Impact of a Child Abuse Primary Prevention Strategy for New Mothers.

Project TEACH (Teaching Equity to Advance Community Health) is a capacity-building training program to empower community-based organizations and regional public health agencies to develop data-driven, evidence-based, outcomes-focused public health interventions. TEACH delivers training modules on topics such as logic models, health data, social determinants of health, evidence-based interventions, and program evaluation. Cohorts of 7 to 12 community-based organizations and regional public health agencies in each of the 6 Colorado Area Health Education Centers service areas participate in a 2-day training program tailored to their specific needs. From July 2008 to December 2011, TEACH trained 94 organizations and agencies across Colorado. Training modules were well received and resulted in significant improvement in knowledge in core content areas, as well as accomplishment of self-proposed organizational goals, grant applications/awards, and several community-academic partnerships.

Educational risk, recidivism, and service access among youth involved in both the child welfare and juvenile justice systems

BackgroundAutistic youth in the United States face many challenges accessing services as they transition to adulthood. Improving parents' ability to advocate for services is a promising way to improve service access. The current study tested whether participation in an intervention to improve parents' ability to advocate for adult services (called Advocating for Supports to Improve Service Transitions or ASSIST) led to increased service access for their transition‐aged autistic youth.MethodsUsing a multisite, single‐blind parallel‐group design, we randomized 185 parents of transition‐aged autistic youth to either a treatment condition that received the ASSIST intervention, or a control condition that received comprehensive written information about adult services. Primary outcomes for this report – number of government programs that fund services and direct services received by the youth – were collected via parental interview at baseline, six, and 12 months after intervention.ResultsPrimary analyses found no significant treatment effects on service access. Subgroup analyses, however, detected treatment effects for families of youth who had exited high school prior to their families taking ASSIST. Among those families, youth from the treatment group were receiving more government programs that fund services at 6 months after intervention compared with youth from the control group.ConclusionsWe cannot conclude from our findings that ASSIST improved access to services, though there was some evidence to suggest increased access to government programs that fund services for families of autistic youth who had exited high school. Future research should investigate which families can translate written information about adult services (i.e. the control condition) into improved service access, and which families need more individualized support beyond a group‐based class to see improvements in service access.

With an increasing demand for computing professionals with skills in accessibility, it is important for university faculty to select effective methods for educating computing students about barriers faced by users with disabilities and approaches to improving accessibility. While some prior work had evaluated accessibility educational interventions, many prior studies have consisted of firsthand reports from faculty or short-term evaluations. This paper reports on the results of a systematic evaluation of methods for teaching accessibility from a longitudinal study across 29 sections of a human-computer interaction course (required for students in a computing degree program), as taught by 10 distinct professors, throughout four years, with over 400 students. A control condition (course without accessibility content) was compared to four intervention conditions: week of lectures on accessibility, team design project requiring some accessibility consideration, interaction with someone with a disability, and collaboration with a team member with a disability. Comparing survey data immediately before and after the course, we found that the Lectures, Projects, and Interaction conditions were effective in increasing students' likelihood to consider people with disabilities on a design scenario, awareness of accessibility barriers, and knowledge of technical approaches for improving accessibility - with students in the Team Member condition having higher scores on the final measure only. However, comparing survey responses from students immediately before the course and from approximately 2 years later, almost no significant gains were observed, suggesting that interventions within a single course are insufficient for producing long-term changes in measures of students’ accessibility learning. This study contributes to empirical knowledge to inform university faculty in selecting effective methods for teaching accessibility, and it motivates further research on how to achieve long-term changes in accessibility knowledge, e.g. by reinforcing accessibility throughout a degree program.

Introduction: Despite efforts to motivate all reproductive age women to avail cervical cancer screening services, many still do not utilise them. Most researchers have universally identified barriers like the lack of knowledge and lack of accessibility as the reason for not availing services. However, additional barriers also prevent women from making use of these screening services. Aim: To explore the barriers to and facilitating factors for cervical cancer screening beyond the lack of knowledge and accessibility of services. Materials and Methods: This qualitative research was conducted among tribal women residing in the Kiranchandra Tea Estate and Atal Tea Estate (two tea gardens in the rural Naxalbari Block) West Bengal, India, from July 2018 to February 2019. Women aged 30-59 years, living in the garden for at least the last 5 years, not suffering from obstetrics/gynaecological disease during last two years and willing to participate in the study were included, based on a purposive sampling method. Information Education Campaign (IEC) on cervical cancer and screening were undertaken and screening services arranged in the gardens on garden holidays for two consecutive weeks. Four (4) Focus Group Discussion (FGDs) in each garden were conducted, with each FGD consisting of 5 to 6 participants (N=49). Data obtained was recorded and logged with the participants’ permission and consent. A manifest content analysis was used to explore the perceived barriers and facilitators of cervical screening. Results: The major barriers identified were lack of support, burden of responsibility and the lack of felt need. The facilitators found most frequently were provision of information, social motivation, easy accessibility and affordability of screening services. Conclusion: This study revealed that there are various actual and perceived barriers to cervical cancer screening among tribal women in tea garden areas. Even after imparting knowledge and increasing availably and accessibility of a free program, familial support, burden of responsibility and lack of felt needs hinder increased uptake of the services.

Parenting stress and child maltreatment: The buffering effect of neighborhood social service availability and accessibility

AimsTo provide an overview of research literature on ageing and older people who use illicit opioids and stimulants by documenting the conceptual frameworks used and content areas that have been investigated.MethodsWe conducted a scoping review of literature relating to ageing and older people who use illicit stimulants and opioids, defining ‘older’ as 40 years and above. Primary studies, secondary studies and editorials were included. Searches were conducted in PubMed and Embase in July 2020 and March 2021; the Cochrane library was searched in November 2021. Charted data included methodological details, any conceptual frameworks explicitly applied by authors and the content areas that were the focus of the publication. We developed a hierarchy of content areas and mapped this to provide a visual guide to the research area.ResultsOf the 164 publications included in this review, only 16 explicitly applied a conceptual framework. Seven core content areas were identified, with most publications contributing to multiple content areas: acknowledgement of drug use among older people (n = 64), health status (n = 129), health services (n = 109), drug use practices and patterns (n = 84), social environments (n = 74), the criminal legal system (n = 28) and quality of life (n = 15).ConclusionsThe literature regarding older people who use illicit drugs remains under‐theorized. Conceptual frameworks are rarely applied and few have been purposely adapted to this population. Health status and health services access and use are among the most frequently researched topics in this area.

BackgroundThe extent to which a favorable policy environment influences health care utilization and outcomes for pregnant and postpartum women is largely unknown. In this study, we aimed to describe the maternal health policy environment and examines its relationship with maternal health service utilization in low- and middle-income countries (LMICs).MethodsWe used data from World Health Organization’s 2018-2019 sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) policy survey linked with key contextual variables from global databases, as well as UNICEF data on antenatal care (ANC), institutional delivery, and postnatal care (PNC) utilization in 113 LIMCs. We grouped maternal health policy indicators into four categories – national supportive structures and standards, service access, clinical guidelines, and reporting and review systems. For each category and overall, we calculated summative scores accounting for available policy indicators in each country. We explored variations of policy indicators by World Bank income group using χ2 tests and fitted logistic regression models for ≥85% coverage for each of four or more antenatal care visits (ANC4+), institutional delivery, PNC for the mothers, and for all ANC4+, institutional delivery, and PNC for mothers, adjusting for policy scores and contextual variables.ResultsThe average scores for the four policy categories were as follows: 3 for national supportive structures and standards (score range = 0-4), 5.5 for service access (score range = 0-7), 6. for clinical guidelines (score range = 0-10), and 5.7 for reporting and review systems (score range = 0-7), for an average total policy score of 21.1 (score range = 0-28) across LMICs. After adjusting for country context variables, for each unit increase in the maternal health policy score, the odds of ANC4+>85% increased by 37% (95% confidence interval (CI) = 1.13-1.64) and the odds of all ANC4+, institutional deliveries and PNC>85% by 31% (95% CI = 1.07-1.60).ConclusionsDespite the availability of supportive structures and free maternity service access policies, there is a dire need for stronger policy support for clinical guidelines and practice regulations, as well as national reporting and review systems for maternal health. A more favorable policy environment for maternal health can improve adoption of evidence-based interventions and increase utilization of maternal health services in LMICs.

Child abuse: Thoughts on doctors, nurses and prevention

Sexual and reproductive health services in Albania are based on a positive history of services quality and access. However, in the context of the past decades changes in the social and population perspective, these services are faced with the challenge to meet increasing and evolving demands from girls and women. The data available are scare to portray a good picture of the knowledge, attitude practice and other dimensions of access and quality of sexual and reproductive services from the viewpoint of girls and women. The findings introduced in this article present an attempt to add on the evidence, with the target of Tirana, being the most populated city. The methodology used in this research is composed by two components: the quantitative KAP survey, and the qualitative assessment of the services’ access and quality. The first instrument is tested and has passed the necessary reliability and validity tests and the second instrument is a focus group with girls and women. Both data are analysed with respective software. The respondents reported low level of knowledge on contraception methods, risk factors for cervical cancer, and signs of breast cancer. They accept that practices in terms of modern contraception are not frequent, similar are the prevention measures or testing for cervical cancer, IST/HIV. The study identifies that many barriers remain strong for girls and women in Tirana to access quality services.

Preventing Childhood Adversity Through Economic Support and Social Norm Strategies

Introduction: This study aimed to investigate the effect of social determinants of health service quality on patient’s satisfaction at Undata Regional Public Hospital. Methods: The sample consists of 97 inpatients who were treated for at least 2x24 hours. The data analysis technique is Structural Equation Model (SEM) with data analysis tools using SmartPLS software version 3. Results: The results show that the social dimensions of access and quality of education, access to quality health services, and economic stability have no significant effect on service quality. In the dimension of social and community, environmental development influences service quality. Service quality has a significant impact on satisfaction. Access and quality of education, access and quality of health services, social and community context, economic stability have no effect on satisfaction, and the dimension of environmental development influences satisfaction. In the dimensions of access and quality of education, access and quality of health services, economic stability through service quality as an intervening variable has no significant effect on satisfaction. The dimensions of social and community and the dimension of environmental development through the quality of service as an intervening variable have a significant effect on satisfaction at Undata Palu Regional Public Hospital. The level of patient’s satisfaction with health services with a community satisfaction survey value is 3,09 or with good service unit performance. Conclusion: The findings suggest that while some social determinants like education and economic stability do not directly impact service quality or patient satisfaction, factors such as community context and environmental development significantly enhance service quality and satisfaction. These insights underline the importance of a holistic approach to improving healthcare services, focusing on broader social and environmental factors.

Inappropriate handling of biomedical waste (BMW) may pose serious threats to the health of patients and hospital personnel. Among all healthcare workers, staff nurses play a vital role in BMW management (BMWM). Thus, the present study aimed to determine the predictors of BMWM practices among staff nurses of a tertiary care teaching hospital in India. A prospective cross-sectional study was conducted among 150 staff nurses, working at a tertiary care teaching hospital in South India, from July to August 2018. Data were collected using a pretested, semi-structured, and self-administered questionnaire after taking their written informed consent. Regression analysis was carried out to identify the predictors of satisfactory BMWM practice status. Of the total 150 staff nurses, most of them were young females with a work experience of ≤ 5 years. Concerning knowledge scores, most staff nurses (63.3%) belonged to the moderate category, whereas a few (24%) were in the high category. Also, most of them (62.7%) were in the high category of attitude scores. For practice scores, half of the participants were in moderate and high categories, each. Female gender, attended training status, and moderate and high knowledge scores were significantly associated with satisfactory BMWM scores in unadjusted analysis. After adjusting for other independent variables, all these three factors were found significantly associated with satisfactory BMWM practice scores. The present study shows that the female gender, attending training in BMWM, and having a moderate and high knowledge of BMWM were significant predictors of satisfactory BMWM practice among staff nurses. Thus, all hospitals must periodically train their staff nurses to strengthen their BMWM practices. Safe BMWM leads to environmental protection and safeguards the health of patients, hospital personnel, and the public.

The present paper addressed the question: how will the DSM-5 revisions impact access to autism services? While media commentators posited a straightforward link between DSM-5 changes and service access, we should consider the different strength of couplings between a DSM diagnosis and entitlement access by investigating the factors that result in a diagnoses translation into service access. The Article began by outlining the pre DSM-5 policy background for autism entitlements. This background helps contextualize the policy environment into which the DSM-5 changes entered. Rather than examining autism medical and educational services in isolation, we should conceive of these services as interdependent, and investigate how changes to the uptake or depth of medical service access affect changes to the uptake or depth of educational service access. Taking this interdependent perspective, the Article showed how the passage of private insurance mandates for autism services has led to more rapid uptake of special education services for autism, showing how one entitlement that creates a close DSM diagnosis-service link (an insurance mandate) increases uptake of another entitlement with a looser DSM diagnosis-service link (special education services). This shows that if DSM-5 revisions undermine access to medical entitlements there will be a corresponding impact on access to educational entitlements.

With 28% of Australia's population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.