The Photo Essay: A Visual Research Method for Educating Obstetricians and Other Health Care Professionals

When it comes to issues related to low-income women seeking early, adequate, or continuous prenatal ca re, the public health and medical communities continue to tell women to take responsibility for their actions. Rarely are messages aimed at providers. To help physicians see how factors in their offices and clinics can affect service utilization, the photo essay, a visual qualitative research strategy was developed using low- income minority and disenfranchised women who had recently given birth or were near to giving birth. Eight photo essays were completed. Together, the narratives, in collaboration with the photos, provided an opportunity for physicians to hear and observe women, as consumers, as they expanded their descriptions of their prenatal care experience

Promoting Pre-conceptional use of folic acid to Hispanic women: A social marketing approach

Objective: To develop a culturally appropriate communication initiative in an effort to promote the use of pre-conceptional folic acid among Hispanic women of childbearing age. The materials were designed to communicate information about the risks of neural tube defects and the value of folic acid supplementation before conception. Methods: The initiative was developed using a social marketing approach. A series of focus groups were conducted with Hispanic women, particularly Mexican and Mexican-American women, to gain an understanding of their knowledge, attitudes, and behaviors regarding birth defects and folic acid. Additionally focus groups assessed women's preferences for existing folic acid education materials. Qualitative analysis of coded transcripts revealed key themes which were incorporated into a multi-media initiative. Results: Critical themes of the research highlighted the need to include the role of partners and a sense of family in the promotions aimed at these groups. Another key component was the need to dispel myths which act as barriers to preconceptional folic acid use. Other important elements included in the media products were the need for Spanish and English versions, an explanation of neural tube defects, and a reference to the cost of the supplements. Conclusion: The final products of the initiative included Spanish and English versions of a brochure, photo-novella, and radio public service announcement. Pre-testing results showed women understood the message, thought the message was for women like them, and expected to begin taking a folic acid supplement. Results of the overall evaluation of the initiative are on-going

Schools as Moderators of Neighborhood Influences on Adolescent Academic Achievement and Risk of Obesity: A Cross-Classified Multilevel Investigation

Grounded in Bronfenbrenner\u27s (1979) Ecological Systems Theory and through the application of cross-classified random effects models, the goal of this study was to examine simultaneously neighborhood and school influences on adolescent academic achievement and risk of obesity, as well as the moderating effects of schools on these outcomes. By examining concurrently neighborhood and school influences on achievement and risk of obesity, this study aimed to fill gaps in the social determinants literature. For example, it is unclear if where an adolescent lives or where she/he attends school has a stronger influence on academic achievement. We also do not know if schools can moderate neighborhood influences on adolescent achievement, nor do we know much about the relationships among schools, neighborhoods, and adolescent risk for obesity. Using data from the National Longitudinal Study of Adolescent Health and the Adolescent Health and Academic Achievement study, four research questions were investigated: (1) To what extent are neighborhood influences on U.S. middle and high school students\u27 academic achievement moderated by school environments? (2) What are the relative influences of neighborhood and school environments on U.S. middle and high school students\u27 academic achievement? (3) To what extent are neighborhood influences on U.S. middle and high school students\u27 risk of obesity moderated by school environments? (4) What are the relative influences of neighborhood and school environments on U.S. middle and high school students\u27 risk of obesity? Findings did not suggest a moderating relationship between neighborhood and school factors examined in this study. In terms of relative relationships with academic achievement, three neighborhood factors (affluence, racial composition, and urbanicity) and two school characteristics (student body racial composition and school socioeconomic status) appeared to have the strongest relationships with adolescent achievement after controlling for individual and other neighborhood and school characteristics. For adolescent risk of obesity, neighborhood affluence and racial composition had statistically significant unique associations, whereas no school factors evidenced statistically significantly relationships with risk of obesity after controlling for other factors. Results of the study were interpreted in terms of contributions to the social determinants literature, as well as recommendations for the improvement of future large-scale surveys

Patient-physician communication barriers regarding fertility preservation among newly diagnosed cancer patients

With cancer survival rates increasing, new directions have focused on issues of survivorship, with an intense focus on quality of life. One area gaining increased attention is fertility preservation and future parenthood among cancer survivors. Although medical options for fertility preservation exist, most are not well understood by physicians, patients and family members, and are not readily accessible to patients and their health care providers. This paper discusses the current difficulties in communicating information about fertility preservation in the United States. Physician level of knowledge about fertility preservation, attitudes and comfort level with the topics, patient preferences, and financial and practice barriers may serve as obstacles in the communication process. Social, interaction and behavioral research studies are well poised to address the communication barriers and provide possible solutions to problems in understanding fertility preservation, for patients, family members and health care providers alike.Fertility preservation Physician communication Behavioral research Cancer survivorship Health communication