Examining the Utility of the Early Childhood Development Index (ECDI) among Children in the Nigeria Context

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families

Exploring Barriers to Inclusion of Widowed and Abandoned Women through Microcredit Self-Help Groups: The Case of Rural South India

Microcredit programs have been applauded as the magic bullet for the poor, especially women with limited financial resources. Building on previous research, this study examines effects of a microcredit self-help group (SHG) program on perceptions of social exclusion among widowed and abandoned women who participated in groups established after the 2004 Indian Ocean Tsunami in Tamil Nadu, India (N=109). Data were collected on key aspects of the program such as loan amount and investment patterns, group experience, demographics, and perceived barriers to inclusion. Results indicate that investment patterns and group experience impacted the women\u27s perception of barriers to social inclusion. In addition, older or abandoned women were more likely to perceive barriers to inclusion. Implications for designing and developing self-help groups to empower women who are challenged by barriers to full participation in activities that are key to functioning are discussed

Ethical and Methodological Challenges of Implementing Social Work Survey Research in Schools: A Perspective from the Suburban United States

Many researchers view schools as the ideal setting to study social and behavioral interventions with youth. As trusted community-based organizations, schools are natural partners for social work researchers who focus on bridging the needs of the most vulnerable populations. Awareness and consideration of critical issues related to conducting research within the school system enables social work researchers to plan and conduct rigorous studies while developing sustainable partnerships with schools. This article outlines key ethical and methodological challenges of conducting school-based survey research, and shares lessons learned and recommendations from the evaluation of a dating violence prevention curriculum implemented in U.S. suburban high schools

Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children

Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child’s EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child’s visit to a mental health specialist (0.28) and child’s age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013–0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing

Investigation of Disparities in Cervical Cancer Prevention in the United States: HPV Vaccination and PAP Screening in 18-30 Year Old Women

Thesis advisor: James LubbenIn 2011, an estimated 12,710 women suffered from cervical cancer and 4,290 died from it in the U.S. HPV vaccination (HPV-V) and PAP screening (PAP-S) could reduce this burden. Using 2010 National Health Interview Survey data, current disparities in the use of PAP-S and HPV-V in U.S. women aged 18-30 years were investigated. An adapted Behavioral Model of Health Care Utilization guided the study. Main outcomes were PAP-S in prior year and ever-HPV-V, both initiation and completion. Adjusted predictor estimates were obtained through multivariate logistic regressions with appropriate statistical procedures and weights for complex survey design. A sub-analysis focused on unvaccinated women. The sample had 3,129 women aged 18-30 years, representing about 27 million women of similar age in the U.S. PAP-S, HPV-V initiation and completion rates were 53.5%, 17.9%, and 10.3%, respectively. Hispanics were 33% less likely than Non-Hispanic-Whites to initiate HPV-V. Non-Hispanic-Blacks were 55% more likely and 57% less likely than Non-Hispanic-Whites to receive PAP-S and complete HPV-V, respectively. Non-Hispanic Asians were 36% less likely than Non-Hispanic-Whites to receive PAP-S, but this result was borderline significant. Younger age and being unmarried were predictors of lower PAP-S but higher HPV-V. Ever gave birth was a predictor of higher PAP-S but lower HPV-V. Preventative behaviors (PAP-S and flu vaccination) were predictors of higher HPV-V. STI-history was a predictor of higher HPV-V and PAP-S. Not having health insurance for over one year or recent health provider visit were predictors of lower PAP-S and HPV-V. Living in the South was a predictor of lower HPV-V. Household income was not a predictor of any outcomes. Most common reported reason for no HPV-V was "no need." Study findings indicate interventions to mitigate disparities in cervical cancer prevention are needed. Tailored education interventions for both women and health care providers along with opportunities associated with the 2010 Affordable Care Act, such as broader access to health care, emphasis on health information technology, and initiatives with PAP screening and adult vaccination as potential quality indicators for performance/payment, can reduce these disparities. Future research should focus on the feasibility of alternative venues for receiving HPV-V and PAP-S.Thesis (PhD) — Boston College, 2013.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work

Interdisciplinary Children’s Behavioral Health Workforce Development for Social Work and Nursing

This paper will begin with a review of child health inequities globally, in the United States and in the State of New York. It will then describe a model training program that was designed to educate social workers and nurse practitioners to create a workforce able to address child behavioral health inequities in the United States (US), specifically New York State. Behavioral health care refers to prevention, care and treatment for mental health and substance abuse conditions as well as physical conditions caused by stress and life crises. This project uses an interdisciplinary training program for nurse practitioner and Master of Social Work students to address workforce shortages in underserved communities in New York State. It will present process evaluation findings to highlight the program’s initial success and will conclude with a discussion of the data that are still needed and the challenges of obtaining this data

Maternal caregiver\u27s typologies and internalized behaviors in African American adolescents living in urban public housing

Aims: This study explores how variations in maternal caregiver types may be associated with adolescents\u27 internalized behaviors (i.e., depressive symptoms) and resources (i.e., attitudes toward delinquent behaviors and efficacious beliefs). Method: Using a sample of 375 African American youth from public housing in three large US cities, we used Latent Profile Analysis to identify various maternal caregiver classes. Multinomial logistic regression analyses were conducted to assess whether youth can be correctly classified into maternal caregiver classes based on their internalized behaviors. Results: Three maternal caregiver classes were identified. Results suggest youth living with high encouragement and high (supervision) maternal caregivers were associated with more conventional attitudes, higher self-efficacy, and lower depressive symptoms. Conclusion: Findings highlight how maternal caregivers can influence the internalizing behaviors of African American youth in US public housing. Individual, community, and system-level interventions can be leveraged to support the impact of these maternal caregivers

Ethical and Methodological Challenges of Implementing Social Work Survey Research in Schools: A Perspective from the Suburban United States

Many researchers view schools as the ideal setting to study social and behavioral interventions with youth. As trusted community-based organizations, schools are natural partners for social work researchers who focus on bridging the needs of the most vulnerable populations. Awareness and consideration of critical issues related to conducting research within the school system enables social work researchers to plan and conduct rigorous studies while developing sustainable partnerships with schools. This article outlines key ethical and methodological challenges of conducting school-based survey research, and shares lessons learned and recommendations from the evaluation of a dating violence prevention curriculum implemented in U.S. suburban high schools

Individual, familial, and sociocontextual correlates of maternal caregiving among African American adolescents in public housing

Objective: African American adolescents (N = 372), recruited from public housing in three large U.S. cities, participated in this study that explores individual, familial, and sociocontextual correlates of maternal caregiving profiles, based on supervision and encouragement. Background: Maternal caregivers play an important role in ensuring the safety and welfare of adolescents as they encounter multiple challenges in their social environment. Public housing magnifies the risk of experiencing such challenges for African American adolescents. Evidence on the experiences of African American adolescents living in public housing is scarce. Our study contributes to this body of knowledge by exploring profiles of maternal caregivers, based on supervision and encouragement, their association with demographics, and familial and sociocontextual challenges among adolescents in public housing. Method: Using multinomial logistic regression, we explore the associations between profiles of maternal caregiving, based on supervision and encouragement and adolescent characteristics, adolescents\u27 experiences, and assessment of their family (e.g., quality of parent–child relationship, family conflict) and sociocontextual (e.g., peer influence, victimization, witnessing of community violence). Results: Adolescents living in households with high levels of maternal encouragement and supervision reported a high-quality relationship with their caregivers and less witnessing of community violence. These adolescents were also less likely to report victimization. Conclusions: The study identified parenting strategies that could potentially reduce risks of adverse exposures among urban African American youth in public housing. Practitioners and policymakers must consider programs to bolster these strategies and further serve urban African American adolescents in challenging environments