Access to Prenatal Care and County Size: Implications for Service Delivery

The impact of population size across twenty-three west Michigan counties was examined to determine access to prenatal care, low birth weight, and infant mortality. Surveys were completed by forty-five managers of hospitals and county health departments. Service availability, sociodemographic, system-related and lifestyle factors were examined as contributors to perinatal support utilization. Low birth weight and infant mortality were highest in the small- and large-sized counties. Positive birth outcomes in medium-sized counties may have been due to greater availability of infant and child health services through health departments, and the targeting of resources to specific problem areas, such as smoking cessation. The need for a comprehensive maternity system, which views health care as a basic right, is discussed

Sociological Variables Affecting Clinical Issues: A Comparison of Graduate Distance Education Sites

This study examined the differences between students residing in urban and rural areas while enrolled in a graduate practice methods course taught via two-way interactive television. A questionnaire was administered to sixty-six students which assessed sociodemographic characteristics, current practice topics, practice approaches, and diversity issues. Rural offcampus students were found to reside in significantly smaller communities than the urban-based university campus students, and viewed several clinical issues as having more relevance to their future practice. Further, on-campus students were significantly younger than their rural counterparts, were more ethnically diverse, and placed more emphasis on the relevance of course material to address ethnicity, physical disability, and religiosity. Qualitative findings revealed mat the university site was the most supportive of privatization. The applicability of urbanized course content across rural sites was discussed, and implications for clinical sociology were provided

Expanding infant mental health treatment services to at-risk preschoolers and their families through the integration of relational play therapy: Integrating relational play therapy into infant mental health treatment services

The expansion of infant mental health (IMH) to at-risk preschoolers and their families has contributed to the integration of relational play therapy (RPT) into IMH treatment services for this population. Integrating RPT allows access to specialized play and expressive techniques specific to preschool and family development, which improves the clinical ability to meet the multiple and complex needs of at-risk parent–child dyads and their families. This article will examine the RPT literature and explore the similarities and differences between IMH and RPT. In addition, two case studies will highlight a five-phase, integrative clinical-treatment process and provide insight into how IMH clinicians are integrating RPT models and maintaining adherence to the IMH treatment approach