Scaling Impact in the Health Sector

This essay examines possible routes to achieving significant health improvements in the underserved populations of developing countries. It argues that unconventional strategies, largely outside the health sector as conventionally defined, have the greatest potential to scale sustainably. The essay describes two such strategies—nutrition and safe drinking water. In particular, the essay argues that impact investors focused on social enterprises can best maximize their health impact by looking closely at the strategies described herein

Prenatal Care Choices in Appalachia: A Qualitative, Critical Realist Description & Content Analysis

Introduction: Appalachian women have high rates of preterm birth and low birth weight infants. A new format of group prenatal care, known as CenteringPregnancy, decreases the rate of preterm birth and low birth weight when compared with individual care. However, clinics in Appalachia often struggle to recruit women into group care. Theory & Methods: Using critical realism and the middle-range theory of motivation-ease as frameworks, this qualitative study had two research questions: ‘What influences Appalachian women’s choice of traditional prenatal care instead of CenteringPregnancy care?’ and ‘What are Appalachian women’s perceptions of prenatal care and their access to prenatal care?’. Twenty-nine Appalachian women, who had declined CenteringPregnancy care, were interviewed about their perceptions of prenatal care, what facilitated care, and their decision to decline CenteringPregnancy. Verbatim transcripts of these semi-structured interviews, in-depth demographic questionnaires, and field notes were coded and analyzed using conventional (inductive) content analysis. Findings: Two meaning units were identified, information concerning women’s reason(s) for declining CenteringPregnancy and facilitators of prenatal care access. The reasons women provided for declining CenteringPregnancy care fell into three overarching categories, preferred one-to-one care, experienced barriers to Centering, and did not know Centering was an option. The most common reason for declining Centering was a preference for individual care. This category had three subcategories: do not like groups, don’t want to put everything out there with other women, and no need for change from existing care. Women predominately named two facilitators of prenatal care access, insurance and compassionate care. Conclusions: Clinicians should decrease barriers to CenteringPregnancy utilization and should partner with the local community to better market this new model of care. In addition, small modifications in Centering may make the model more appealing and accessible. However, clinicians should continue to provide individual care for women who cannot access group care. Participants stated state-provided insurance greatly facilitated prenatal care which supports the need for ongoing Medicaid funding. Women also stated compassionate care enhanced their ability and desire to get prenatal care. Healthcare providers should renew efforts to provide personalized and unrushed clinical environments to assist women in obtaining needed prenatal care

Emotional Competence, Family Social Support and Parental Stress in Mothers of Children with Autism during the Pandemic

This study was aimed to determine the relationship between emotional competence, family social support and parental stress in mothers of children with autism spectrum disorder (ASD). This research was a quantitative research with correlational method. Purposive sampling technique by distributing questionnaires using Google form resulted in a total of 165 participants who are mothers of children with ASD, as members of therapy centers and schools for children with special needs in Semarang, Solo and Yogyakarta. The data were analyzed using structural equation model (SEM) technique on Lisrel program. This research resulted in two models showing that there are fit model with empirical data. The first model shows that each of emotional competence and family social support had a significant effect on parental stress in mothers of children with ASD. The second model shows the influence of emotional competence on the stress of parenting of children with ASD, with family social support as a moderating variable. The implications of this study are empirical evidence on the importance of family social support and emotional competence for mothers in raising children with ASD to prevent excessive parental stress

Baystate Medical Practices Annual Report - 2018

https://scholarlycommons.libraryinfo.bhs.org/bmpannual_report/1003/thumbnail.jp

Increasing the Awareness of Black Women to Promote Medical Research Engagement

Medical research in the United States has drastically improved over the past forty years with the implementation of policies and procedures through government regulation and significant technological advancements. Despite these measures, there are still low participation rates among minority groups, especially Black women, who have proven to suffer the most drastic effects from underrepresentation in medical research. Despite their willingness to participate in medical research, a leading barrier to participation is the need for more knowledge and awareness about how to engage in medical research. This research is a field experiment conducted at a Black Women’s Health Symposium in urban Atlanta to explore the research question, Does awareness improve Black Women’s intent to engage in medical research?” During the symposium, a workshop focusing on the importance of participating in medical research was conducted to increase the knowledge and awareness of Black women. The intent is to encourage engagement and reduce health disparities to improve health equity for Black women

Community-Engaged Development of a Parent-Child Book Reading Wise Intervention

Children living in communities with high rates of poverty experience significant detriment to their academic skills and social, emotional, and behavioral health. Though a range of evidence-based interventions exist that aim to reduce these disparities, they face substantial barriers (e.g., related to financial and human resources, opportunity cost to target families, variable fit across the diverse populations in low-income households). In contrast, wise interventions use psychologically precise pathways to produce small, recursive changes that result in significant benefits. As such, they represent a resource efficient strategy with the potential for considerable impact with contextual adaptation. The current study utilized social marketing research strategies in the context of an academic-community partnership to design, iteratively refine, and examine an emotion-enhanced children’s book – or picture book infused with opportunities to label and explain character emotions – as a wise intervention based in parent-child book reading, an especially warm and nurturing form of parent-child interaction. We employed the Social Marketing Assessment and Response Tool (SMART Model) to guide intervention development and evaluation. In SMART Phases 2-4 (Formative Research), end-users (n=14) completed surveys on basic demographic information, mental health, current beliefs about joint book reading and ongoing practices, and perspectives and response styles to children’s emotions. We then engaged participants in focus groups and interviews to obtain insights regarding the perceived need and preferred characteristics of the proposed intervention. Feedback informed the design of prototype components (i.e., book characters and storylines) that we presented to both new and returning end-users (n=10) for feedback in SMART Phase 5 (Development) pre-testing. Stakeholders (i.e., end-users) again completed surveys on basic demographic information, mental health, current beliefs about joint book reading and ongoing practices, and perspectives and response styles to children’s emotions, and participated in interviews to provide additional feedback. Results from Phase 5 pre-testing informed iterative refinement, and a completed intervention was evaluated by a broad audience via an online survey (n=31) to examine acceptability, usability, and perceived effectiveness

Hearing the Voices of Four African American Grandmothers Raising Their Academically Successful Grandchildren

The purpose of this qualitative study is to examine and interpret the lived experiences and parenting practices of four African American grandmothers raising grandchildren in one urban school district. A disproportionate number of custodial grandmothers raising grandchildren are African American. There is a void where the voices of African American grandmothers raising academically successful grandchildren are limited. Specifically, regarding their personal attributes, acts of grandmothering, and their perceptions about grandmothering to support academic achievement. Although each grandmother faced obstacles and made sacrifices, findings from this study reveals that African American grandmothers believe they can raise academically successful grandchildren to become productive members of society despite the negative life events precipitating their new living arrangements. Participants acknowledged a strong parental and spiritual influence in their own lives played a major roles in how they parented their grandchildren. The grandmothers expressed the importance of limiting or eliminating the interactions their grandchildren had with their absent parent while they carried out their role of parent. The thoughts, voices, expressions, and actions conveyed by the grandmothers provide a clear commitment to the needs of their grandchildren over all else. This research recommends further study regarding African American grandmothers raising academically successful grandchildren to provide insight to educators, policy makers, and other grandmothers raising grandchildren

Designing prenatal m-Health interventions through transmigrants reflection on their pregnancy ecology

This dissertation presents the findings from three participatory focus group and co-design sessions with Caribbean transmigrant women in the United States. Informed by their focus group discussions regarding their pregnancy experiences in the United States, the participants produced design ideas that reflected on physical, emotional, informational and social gap themes. The purpose of this study was to understand the challenges affecting the women’s prenatal wellbeing practices, and to conceive a set of recommendations and opportunities for mHealth technology design to assist with prenatal preventative care and management. The study uses the theoretical concept of pregnancy ecology to identify gaps in prenatal health management, and understand participants’ reflection on these gaps through design. Then, the study identifies opportunities for mHealth and HCI research to consider designing tailored interventions to the realities of the expecting immigrant mother, including the role of transnational social support, and embracing the role of entertainment in mental health during pregnancy