization services, and professional health delivery assistance and services in a health facility; these services are very scarce in gecekondu districts. Health status of gecekondu populations can be improved by social and economic support and by making health services more available and accessible, especially maternity and child health services.     

Organizational justice at school and its associations with pupils’ psychosocial school environment,health, and wellbeing

It has been shown that the psychosocial environment perceived by school staff is associated with children’s academic performance and wellbeing. In this study we examined the associations between organizational justice (procedural and relational justice) as reported by school staff and pupils’ perceptions of their school environment, health problems, academic performance, and absenteeism. We combined data from two surveys: for the staff (the Finnish Public Sector Study, n = 1946) and pupils (the Finnish school health promotion survey, n = 11,781 boys and 12,842 girls) of 136 secondary schools, collected during 2004–2005. Multilevel cumulative logistic regression analyses showed that after adjustment for potential individual and school-level confounding factors, low procedural justice was associated with pupils’ dissatisfaction with school-going. Low relational justice was associated with a 1.30 times higher risk of poor academic performance, 1.15 times higher risk of psychosomatic symptoms and 1.13 times higher risk of depressive symptoms among pupils. Both organizational justice components were associated with truancy. We concluded that staff perceptions of organizational justice at school are associated with pupils’ reports of their psychosocial school environment, health, performance, and absenteeism due to truancy. Improving managerial and decision making procedures among school personnel may be an important factor for protecting pupils’ academic performance and wellbeing.     

Accessing vulnerable children’s lived experiences through visual stimuli illustrations (VSI)

One challenge that is often encountered when researching with children is finding effective research tools targeting younger children in sub-Saharan Africa. Consequently, many childhood experiences for those in adversity are less reported due to limitations in research tools to capture their lived experiences. This article explores the choice, design and use of visual stimulus illustrations (VSI) as a research tool to access lived experiences of orphans and vulnerable children (OVC) who enrol into early childhood development and education centres within low-resourced areas in Nairobi – Kenya. This paper views VSI with a range of participatory engagements to meaningfully benefit the younger OVC directly as a medium through which they can access, engage, interrogate, identify and ventilate their lived experiences, thus providing insights into the less researched domains of their childhood experiences.     

Diverging perspectives on children’s rehabilitation services: a mixed-methods study

Background: Family-centred ideology is increasingly regarded as a conceptual foundation in services to children with disabilities.

Objective: First, to examine the extent to which parents and therapists perceive the service as family-centred; second, to explore factors affecting parents’ perceptions of the service; and third, to explore how parents understood service aspects typically characterising family-centred services (FCS), such as the goal-setting process.

Material and methods: Parents of 236 children and 25 therapists completed questionnaires (MPOC-32; MPOC-SP). Five parents shared their experiences in an open interview.

Results: On average parents and professionals consider the service to be family-centred from a ‘fairly great’ extent (Respectful and Supportive Care/Treating People Respectfully) to a ‘small’ extent (Providing General Information). Parents’ experiences were influenced by their child’s age, functional performance, and type of disability. Analysis of interview data revealed three categories: Experiencing trust and respect, Collaborating or just following instructions?, and Balancing therapy with daily activities.

Conclusion: Parents praise interpersonal relations but lack of information limits their possibilities to make informed choices about services. In order to translate better into the daily life of the family the intervention should focus more on their activities, routines and participation within the communities they live in.     

Young children’s perceptions of health warning labels on cigarette packages: a study in six countries

Aim

Health warning labels on cigarette packages are one way to reach youth thinking about initiating tobacco use. The purpose of this study was to examine awareness and understanding of current health warning labels among 5 and 6 year old children.

Subjects and methods

Researchers conducted one-on-one interviews with urban and rural 5 and 6 year olds from Brazil, China, India, Nigeria, Pakistan, and Russia.

Results

Among the 2,423 participating children, 62 % were unaware of the health warnings currently featured on cigarette packages, with the lowest levels of awareness in India and the highest levels in Brazil. When shown the messages, the same percentage of participating children (62 %) showed no level of message understanding.

Conclusion

While youth are receiving social and informational messages promoting tobacco use, health warning labels featured on cigarette packages are not effectively reaching young children with anti-smoking messages.     

Measuring outcomes in Parkinson’s disease: a multi-perspective concept mapping study

Purpose  

To identify and develop a conceptual map of prioritized areas and to determine their relative importance for outcome measurement in clinical Parkinson’s disease (PD) trials, from the perspectives of health care professionals and people with PD.     

Parents’ reminiscing training in typically developing and ‘at-risk’ children: a review

Reminiscing is a conversation between a child and caregiver about past events they have experienced together. In recent years, researchers have been interested in implementing training to improve the quality of parents’ reminiscing styles, both in typically developing and ‘at-risk’ children and disadvantaged families. The review analysed studies on reminiscing training in order to provide support for their effectiveness, to identify gaps in the literature and to propose directions for future research. The review showed the effectiveness of reminiscing training for parents but highlighted the paucity of these studies, their focus on the mothers and the variability of the length of the training. Finally, the review emphasized the potential areas of reminiscing training in clinical and educational settings.     

Sports and martial arts activities for public health purposes: the musician’s risk profiles and exercise-based health care as a model

Purpose

The common saying that sports promote good health is in line with main results of sports medicine, but conflicting with the high amount of sports injuries and sports-related diseases. This paper contributes to the discussion of the pros and cons of sports, particularly of the martial arts. It intends to shed light on the benefits of sports in the general public and to explore the enormous and yet unexploited potential of individually tailored sport activities for public health.

Methods

Comparative analyses and meta-synthesis of empirical studies on the health benefits of sports. Musicians with very heterogeneous work-related risk profiles serve as a model for inductive generalisation.

Results

For health promotion and to avoid adverse outcomes, sport activities must take one’s physical status and risk profiles into account and refer to well-adjusted training zones. This encompasses musculoskeletal and biomotor factors, behavioural means to rebalance the nervous system, cardiorespiratory fitness, mental health and psychological benefits, and active pain management and pain relief.

Conclusion

Sports organisations provide a wide spectrum of facilities for sports-oriented lifestyles; however, informal experience and relevant publications let us assume that they rather do not explore how to optimise preventative and health-related benefits, except for training with personal coaches. And yet, relatively simple screening methods and individually adjusted intensities, modes, and frequencies of trainings can enhance benefits and greatly contribute to public health, which would, however, require a stronger health awareness of providers and specific education of sports coaches.

     

Landscape and children’s health: Old natures and new challenges for the preventorium

Preventoria were established in the early part of the twentieth century at fresh air sites away from cities for the purposes of rest cures for children, usually for those who were at risk of contracting tuberculosis. This paper discusses preventoria in relation to their general landscapes, and outlines the types of landscapes in which preventoria are found, namely woods and forests, ocean, rivers and lakes, and agricultural settings. The preventorium movement is placed in historical landscape context, with urban planning, national parks, and other nineteenth century trends. Fresh air was the driving force of both treatment and locations of preventoria and sanatoria. Current movements in child health to combat obesity and ‘nature-deficit-disorder’ also call for greater engagement with fresh air, and stress the therapeutic value of natural landscape.Australia’s oldest preventorium is examined as a case study of preventoria and the challenges which old preventoria are facing today to re-invent themselves in predominantly rural landscapes.     

When daddy comes to school: father–school involvement and children’s academic and social–emotional skills

The present study used a large sample of mostly non-resident fathers (74%) to determine whether father–school involvement (e.g. attending parent–teacher conferences) predicted better academic and social emotional skills after controlling for the influence of mother–school involvement, the quality of children’s home learning environment, and demographics. A total of 3570 children participated in the study (47% European American, 35% African-American, and 18% Hispanic). Although mothers in this study engaged in more frequent involvement in their children’s schools, father–school involvement was positively associated with children’s reading, math, and teacher-rated approaches to learning scores in elementary school. Furthermore, father–school involvement predicted better reading and math scores after controlling for the influence of mother–school involvement, the quality of children’s home learning environment, and demographics.     

HIV-negative children’s experiences and opinions towards parental HIV disclosure: a qualitative study in China

In HIV/AIDS research, few studies to date have evaluated ways to improve parental HIV disclosure practices using feedback from HIV-negative children who have recently experienced this event. We conducted semi-structured in-depth interviews with 20 children (aged 6–15) who were partially to fully aware of their parents’ HIV status in rural Guangxi, China. Of the 20 children, eight children who were of older age (11.38 years in average) endorsed parental HIV disclosure, five discouraged it and seven expressed uncertainty. Children’s different experiences and attitudes towards disclosure were seen to be associated with their family dynamics (especially the parent–child relationship), social support and care, experiences of stigma and discrimination, psychosocial suffering, comprehension of the disease and the children’s age. Our study contributes to building a child-centered comprehensive understanding for Chinese parental HIV disclosure. It is imperative that counselors and community advocates assess and help parents achieve optimal readiness preceding disclosure of their illness to their HIV-negative children.     

Football pitches and Barbie dolls: young children’s perceptions of their school playground

Playgrounds and play times offer valuable contexts for children to explore and learn about themselves and their social lives. This study sought to gather evidence of children’s perceptions of their playgrounds and play times, specifically whether the playgrounds were seen positively or negatively and the types of activities in which they engaged. Child-oriented methods were adopted inspired by the Mosaic approach. The main themes from the focus group interviews were social play (friendship, loneliness/solitude and fair play); physical activity play (activities and rationale); risk (injuries and bullying); and gender (action/stillness and gendered roles). Research suggests that segregation declines when adult supervision supports shared play, and our experiences suggest that such intervention is the most likely solution to the ‘problem’ of gender play in this setting.     

Improving on‐time performance in health care organizations: a case study

In this paper, we propose a strategy to build a measurement system that helps improve ontime performance in health care organizations. We analyze the measurement system for monitoring the performance of daily start times of first surgeries in a U.S. hospital. Although surgeons appear to be the main cause of delay, efforts to improve their ontime performance alone are not sufficient to improve ontime performance for first surgeries. Therefore, working on the main source of delay to improve performance, as the Pareto principle suggests, does not always work in the health care context. Rather, we found that ameliorating the hospital's overall ontime performance achieves the desired result of improving surgeons' performance through a snowball effect (a selfreinforcing effect) and, consequently, the ontime performance for first surgeries also improves.