Help-seeking behaviour for internalizing problems

Objective Although adolescent girls from ethnic minorities are at an increased risk of internalizing problems (e.g. depression), only a small fraction seeks formal help for these problems. To enhance help-seeking for internalizing problems among ethnic minority adolescent girls, insight into their help-seeking behaviour is required. This study explored the perceptions of adolescent girls from different ethnic backgrounds regarding their help-seeking behaviour for internalizing problems. Design A qualitative study using focus group discussions (FGDs) was employed. Eight ethnic-specific FGDs were conducted with 50 adolescent girls of mostly Turkish (n=23), Moroccan (n=13), and Dutch (n=10) backgrounds recruited in Rotterdam, a multicultural city in the Netherlands. FGDs were conceptually framed within a help-seeking model, facilitated by a vignette and analysed using NVivo software. Results When describing the internalizing problems presented in the vignette, participants of non-Dutch FGDs tended to state the causes of the problems (e.g. lack of attention) whereas participants of Dutch FGDs mentioned the emotional state. Participants did not perceive the presented internalizing problems as severe. If participants were to face internalizing problems of their own, their decision to seek help would be hampered by negative attitudes towards professionals and school-based services. Particularly in non-Dutch FGDs the fear of parental and friend's reactions was identified as a barrier. Participants identified their mother and a good friend as primary sources of help.ConclusionIn this study, adolescent girls of Turkish, Moroccan and Dutch backgrounds had difficulty recognizing the severity of internalizing problems, and various barriers could hamper their decision to seek help. To enhance utilization of mental health services by youth, promoting a change in their attitudes towards mental health/school-based services is recommended. Guaranteeing confidentiality within school-based services, and training for professionals in communicating with adolescent girls, may also prove beneficial. In ethnic minorities, tackling the negative reactions of family/friends requires attention

The role of maternal perceptions and ethnic background in the mental health help-seeking pathway of adolescent girls

Mothers play a crucial role in the help-seeking pathway of adolescents. This study examined how mothers with different ethnic backgrounds perceive the issue of help-seeking for internalizing problems (e.g. depression) in adolescent girls. Seven focus group discussions were conducted with 41 Dutch, Moroccan and Turkish mothers with a teenage daughter. Discussions were conceptually framed within a model of help-seeking and facilitated by a vignette. The internalizing problems sketched in the vignette were recognized as severe nonetheless; identified long term consequences varied per ethnic group. Negative attitudes towards General Practitioners, inaccessible mental health services and denial by daughters would hamper help-seeking. Fear of negative judgments/gossiping was considered a barrier by Turkish and Moroccan participants. Participants identified themselves and schools as primary sources of help. Turkish participants also named chaplains. To enhance utilization of mental health services by (minority) youth it is important to also address maternal barriers

First-Time Parents Are Not Well Enough Prepared for the Safety of Their Infant

Background: Unintentional falls and poisonings are major causes of death and disability among infants. Although guidelines are available to prevent these injuries, safety behaviours are not performed by parents, causing unnecessary risks. Little is known about safety behaviours of first-time parents and whether they behave according to these guidelines. Aims/Objectives/Purpose: The objective of this study was to compare safety behaviours of first-time parents with those of non-first-time parents and to determine correlates of unsafe behaviour of parents of infants. We used self-report questionnaires to assess safety behaviours in a cross-sectional study sample. Methods: A total of 1439 parents visiting a preventive youth healthcare centre in the Netherlands were invited to complete a questionnaire with regard to the prevention of falls and poisonings. Parents were categorized into first-time parents and non-first-time parents. Correlates of parents' child safety behaviours were determined using multiple logistic regression analyses. Results/Outcome: Most respondents were mothers (93.2%); 48.2% of families were first-time parents. The mean age of the infants was 7.2 months (SD 1.1; range 4-12), 51.8% were boys, and 34.5% of infants could crawl. First-time parents were more likely not to have a stair gate installed (OR 16.46; 95% CI 12.36-21.93); were more likely to store cleaning products unsafely (OR 4.55; 95% CI 3.59-5.76); and were more likely to store medicines unsafely (OR 2.90; 95% CI 2.31-3.63) than non-first-time parents. First-time parents were more likely to not have a window guard installed (OR 1.52; 95% CI 1.08-2.15) (all P<0.05). Discussion/Conclusion: First-time parents are not well prepared for the safety of their infant, causing unnecessary risks. The various parents' safety behaviours were influenced by different variables, for example, age of the infant, crawling of the infant, mother's educational level, mother's ethnicity, self-efficacy, vulnerability, severity

Effectiveness of web-based tailored advice on parents' child safety behaviors: Randomized controlled trial

Background: Injuries at home are a major cause of death, disability, and loss of quality of life among young children. Despite current safety education, required safety behavior of parents is often lacking. To prevent various childhood disorders, the application of Web-based tools has increased the effectiveness of health promotion efforts. Therefore, an intervention with Web-based, tailored, safety advice combined with personal counseling (E-Health4Uth home safety) was developed and applied. Objective: To evaluate the effect of E-Health4Uth home safety on parents’ safety behaviors with regard to the prevention of falls, poisoning, drowning, and burns. Methods: A randomized controlled trial was conducted (2009-2011) among parents visiting well-baby clinics in the Netherlands. Parents were randomly assigned to the intervention group (E-Health4Uth home safety intervention) or to the control condition consisting of usual care. Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit (age approximately 11 months). Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit. Parents’ child safety behaviors were derived from self-report questionnaires at baseline (age 7 months) and at follow-up (age 17 months). Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated. Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up. Results: A total of 1292 parents (response rate 44.79%) were analyzed. At follow-up, parents in the intervention condition (n=643) showed significantly less unsafe behavior compared to parents in the control condition (n=649): top of staircase (23.91% vs 32.19%; OR 0.65, 95% CI 0.50-0.85); bottom of staircase (63.53% vs 71.94%; OR 0.69, 95% CI 0.53-0.88); top and bottom of staircase (68.94% vs 78.28%; OR 0.62, 95% CI 0.48-0.81); storage of cleaning products (30.33% vs 39.91%; OR 0.67, 95% CI 0.53-0.85); bathing of the child (23.46% vs 32.25%; OR 0.65, 95% CI 0.51-0.84); drinking hot fluids (34.84% vs 41.73%; OR 0.76, 95% CI 0.61-0.96); using rear hotplates (79.34% vs 85.27%; OR 0.67, 95% CI 0.50-0.90); and the total risk score in which a higher score indicates more unsafe behavior (mean 13.63, SD 6.12 vs mean 15.34, SD 6.07; beta –1.59, 95% CI –2.26 to –0.93). There were no significant differences for other specific behaviors between the two study conditions. Conclusions: Compared to generic written materials, the E-Health

Health-related quality of life of infants from ethnic minority groups: The Generation R Study

Purpose: To assess whether the health-related quality of life of infants from ethnic minority groups differs from the health-related quality of life of native Dutch infants and to evaluate whether infant health and family cha

Home-related Injury Prevention and Safety Promotion in the Setting of Preventive Youth Health Care

This thesis presents studies on the primary prevention of home-related injuries among preschool children. In this introductory chapter a model for planned health promotion of population health is introduced, which is used to describe the relevance of the prevention of home-related injuries among preschool children and the methods used for the conducted studies

Correlates of unsupervised bathing of infants: A cross-sectional study

Drowning represents the third leading cause of fatal unintentional injury in infants (0-1 years). The aim of this study is to investigate correlates of unsupervised bathing. This cross-sectional study included 1,410 parents with an infant. Parents completed a questionnaire regarding supervision during bathing, socio-demographic factors, and Protection Motivation Theory-constructs. To determine correlates of parents who leave their infant unsupervised, logistic regression analyses were performed. Of the parents, 6.2% left their child unsupervised in the bathtub. Parents with older children (OR 1.24; 95%CI 1.00-1.54) were more likely to leave their child unsupervised in the bathtub. First-time parents (OR 0.59; 95%CI 0.36-0.97) and non-Western migrant fathers (OR 0.18; 95%CI 0.05-0.63) were less likely to leave their child unsupervised in the bathtub. Furthermore, parents who perceived higher self-efficacy (OR 0.57; 95%CI 0.47-0.69), higher response efficacy (OR 0.34; 95%CI 0.24-0.48), and higher severity (OR 0.74; 95%CI 0.58-0.93) were less likely to leave their child unsupervised. Since young children are at great risk of drowning if supervision is absent, effective strategies for drowning prevention should be developed and evaluated. In the meantime, health care professionals should inform parents with regard to the importance of supervision during bathing