Arab Mothers Research Articles

Attitudes towards human papillomavirus vaccination among Arab ethnic minority in Denmark: A qualitative study.

Knowledge regarding the human papillomavirus (HPV) and HPV vaccine uptake among ethnic minorities is poorly explored in Denmark. The objective of this study was to explore attitudes and knowledge towards HPV vaccination among Arab mothers and their daughters. Five Arabic-speaking focus groups with mothers of vaccine-eligible girls and three focus groups with daughters were conducted. The participants were recruited through different social clubs. A phenomenological approach was used to investigate attitudes and knowledge of HPV vaccination. Meaning condensation inspired by Amedeo Giorgi was used to analyse the transcribed material. A total of 23 women and 13 daughters were included in this study. The mothers' knowledge regarding HPV was limited to the fact that HPV can cause cervical cancer. Two focus groups mentioned that HPV is a sexually transmitted disease and none of the mothers knew that HPV also causes genital warts. Both mothers and daughters acknowledged that the daughters have deeper insight into health-related issues. A gap of knowledge between generations was identified, as mothers and daughters obtained health information from different sources: mothers used the Arabic TV channels as a source of knowledge and daughters had a range of sources, e.g. school, internet, and Western TV channels. The consequence of these differences in obtaining knowledge is that mothers and daughters lack a common language to discuss health issues. Mothers were influenced by Arabic society, while daughters had created a hybrid of Arabic and Danish. Each generation had its own reasons for accepting the vaccine. The level of HPV knowledge and awareness did not affect their uptake decision in that all the participating mothers had accepted the vaccine for their daughters. Educational programs should target both mothers and daughters because mothers have an inadequate knowledge about HPV. This is likely to bridge the gap of knowledge between mothers and daughters, which constitutes a barrier between the generations.

Understanding the mediating role of corporal punishment in the association between maternal stress, efficacy, co-parenting and children's adjustment difficulties among Arab mothers

This study, guided by the Family Systems Theory, examines the direct effect of maternal use of corporal punishment on children's adjustment difficulties. Also, it explores whether corporal punishment serves as a mediating factor in the relationship between several maternal characteristics, marital relationships, and children's adjustment difficulties. A total of 2,447 Arab mothers completed anonymous, structured, self-report questionnaires. The use of corporal punishment was generally strongly supported by the Arab mothers in our sample. A greater likelihood of using corporal punishment was found among mothers of boys rather than girls, among mothers with lower perceived self-efficacy to discipline children, and among mothers with a lower perception of their husbands’ participation in child-related labor. In addition, the higher a mother's reports on disagreement with her husband about discipline methods and the stronger her level of maternal stress, the more likely she was to use corporal punishment. Corporal punishment also mediated the association between the above mentioned factors and child adjustment difficulties. Furthermore, a husband's emotional support and family socioeconomic status were directly associated to children's adjustment difficulties. The results of the current study emphasize the need to observe children's development within the context of their family systems and to consider the mutual influences of different subsystems such as marital relationships and mother–child interactions. Prevention and intervention programs should raise parents’ awareness concerning the harmful effects of corporal punishment and take into account the impact of dynamic transactions of parental conflicts and disagreements regarding discipline methods on child outcomes.

Vitamin D receptor polymorphism FokI is associated with spontaneous idiopathic preterm birth in an Israeli population

ObjectiveThe active form of vitamin D (1,25[OH]2D3) has been established to have potent anti-proliferative, immuno-modulatory, and anti-microbial action in addition to its effects on bone. The nuclear vitamin D receptor (VDR) is expressed in the placenta-decidua, regulating genes associated with implantation and implantation immuno-tolerance. If VDR polymorphisms regulate VDR functionality at the placenta-decidua interface, VDR genotypes may be involved in idiopathic preterm birth (PTB). Study designMaternal and fetal (umbilical cord) blood samples from 33 Jewish and Arab mothers with PTB of a singleton neonate were compared to 98 samples from Jewish and Arab maternal and fetal blood samples from full-term, uncomplicated singleton births. Maternal age and ethnicity were comparable between groups. PCR amplification/digestion identified the VDR SNPs: FokI, ApaI, TaqI, and BsmI. ResultsAllele frequency for the FokI VDR in maternal blood samples from preterm births (but not umbilical cord samples) was significantly different (p=0.01) from that in maternal and umbilical cord blood samples from full-term singleton births, with an odds ratio for FokI carriers of 3.317 (95% CI, 1.143, 9.627) for preterm birth. The FokI VDR variant may therefore be a maternal risk trait for PTB among these women. ConclusionThis study may support a future platform for the study of vitamin D during pregnancy and treatment of selective target populations with vitamin D and/or VDR “tissue-specific therapeutic intervention” for prevention of PTB.

Intergenerational Transmission of Parenting Style Among Jewish and Arab Mothers in Israel

Parental modeling of behavior has long been considered a major socialization process for children. In this piece, the author explores how parenting behavior is passed from one generation to the next, focusing on parenting styles among Jewish and Muslim mothers in Israel. The results indicate that young mothers tend to reproduce their parents' styles, irrespective of their social or religious backgrounds. While culture tends to influence parenting styles, factors like religion, ethnicity, and national origin are found to have little influence on this intergenerational transmission of parenting behavior. Rather, modeling and imitation of parents' behavior had a deeper effect. This article contributes to research on the parenting styles beneficial to children and suggests the need to examine patterns of intergenerational parenting among different ethnic populations and among fathers.

Perceived Need for Psychosocial Services in the Context of Political Violence: Psychological Distress Among Israeli Mothers with Young Children

The current study investigated the association between mothers’ perceived need for psychosocial services due to exposure to political violence, and theirs and their children’s psychological distress. A representative sample of 904 Israeli mothers of young children aged 2–6 were asked to fill out a questionnaire about exposure to war and other types of trauma, psychological distress, social support, and perceived need for help. The results showed that mothers who reported a need for psychosocial services due to exposure to political violence had higher levels of exposure to political violence, depressive symptoms and more emotional problems in their young children than mothers who reported no need for help. Those who reported a need for psychosocial services also had less social support even when all other variables are controlled. Furthermore, Arab mothers and mothers with low family income perceived a greater need for psychosocial services. The implications of this study are relevant for policies of outreach to vulnerable groups in situations of ongoing political violence.

Psychological distress among postpartum mothers of preterm infants and associated factors: a neglected public health problem

The aim of the present study was to determine the prevalence of psychological distress, depression, anxiety, and stress among postpartum Arab mothers of preterm or low birth weight (LBW) infants and to identify maternal characteristics that can predict psychological distress among mothers of preterm infants. A hospital-based study was conducted. A representative sample of 2,091 postpartum mothers was surveyed and 1,659 women (79.3%) gave their consent to participate in the study. The study was based on a face-to-face interview with a designed questionnaire covering sociodemographic characteristics, anthropometric measures, medical history, and maternal characteristics. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scale (DASS-21). In the study sample, 10.2% of the postpartum mothers had preterm/LBW infants. Depression (29.4 vs. 17.3%) and anxiety (26.5 vs. 11.6%) were significantly more common among mothers of preterm births compared to mothers of full term infants (p < 0.001). The risk of depression in mothers of preterm/LBW infants was two times the risk in mothers of full term infants, while the risk of anxiety was 2.7 times in mothers of preterm/LBW infants than in mothers of full term infants. Young mothers and those who had less than secondary education (42.0 vs. 21.7%; p = 0.007) and lower monthly household income (72.0 vs. 53.3%; p = 0.024) were more depressed and anxious after the preterm birth when compared with mothers of full term infants. Psychological distress was higher in mothers with history of preterm birth (30.0 vs. 21.7%) and delivery complications (52.0 vs. 33.3%). We found a greater risk of depression and anxiety in mothers of preterm births than in mothers of full term infants. Our analysis revealed that depressed and anxious women of preterm infants were younger, less educated, had a lower body weight and low household income than non-depressed and non-anxious women.

Contextual Factors Influencing Breastfeeding Practices Among Arab Women in the State of Qatar

Breastfeeding is an important source of nutrition and sustenance for infants and toddlers, and has also been linked to several aspects of emotional, physiological, and psychological developments. Benefits of breastfeeding include lower morbidity and mortality rates in infants, appropriate nutrition for early physiological development, and improved immune system development. Some studies also suggest it may enhance cognitive development and reduce the risk of diabetes. These health benefits positively influence the physiological status of the infant throughout his or her early childhood and adolescence. The World Health Organization (WHO) recommends that breastfeeding be initiated immediately following birth and continued until the infant is at least 6 months of age. However, according to the UNICEF report, between 2000-2007 in Qatar, only 12% of babies under 6 months were exclusively breastfed. Funded by the QNRP (Qatar Undergraduate Research Experience Program), the goal of this exploratory qualitative study was to find ways to effectively promote breastfeeding practices among Qatari women by investigating factors affecting the ways in which Qatari women (national and nonnational Arab women) make decisions to engage in breastfeeding practices and their overall knowledge of breastfeeding. Purposive sampling was used to recruit 32 Arab mothers as research participants and individual in-depth, semi-structured interviews were conducted with each participant. Results showed that professional support from doctors and nurses, social support from parents and spouse, cultural and religious values, economic ability work restrictions, time, as well as availability of help and care at home, personal challenges, such as perceptions of pain, body image, and body changes, were some of the major factors in making decisions to breastfeed or not.

Dissociative experiences and its relationship to mood problems in Arabic mothers with disabled children

IntroductionTo examine the presence of dissociation among Arab mothers with disabled children in Saudi Arabia, and to explore if this is linked to their mood difficulties, in addition to certain other demographic variables.MethodsWe conducted a prospective study during the period of June 2011 to February 2012, on 86 mothers (study group) caring for children with physical, mental or sensory disabilities treated at Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia. Patients’ selection was conducted using convenience sampling, non-probability technique. A total of 32 mothers (control group) with healthy children were also included. The Dissociative Experiences Scale (DES-11 Arabic) was used to measure dissociation whereas; the hospital anxiety and depression scale (HADS) was used to measure the mood symptoms of mothers. The demographic data of mothers and children were also collected.ResultsThe mean age of the children with disability was 5.6.±3.1 and healthy children 6.3±3.7 (range 1-14) years. The mean age of mothers in the study group (n=86) was 33.9±6.1 while the control group was 35.2±7.3 years. Results showed that the study group had higher level (Mean=39.9; SD=24.033) of dissociative experience than control sample (Mean=21.08; SD=14.487) (p=0.0001). Compared to control, mothers of disabled children scored significantly higher HADS-anxiety (p=0.042) and HADS-depression (p=0.021). In addition, results also showed that dissociation had significant correlation with mother's depression and anxiety. However, no significant correlations were found between dissociation and child's and mother's age.ConclusionMothers of disabled children in Saudi Arabia showed significantly more dissociative experiences than controls, which is correlated to their anxiety and depression. Clinical implications are discussed.

Arab Mothers' Involvement With Their Offspring With Severe Intellectual Disabilities After Placement in Institutional Care

This study examines the cognitive-behavioral and emotional involvement among 81 Israeli Arab mothers after placement of their offspring with severe intellectual disabilities in institutional care, with respect to mothers' and offspring's background data and measures of divisional roles in the Arab family. Core findings indicate that the most important predictors of maternal cognitive and behavioral involvement are the existence of psychiatric disability in addition to intellectual disability, and the offspring's duration of stay in institutional care. These predictors were poorer in explaining maternal emotional involvement. Findings are interpreted with respect to social work research and practice with Israeli Arab families.

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High prevalence of moderately severe vitamin D deficiency in preterm infants

The recommended dose of vitamin D supplementation of preterm infants is based on data from populations in which severe vitamin D deficiency is uncommon and may be inadequate for infants in high risk population. However, data on vitamin D status of preterm infants in high-risk populations, such as Middle Eastern countries is scarce. This study investigates the vitamin D status of Arab mothers and their preterm infants. Maternal serum and cord blood 25(OH)D, calcium (Ca), phosphorus (P) and alkaline phosphate (ALP) were measured at delivery. Serum 25(OH)D was measured by HPLC while the other biochemical parameters were measured by standard autoanalyzer. Thirty-four preterm infants were studied. The mean gestational age was 31.4 weeks and birth weight was 1667g. The median serum 25(OH)D of 17.0nmol/L in 28 mothers and 14.5nmol/L in 34 cord blood samples were low. The median maternal and cord blood Ca, P and ALP levels were within normal range. Fifteen (44%) of the infants had moderately severe vitamin D deficiency (serum 25 (OH)D levels <12.5nmol/L). The median serum 25(OH)D levels of mothers who had reportedly taken prenatal vitamin D supplementation and those who had not were similar (17.3 vs 16.3) nmol/L. The mean serum 25(OH)D levels among preterm infants in this study were low when compared to levels in Caucasians preterm infants on which the current vitamin D recommendations are based. The high prevalence of moderately severe vitamin D deficiency in Arab preterm infants provides a justification to investigate vitamin D requirement of preterm infants in this and other high-risk populations.

Prenatal testing and termination of future pregnancies in Arab mothers of children with severe defects: impact of Moslem cleric or physician on the decision making

The authors investigated: 1) How many of 250 Israeli Arab mothers (50% in consanguineous marriages) of babies with severe congenital anomalies had undergone prenatal testing during pregnancy, and how many had refused termination of pregnancy (TOP) when recommended; 2) Why TOP had been refused; 3) Attitudes regarding prenatal testing and TOP in future pregnancies; and 4) Whether the women would have changed their decision had they been able to talk to a Moslem cleric or Moslem doctor in addition to the regular personnel. Eighty seven (35%) refused to even consider TOP, 55 (22%) agreed to undergo TOP, and 87 (35%) agreed provided the procedure would be performed before 120 days gestation. The remainder were undecided. Of 195 women, the addition of a Moslem religious cleric or physician to the Committee would influence 89 (46%) and 55 (28%), respectively, to change their opinion and agree to TOP, and 26 (13%) and 10 (5%), respectively, to change their opinion and agree to TOP prior to 120 days of gestation. The remainder either continued to refuse TOP or were undecided.

Health Capital and the Prenatal Environment: The Effect of Maternal Fasting During Pregnancy

We use the Islamic holy month of Ramadan as a natural experiment in fasting and fetal health. In Michigan births 1989-2006, we find prenatal exposure to Ramadan among Arab mothers results in lower birthweight and reduced gestation length. Exposure to Ramadan in the first month of gestation is also associated with a sizable reduction in the number of male births. In Census data for Uganda, Iraq, and the US we find strong associations between in utero exposure to Ramadan and the likelihood of being disabled as an adult. Effects are particularly large for mental (or learning) disabilities. We also find significant effects on proxies for wealth, earnings, the sex composition of the adult population, and more suggestive evidence of effects on schooling. We find no evidence that negative selection in conceptions during Ramadan accounts for our findings, suggesting that avoiding Ramadan exposure during pregnancy is costly or the long-term effects of fasting unknown.

Attitudes of Arab and Jewish mothers towards punitive and non‐punitive discipline methods

ABSTRACTThis study used data from 234 Jewish and Arab mothers in Israel to determine the association between cultural and socioeconomic factors on their views of punitive and non‐punitive discipline behaviours. Mothers highly approved the use of nonpunitive disciplines. For example, all mothers supported to explain to the child what the rules are to try to prevent misbehaviour; however, their support of punitive disciplines was not negligible. For instant, 15.32% approved spank, slap, smack or swat children; one out of 10 mothers endorsed using an object such as a paddle, hairbrush, belt, etc. on children. Mothers with lower levels of education (completing high school or lower) and Arab mothers approved the use of corporal punishment and psychological aggression more than others. More support and training are required for these families.

“Back to sleep”: parents compliance with the recommendation on the most appropriate sleeping position of infants, Haifa District, Israel, 2001

Background In 1993, the Israel Ministry of Health issued a formal recommendation to avoid placing healthy infants to sleep in the prone position in order to prevent sudden infant death. The objective of the study was to study parents' compliance with this recommendation and to identify characteristics of noncompliant parents of infants aged less than 6 months old. Methods The study population consisted of 1912 parents of infants aged 0–12 months who visited the Haifa District primary preventive health centers during the study week and answered the self-administered questionnaire. Results 15.6% of infants younger than 1 year were placed to sleep in the prone position: 12.4% among infants younger than 3 months, and 17.6% among infants 3–6 months old. Surprisingly, multiple logistic regression analysis demonstrated that Israeli-born Jewish mothers were more likely to place their babies prone than Israeli-born Arab mothers or mothers born in the former Soviet Union who had immigrated to Israel after 1990. Conclusions At-risk behaviors are usually associated with minority and immigrant populations. Culture specific and other possible reasons for our unusual findings are discussed.

Association of parental consanguinity with congenital malformations among Arab newborns in Jerusalem.

The aim of this work was to determine the impact of parental consanguinity on congenital malformations in a mixed urban and rural Arab community in Jerusalem, Israel. Arab mothers admitted to four hospitals in west Jerusalem were interviewed after delivery. Demographic and obstetric data were recorded. Neonatal data were extracted from the medical records of the nursery. When malformations were suspected, a 4- to 10-month follow up was achieved for confirming the diagnosis. Of 561 infants, 253 (45%) were born to consanguineous couples. The incidence of major congenital malformations in the offspring was 8.7, 7.1 and 2.6% in cases of first cousins, all consanguineous, and non-consanguineous couples, respectively. No association was found between parental consanguinity and prematurity (p = 0.357) or low birth weight (p = 0.589). Parental consanguinity was also associated with an increased incidence of death in previous siblings (p < 0.000). The increased incidence of congenital malformations and infant mortality in cases of inbreeding prompt the necessity of establishing programs to avoid these complications in the offspring.

Stress, social support and well-being of Arab mothers of children with intellectual disability who are served by welfare services in northern Israel.

The present study examined the influence of a social support system on the level of stress and the sense of personal well-being of 100 Israeli Arab mothers of young children with special needs. Fifty mothers were served by the welfare services in the Nazareth area while 50 did not get help on a regular basis. A comparison was done between educated, urban mothers, and less-educated, rural mothers. The research results point to a relationship between informal support resources, and the marital and economic stress of the mothers: the higher the amount of the informal support resources, the lower the level of stress that was experienced by the mothers. A relationship between the amount of informal support and level of parental stress was not confirmed. A relationship between the amount of support resources and the personal well-being of the mothers was found: the higher the amount of informal support resources, the higher the sense of well-being of the mothers. A relationship between formal support (the welfare services), and level of stress or personal well-being was not found. Education and place of living were not related to level of stress or personal well-being. Educated mothers from urban areas used the formal support (the welfare services) less than less-educated mothers who lived in rural areas. The findings are interpreted with respect to practice and previous studies.

Sleep position, bedding and heating practices in high- and low-risk ethnic groups for unexpected death in infancy (UDI).

In a previous study, a significant increased risk for unexpected death in infancy (UDI) among Arab infants as compared to Jews (RR: 5.2) was found. The incidence has significantly decreased in both groups during the 'back to sleep' campaign. The objective of this study was to compare the prevalence of three risk factors, i.e. positioning, night dressing/covering and heating practices in these ethnic groups. A community sampling procedure was employed, resulting in the participation of 264 Jewish and 146 Arab mothers of infants between 1 and 4 months, born at term and with no chronic illness at the time of the study. A questionnaire in Arabic and Hebrew was designed, pertaining to sleep positioning at the time of the study and of the previous infant, prior to the SIDS prevention campaign, as well as clothing and heating practices. Significantly, more Arab infants were put to sleep in a supine or side position as compared to Jewish infants both during the study (p = 0.002) as well as prior to the SIDS campaign (p = 0.001). No ethnic difference was related to clothing practices. Open heating, however, was significantly more common in the Arab sector (p = 0.001). A logistic procedure for each of the practices indicated that ethnicity is related significantly to both sleep position (p = 0.002) and beating practices (p = 0.001). Prone sleep positioning was still prevalent (32.2%) more so among Jews (35.2%) than Arabs (27%). Sleep positioning and overdressing do not appear to be the major attributable risk factors for UDI among Arab infants as compared to Jews. The compliance with positioning recommendations is lower than expected in both ethnic groups.

Bedouin Arab mothers' aspirations for their children's education in the context of radical social change

This study examines the aspirations of Bedouin Arab mothers toward their children's educational attainment and future occupations. The study was conducted in 1991–92 among the Bedouin community in Israel which is in the process of being transferred from spontaneous tribal settlements to government planned towns. The study was based on interviews with 309 mothers, 90% of whom had no formal education themselves. The data revealed that 62% of the mothers lived in government planned towns, and 38% lived in spontaneous tribal settlements. Ninety eight percent of mothers would like to see their sons finish high school and 81% would like to see their daughters finish high school (though about 20% of these acknowledged the existence of family or financial barriers to realizing their aspirations). There were no significant differences between the aspirations of mothers who lived in the planned towns and those who lived in spontaneous settlements for their sons' and daughters' high school and higher education, or their future occupations.

Breast-Feeding Habits Among Jewish and Arab Mothers in Hadera County, Israel

A survey of breast-feeding habits of Jewish and Arab mothers was carried out in Hadera county in Israel. Jewish mothers breast-fed their babies approximately 3 months, while Arab mothers did so for 5 months. The rate of breast-feeding among Jewish and Arab mothers was 84% and 94.4%, respectively. The results indicated that education, previous experience, enjoyment, husband's encouragement, previous information about the importance of breast-feeding, belief that breast-feeding strengthens the mother-child relationship, and the convenience of breast- over bottle-feeding were all factors that had an impact on breast-feeding habits among Jewish but not Arab mothers. Breast-feeding as a means of birth control, religion, and impairment of the breast's shape were factors that had no effect on either Arab or Jewish mothers. Complications during pregnancy and cesarean delivery decrease the probability of breast-feeding in Arab and Jewish mothers. Jewish mothers stopped breast-feeding because of insufficient milk, fatigue, work obligations, and physician's recommendation. Among Arab mothers the main reasons were insufficient milk, physician's recommendation, baby's refusal, and nipple problems. Jewish mothers who decided not to breast-feed stated that the reasons were previous experience with insufficient milk, nipple problems, and unpleasant feelings. The few Arab mothers who did not breast-feed cited medical or nipple problems.