Lesbian Mothers

Within a society that long considered "lesbian motherhood" a contradiction in terms, what were the experiences of lesbian mothers at the end of the twentieth century? In this illuminating book, lesbian mothers tell their stories of how they became mothers; how they see their relationships with their children, relatives, lovers, and friends and with their children’s fathers and sperm donors; how they manage child-care arrangements and financial difficulties; and how they deal with threats to custody. Ellen Lewin’s unprecedented research on lesbian mothers in the San Francisco area captured a vivid portrait of the moment before gay and lesbian parenting moved into the mainstream of U.S. culture. Drawing on interviews with 135 women, Lewin provided her readers with a new understanding of the attitudes of individual women, the choices they made, and the texture of their daily lives

Development of a checklist for people communicating evidence-based information about the effects of healthcare interventions: A mixed methods study

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Developing Evidence to Decision Frameworks and an Interactive Evidence to Decision Tool for Making and Using Decisions and Recommendations in Health Care

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Near-infrared Spectral Characterization of Solar-type Stars in the Northern Hemisphere

Although solar-analog stars have been studied extensively over the past few decades, most of these studies have focused on visible wavelengths, especially those identifying solar-analog stars to be used as calibration tools for observations. As a result, there is a dearth of well-characterized solar analogs for observations in the near-infrared, a wavelength range important for studying solar system objects. We present 184 stars selected based on solar-like spectral type and V-J and V-K colors whose spectra we have observed in the 0.8-4.2 micron range for calibrating our asteroid observations. Each star has been classified into one of three ranks based on spectral resemblance to vetted solar analogs. Of our set of 184 stars, we report 145 as reliable solar-analog stars, 21 as solar analogs usable after spectral corrections with low-order polynomial fitting, and 18 as unsuitable for use as calibration standards owing to spectral shape, variability, or features at low to medium resolution. We conclude that all but 5 of our candidates are reliable solar analogs in the longer wavelength range from 2.5 to 4.2 microns. The average colors of the stars classified as reliable or usable solar analogs are V-J=1.148, V-H=1.418, and V-K=1.491, with the entire set being distributed fairly uniformly in R.A. across the sky between -27 and +67 degrees in decl.Comment: 19 pages, 8 figures, 2 table

Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis

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Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Rwanda: A Mixed Methods Study

Introduction: We evaluated the Informed Health Choices secondary school intervention in a cluster randomized trial in Rwanda. The intervention was effective in helping students to think critically about health. In parallel to the trial, we conducted a process evaluation to assess factors affecting the implementation, impacts, and scale-up of the intervention. Methods: We used a mixed methods approach that included quantitative and qualitative methods. We collected quantitative data from teachers to evaluate the teacher training and each lesson. We conducted focus group discussions with students (n=10) and their parents/guardians (n=5). We conducted lesson observations (n=16) and key informant interviews with teachers (n=10) and school administrators (n=10) from intervention schools and policymakers (n=2). We analyzed the quantitative data using descriptive statistics. We used framework analysis and thematic content analysis to analyze the qualitative data. Results: Teachers noted that the teacher training supported their delivery of the intervention and that they made only small adaptations to fit student, teacher, or contextual needs. Students reported obtaining important skills, including recognizing health claims, understanding the need for research, and “thinking twice” before deciding. Participants saw the design of the intervention, students’ and teachers’ motivation, and school and home support as key facilitators for the implementation and impact of the intervention. Implementation barriers identified included the content of the lessons not being included in national examinations, competing priorities, and time constraints. Participants identified several factors that could facilitate intervention scale-up, including the need for the skills taught in the lessons and compatibility of the intervention with the national curriculum. Conclusion: We found that it was feasible to implement the intervention in Rwandan secondary schools and that students benefited from the intervention. Scaling up the intervention will likely require addressing the barriers identified in this study.publishedVersio

Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Kenya: A Mixed Methods Study

Introduction: We evaluated the Informed Health Choices secondary school intervention to help students in Kenya think critically about health choices. We conducted this process evaluation to explore if the intervention was implemented as planned, identify factors that facilitated or hindered implementation, potential benefits of the intervention, and how to scale up the intervention beyond the trial. Methods: This was a mixed methods process evaluation nested in a cluster-randomized trial of the Informed Health Choices intervention. We analyzed quantitative data from teacher training evaluation forms completed by 39 teachers, 10 lesson evaluation forms completed by 40 teachers allocated to the intervention, and 72 structured classroom observation forms. We conducted a framework analysis of qualitative data from 14 group interviews (with 96 students, 23 teachers, and 18 parents) and 22 individual interviews (with 8 teachers, 5 school principals, 6 curriculum developers, and 3 policymakers). We assessed confidence in our findings from the qualitative analysis using a modified version of Confidence in the Evidence from Reviews of Qualitative Research. Results: Lesson objectives were achieved with minimal adaptations. Factors that might have facilitated the implementation of the intervention include teacher training; perceived value of the intervention by students, teachers, and policymakers; and support from school administration. Time constraints, teachers’ heavy workloads, and the lessons not being included in the curriculum or national examination are factors that might have impeded implementation. Both students and teachers demonstrated the ability to apply key concepts that were taught to health choices and other choices. However, they experienced difficulties with 2 of the lessons. Conclusion: Scale-up of this intervention in Kenyan schools is feasible but may depend on adjusting the time allocated to teaching the lessons, modifying the 2 lessons that teachers and students found difficult, and including the lesson objectives and assessment in the national curriculum.publishedVersio

Effects of the informed health choices secondary school intervention after 1 year: a prospective meta-analysis using individual participant data

Background: Critical thinking about health choices is essential to avoid being misled by unreliable information and to use reliable information appropriately. The aim of this prospective meta-analysis was to synthesize the results of 1-year follow-up data from three cluster-randomized trials of an intervention designed to teach lower secondary school students to think critically about health choices. Only one other randomized trial has evaluated a school-based intervention to teach adolescents to think critically about health choices. That trial compared two teaching strategies to teach statistical reasoning. It did not assess long-term learning-retention. Methods: We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included providing a 2–3-day teacher training workshop and digital resources for ten lessons. The intervention focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥ 9 of 18 multiple-choice questions answered correctly). We performed random effects meta-analyses to estimate the overall intervention effects. We calculated learning retention as the test results in the intervention schools after 1 year relative to just after the intervention, adjusted for chance. Results: Altogether, 244 schools (11,344 students) took part in the three trials. Follow-up data was collected for 8298 students (73%). The overall odds ratio for the primary outcome after 1 year was 3.6 (95% CI: 1.9–7.1; p = 0.0001) in favor of the intervention, whereas it was 5.5 (95% CI: 3.0–10.2) just after the intervention. This corresponds to 25.6% (95% CI: 21.1–30.0%) more students in the intervention schools passing the test after 1 year versus 33.3% (95% CI: 28.7–37.8%) just after the intervention. Overall, 2273 (52.6%) of 4324 students in intervention schools had a passing score after 1 year compared to 3397 (58.1%) of 5846 students just after the intervention, indicating 88.3% learning retention. Conclusions: One year after the intervention, we still found a positive effect on the ability of students to think critically about health choices, but 5.5% fewer students in the intervention schools had a passing score. The certainty of the evidence was also lower due to 27% of students being lost to follow-up. Trial registration: The protocol for this prospective meta-analysis was registered with PROSPERO May 31, 2022, ID 336580. The three randomized trials were registered in the Pan African Clinical Trial Registry February 15, 2022, PACTR202203880375077; April 5, 2022, PACTR20220488391731; and April 14, 2022, PACTR202204861458660.publishedVersio

Use of the informed health choices educational intervention to improve secondary students’ ability to think critically about health interventions in Uganda: A cluster-randomized trial

Aim:: The aim was to evaluate the effect of the Informed Health Choices (IHC) educa- tional intervention on secondary students’ ability to assess health-related claims and make informed choices. Methods:: In a cluster-randomized trial, we randomized 80 secondary schools (stu- dents aged 13–17 years) in Uganda to the intervention or control (usual curriculum). The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in one school term. The lesson plans were developed for classrooms equipped with a blackboard or a blackboard and projector. The lessons addressed nine prioritized concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to assess claims and make informed choices. The primary outcome was the proportion of students with a passing score (≥9 of 18 questions answered correctly). Results:: Eighty schools consented and were randomly allocated. A total of 2477 stu- dents in the 40 intervention schools and 2376 students in the 40 control schools participated in this trial. In the intervention schools, 1364 (55%) of students that com- pleted the test had a passing score compared with 586 (25%) of students in the control schools (adjusted difference 33%, 95% CI 26%–39%). Conclusions:: The IHC secondary school intervention improved students’ ability to think critically and make informed choices. Well-designed digital resources may improve access to educational material, even in schools without computers or other information and communication technology (ICT). This could facilitate scaling-up use of the resources and help to address inequities associated with limited ICT access.publishedVersio