Family Provision Research Articles

Worker, workplace or families: What influences family focused practices in adult mental health?

Introduction Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions. Aim The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services. Method Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices. Thesis It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child's connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers. Implications for practice Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to.

قراءة نقدية في تقنين أحکام الفقه وصياغتها تطبيقاً على مسودة مشروع قانون الأسرة البحريني – الشق السني

لم تبزغ شمس القرن الثالث الميلادي إلا وأکثر القضايا تتحول من ولاية الدولة القطرية إلى ولاية النظام العالمي الجديد ، الذي استخدم آليات القانون الدولي لفرض رؤيته في الحياة والسلوک ، وتکاثرت دواعي التغيير في مناح شتى يلفتنا منها بوجه خاص التغيير القانوني في مجال الأحوال الشخصية، في دول مجلس التعاون الخليجي، التي شهدت ثورة حقيقية في مصدرية الأحکام والحقوق وتنظيمها ، فلم ينتصف العقد الأول من القرن الجديد إلا ودول المجلس ، عدا المملکتين ، قد تحولت عن مصدرية الفقه والعرف إلى التشريع المکتوب ، ولا شک أنه أحفظ للاستقرار ، وأبعد عن الاضطراب ، وأدعى إلى اعتبار الأمثل من الأحکام شريطة أن تغلب اعتبارات التشريع الحقيقية على کافة الاعتبارات الأخرى ، ولا يتأتى ذلک في الواقع إلا بمراعاة أصول وضع وصياغة التشريعات ، في إطار الحفاظ على ثوابت المجتمع دون إغفال للمتغيرات والمستجدات. ومملکة البحرين وإن لم تسن بعد تشريعا للأحوال الشخصية إلا أنها تبغي ذلک في القريب ، وقد تصدت غير جهة من جهات المجتمع المدني إلى تقديم أفکار قانونية ، وتأمل کل جهة منها أن تجد من أهل الاختصاص من يتبنى فکرتها کاقتراح أو مشروع قانون ، إلا أن المسودتين اللتين أفصح عنهما في نوفمبر 2005 مثلتا أبرز ما وضع من أفکار في هذا الخصوص ، لذا فقد اخترت المسودة السنية ، وهى إحدى المسودتين، لتکون مثلا تطبيقيا أبرز من خلاله الآثار العملية لأصول تقنين وصياغة الأحکام الأسرية ذات الأصل الإسلامي، وأقيم ما وضع في صورة مواد ، فاقترح تبني ما ترجحت صحته ، وأرجو إعادة النظر فيما تبدى وجه ضعفه ، بعد أن أبرهن عليه ، وقد قسمت الدراسة إلى ثلاثة فصول أولها أخصصه للمسودة محل التطبيق وظروف وضعها ، والثاني أعالج فيه أصول وضع وصياغة القوانين، مع ذکر أمثلة لبيان أوجه الخلل التي تعتري القوانين التي لم ترع أصول الوضع والصياغة ، وفي الفصل الثالث أتناول مواد المسودة بالتقييم مقتصرا على إبراز مظان التميز الواضح ، أو أوجه الخلل الظاهر . Summary of search Search Title: Rationing provisions of Islamic jurisprudence and formulating then applying on a draft of the first section of the Bahraini family bill critical study The sun of the third century AD, had not emerged till the most cases turned from the state of Qatar to the mandate of the new world discipline, which used the mechanism of international law to impose his vision of life and behavior. The need of change has increased in various aspects mentioned in particular way the legal change in personal circumstances, in Gulf cooperation Council countries, which has seen a real revolution in of source in Rights and Judgments and its organizing. The first decade of the new century has not middel till the states of GCC have been transformed from a source of custom and Fiqh to the written legislate except for the two Kingdoms. There is no doubt that will be memorized stability and further from the turmoil, and arrogated to optimal consideration of provisions provided the overcome of real legislation on all other considerations. This will not be taken in fact without taking into account the basics of the formulating and applying legislations in the Franc of maintaining the principles of the society without omission the developments and changes. Although the Kingdom of Bahrain has not adopted legislation concerning personal status yet, It wishes so in the near. Many of civil society actors have provided legal ideas, and every one hopes to find specialists who adopted its idea as a suggestion or as a bill, but the drafts which have been disclosed in November 2005 represented the highlight of the ideas set in this regard. So, I choosed the Sunni draft. It’s one of the two drafts, to be applied as a practical example which represents practical figures of the basics of rationing and the formulation of family provisions of Islamic origin and I evaluate what is held in the form of articles. I suggest adopting what is supposed to be right and I hope to reconsider showing the face of weakness after proving that. This study is divided in to three chapters : The first chapter for the draft application and its setting conditions. The second chapter within it I treat the basics and formulation of the law by stating setting examples to show the faces of deficit which permate the law that didn’t consider the setting and the formulating basics. The third chapter I treat the draft articles by evaluation limited to show clear excellence doubts or aspects of the apparent deficit

Trafficking victims and families

Frances Trevena, head of policy and programmes at Coram Children's Legal Centre, examines the gaps in service provision for families and child victims of trafficking and how this group can be better supported

A qualitative analysis of the effect of a community-based primary health care programme on reproductive preferences and contraceptive use among the Kassena-Nankana of northern Ghana.

BackgroundIn 2000, Ghana launched the Community-based Health Planning and Services (CHPS) initiative to improve access to health and family planning services. This initiative was based in part on research, known as the Navrongo Project, conducted in the Kassena-Nankana district (KND) between 1994 to 2003 which demonstrated significant impact on fertility and child mortality. This paper examines current contraceptive perceptions in communities that were exposed to the Project’s service models over the 1994 to 2003 period, and the post-experimental policies of the CHPS era.MethodsQualitative study was conducted in the KND of Ghana from June to September, 2012, by convening 8 male and 8 female FGD panels as well as 8 in-depth interviews of community leaders. Data collection was stratified by original experimental cell of the Navrongo Project to permit appraisal of social effects of contrasting experimental conditions. Inductive content analysis was performed with QSR Nvivo 10 to identify predominant themes.ResultsWhile findings show that exposure to community-based services was associated with enhanced approval of birth spacing and limitation, this view is grounded in perceptions that childhood survival has improved. Nonetheless, concerns were expressed about contraceptive side effects, prominently permanent sterility. Strategies for male outreach and community engagement originally introduced during the Navrongo Project have not been sustained with CHPS scale-up. The apparent atrophy of attention to the needs of men may explain the resistance of some males to the notion of female reproductive autonomy and the practice of some women to adopt contraception in secret. Despite this apparent programmatic dearth of male engagement, there is evidence to suggest that social impact of the original male engagement strategy persists in communities where male mobilization was combined with doorstep provision of family planning care during the Navrongo Project.ConclusionCommunity-based services fostered attitudinal change towards family planning in a traditional sub-Saharan African setting. Sustained exposure to primary health care that have improved the survival of children has made the use of contraception more acceptable. Efforts should be embedded in primary health care programmes that address concerns about child survival while also consigning sustained priority to the information needs of men.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1325-6) contains supplementary material, which is available to authorized users.

Cultural Considerations in Will-Making in Australia

There are major legal and cultural differences across countries in principles guiding intergenerational transmission of wealth, and individual differences in views on inheritance.1 Australian succession law is based upon English common law, starting with the presumption of testamentary freedom, which allows a testator to dispose of their estate as they see fit. However, this freedom can be limited by family provision laws that allow 'eligible applicants' to contest distributions on the basis of insufficient provision in accordance with legislation of the particular State or Territory. Hence, the legal framework represents a balance between testamentary freedom and familial obligation. Internationally there are significant cultural and legal differences in the degree of will-makers' testamentary freedom.

Differences in Family Planning Services by Rural–urban Geography: Survey of Title X–Supported Clinics In Great Plains and Midwestern States

Understanding the nature of rural-urban variation in U.S. family planning services would help address disparities in unmet contraceptive need. In 2012, some 558 Title X-supported clinics in 16 Great Plains and Midwestern states were surveyed. Rural-urban commuting area (RUCA) codes were used to categorize clinic locations as urban, large rural city, small rural town or isolated small rural town. Bivariate analyses examined key domains of service provision by RUCA category and clinic type. The proportion of clinics offering walk-in appointments was lower in isolated small rural towns (47%) than in the other RUCA categories (67-73%). Results were similar for sites that do not specialize in family planning or reproductive health, but no variation was seen among specialty clinics. Overall, availability of evening or weekend appointments varied in a linear fashion, falling from 73% in urban areas to 29% in isolated small rural towns. On-site provision of most hormonal methods was most common in urban areas and least common in isolated small rural towns, while provision of nonhormonal methods was similar across RUCA categories. Sixty percent of clinics provided IUDs or implants. For clinics that did not, the only barriers that varied geographically were low IUD demand and lack of trained IUD providers; these barriers were most common in isolated rural towns (42% and 70%, respectively). While important characteristics, such as clinics' specialization (or lack thereof), are linked to the provision of family planning services, geographic disparities exist.

The Relationship between Intimate Partner Violence and Family Planning among Girls and Young Women in the Philippines.

This study explored the relationship between intimate partner violence (IPV) and family planning among adolescent girls and young women in formal unions in the Philippines. Analyzing a sample (n =1,566) from the 2013 Philippines Demographic and Health Survey, logistic regression models were separately run for current contraception use and unmet need for family planning on recent physical violence (yes/no), recent sexual violence (yes/no), and recent emotional (yes/no). Findings revealed that the odds of using contraception were significantly higher among girls and young women who reported recent physical IPV (OR=1.84; 95% CI=1.13, 2.99; p<0.05) and sexual IPV (OR=2.18; 95% CI=1.17, 4.06; p<0.05). No significant relationship between recent emotional IPV and contraception use was found. Having an unmet need for family planning showed no significant relationship to IPV. The study adds to a growing body of literature revealing a positive association between IPV and contraception use. Findings hold implications for the provision of family planning services for adolescents and young women in response to the recent passage of landmark legislation pertaining to reproductive health in the Philippines, the Responsible Parenthood and Reproductive Health Act.

Closing the gap in family leisure provision: giving leisure facility managers the opportunity to reflect on what they provide for families

The research literature on family leisure has been dominated by the views of participants in family leisure activities, so the purpose of this study was to give leisure facility managers an opportunity to reflect on the issue of family leisure from a provider perspective to address the imbalance. Leisure facility managers operating in different areas of leisure provision play a pivotal role in enacting leisure policy into a range of leisure programmes and activities for families. Their opinions and knowledge concerning family leisure needs are significant, as they help shape and determine the nature of family leisure provision in the facilities they manage. The literature review on which this study is based identified five key areas of research in family leisure (concept of leisure, constraints, parenting, work–life balance and dualities of family leisure). As a result of the interviews with leisure facility managers, six key themes emerged (concept, constraints, empathy, customers/community, family friendly and design). In concluding, suggestions are made based on the feedback given by leisure facility managers to effect change and enhance leisure provision for families and recommendations for new avenues of research in family leisure are given.

Comparative assessment of modern contraceptives knowledge and utilization among women in urban and rural communities of Sokoto State, Nigeria

Although, the effectiveness of contra ception in reversing the high fertility rate that undergirds the high maternal mortality ratio in many developing countries of the world has been demonstrated in several studies, ironically, the contraceptive prevalence rate remains low in these countries. This study was conducted to assess modern contraceptives’ knowledg e and utilization among women in Sokoto State, Nigeria. A comparative cross sectional descriptive study among 401 women (rural 202, urban 199) selected by multistage sampling technique was conducted in the months of January and February 2010. Informed consent was obtained and information wa s collected using a pretested semi-structured questionnaire, data analysis was done using com puter software, SPSS versi on 20. Although awareness of family planning services was high (rural 88.1%, urban 94.5%), knowledge of modern contraceptives was poor (rural 12.9%, urban 28.6%). Respondents with formal education were four times more likely to have good knowledge of modern contraceptive methods as compared to those with no formal education (aOR = 4.119, p < 0.001, 95% CI = 2.333 – 7.274). Current use of modern contraceptives was correspondingly low (rural 5.0%, urban 22.6%). Respondents resident in urban communities were twice likely to use modern contraceptives as compared to those in rural communities (aOR= 2.116, p = 0.029, 95%CI = 1.080 – 4.148). This study demonstrated poor knowledge and utilization of modern contraceptives among women in Sokoto State, Nigeria. These findings suggest the need for intensification of health education on family planning across the populations, girl child education and women empowerment to enable them make informed choices in issues regarding family planning, and equitable provision of family planning services in both urban and rural communities of the State.

Barriers to Contraceptive Use Among Child Bearing Women in Ambo Town, West Shewa Zone, Oromia Regional State, Ethiopia

Background: Contraception is a technique to prevent a conception; its usage is a central element of quality care in the provision of family planning services and an important dimension of women’s reproductive rights. Barriers to use contraceptive is the factor that increase the likely hood of adverse mothers’ sexual and reproductive health consequence such as unwanted pregnancy or poorly timed pregnancy, unsafe abortion, maternal death and others. The objective of this study was to determine the barriers of contraceptive use among child bearing women living in Ambo town, West Shewa zone, Oromia Regional state, Ethiopia. Methodology: The study was conducted in Ambo town from February to March, 2015 G.C. Cross sectional study design was used& Participants were selected using systematic random sampling method. Data was collected by using structured questionnaires through face to face interviews & coded, entered and analyzed using EPI- INFO Version 3.5.1. The analyzed data was presented by using tables and graphs. Result: Forty percent of the respondents were using at least one contraceptive methods; injectable (58.8%) was the most used ones. Fear of side effect (25.8%) and desire to have a children were the most mentioned barrier for non-use. Multiple logistic regression model revealed that Educational status of mother (AOR 7.3, 95% CI: 3.22-16.6), and husband educational status (AOR 4.9, 95% CI: 1.4-16.9), religious influence (AOR 9.15, 95% CI: 1.75-46.9) and marital status (AOR: 1.95, 95% CI: 1.12-3.42) were positively associated with the use of contraceptives. Conclusion and recommendation: Contraceptive use rate was low. Therefore, the community should be encouraged to continue and use contraceptive so as to space family size and also leaders of religions to be involved in the education of the community to use contraceptive.

CONFIGURING A FAMILY FRIENDLY INPATIENT SETTING

The hospital facilities are not structures designed just to accommodate clinical functions and facilities, however they are combination of organized systems working together to meet other diverse functional requirements within the hospital complex. For the hospital to meet the requirements of such wide range of issues, attention has to be paid to each and every component making the hospital whole from the early stages of the design process, especially user needs and preferences. Among the patient’s needs is social support from family. Family presence and participation in caring for their relatives have been identified to have significant impact on restoration, however little or no consideration is given for their accommodation. This study is aimed at exploring the space-activity patterns of familial caregiving activities in a hospital ward spaces that will guide design process. Principles of behavioural mapping was employed in male and female wards of one of the tertiary hospitals in Nigeria. Findings shows that four major spaces within the ward setting where such activities are dominant. Thus proper planning and configuration of such spaces with provision for family will go a long way in promoting and encouraging their presence and participation that will consequently improve restoration.

Young children shaping interprofessional practice in early years settings: Towards a conceptual framework for understanding experiences and participation

Abstract The value of interprofessional service provision for children and families has had widespread support internationally. However, researchers have called for greater focus on service users' experiences to inform future development. Nonetheless, young children's experiences of such practice in early years settings are under researched. Drawing on findings from a study of interprofessional practice from the perspectives of five young children with additional needs, this article suggests a theoretical and methodological conceptual framework as a guide to understanding how children participate in and shape integrated service provision. The stance is framed by social practice theory, whereby our everyday practice draws on, challenges and is constrained by history, context and relationships. Shotter's ( 2008 ) work revealing meaning-making in conversational exchanges and Dreier's conceptualisation of trajectories of participation (2003, 2008) guided the analyses of digital video recordings of children's participation in interprofessional practice in early years settings. Findings showed young children shaping the nature of provision. The theoretical constructs and methods revealed the otherwise hidden dialogic nature of interprofessional practice, highlighting children's influence on elements of fine-grained expert practice. Careful attention to children's perspectives, revealed through analysis of their multimodal voices, contributes to settings' capacity for planning, modifying and evaluating effective integrated working.

Satisfaction With Communication Using Remote Face-to-Face Language Interpretation Services With Spanish-Speaking Parents: A Pilot Study

Effective communication in clinical encounters is dependent upon the exchange of accurate information between clinician and patient and the use of interpersonal skills that foster development of the patient-provider relationship and demonstrate understanding of the patient's social and cultural background. These skills are of critical importance in the diagnosis and management of hearing loss in children of Spanish-speaking families. While the provision of family friendly, culturally sensitive services to families of children with hearing loss can be challenging for audiologists and speech-language pathologists, the quality and satisfaction of these services is widely recognized as the cornerstone of patient satisfaction and improved outcomes. The purpose of this pilot study was to explore patient, audiologist, and interpreter satisfaction of the use of remote face-to-face language interpretation technologies in the context of audiology services. Parent participants rated each session regarding satisfaction with the communication exchange, audiology services, and the interpreting experience. Audiologists rated their satisfaction with the communication exchange, relationship with the parent, and experience with the interpreter. Interpreters rated their satisfaction with the logistics regarding the appointment, information exchange, and experience in working with the audiologist. Audiologists and interpreters were asked to identify what worked well and what challenges needed to be addressed. Data from this pilot study can be used to guide future efforts in providing high quality language interpretation services to Spanish-speaking families of young children who are at risk for or have been diagnosed with hearing loss.

Prevalence and correlates of contraceptive use among female adolescents in Ghana

BackgroundAdolescence is a critical stage in the life course and evidence suggests that even though contraceptive use has been steadily increasing among women in Ghana over the past years, contraceptive prevalence and determinants among female adolescents is quite lacking. This paper examines the prevalence and correlates of contraceptive use among female adolescents in Ghana.MethodsThe paper used data from the 2008 Ghana Demographic and Health survey. Bivariate analysis was carried out to determine the contraceptive prevalence among female adolescents while logistic regression analysis was applied to examine the correlates of female adolescent contraceptive use.ResultsThe study founded that female adolescent contraceptive use was significantly determined by age of adolescent, education, work status, knowledge of ovulatory cycle, visit of health facility and marital status.ConclusionsThis has implications for adolescent sexual and reproductive health programmes in Ghana. It is therefore essential to intensify girl child education and strengthen the provision of family planning information and services for female adolescents in the country.

High prevalence of unwanted pregnancies and induced abortions among HIV-infected women from Western India: need to emphasize dual method use?

This study examines the prevalence, reasons, and predictors of unwanted pregnancies and induced abortions among ever married HIV-infected women attending a care facility in Maharashtra, Western India, and discusses its programmatic and policy implications. Retrospectively collected data of pregnancies conceived after the diagnosis of HIV were analyzed using descriptive and logistic regression techniques. Among the 622 women interviewed, 113 women had 158 pregnancies with known outcomes after HIV diagnosis. Among these pregnancies, 80 (51%) were unwanted and 79 (50%) were voluntarily terminated. Fear of transmitting HIV to the child was a frequently mentioned reason for an unwanted pregnancy (71.8%) and induced abortion (59.5%). Women from urban areas [OR 2.43 (95% CI 1.23–4.79)] and with two or more live births before HIV diagnosis [OR 3.33 (95% CI 1.36–8.20)] were significantly more likely to report an unwanted pregnancy. Women with two or more live births before HIV diagnosis [OR 3.16 (95% CI 1.20–8.35)], who did not know that HIV transmission to the baby can be prevented [OR 3.29 (95% CI 1.48–7.34)] and with an unwanted pregnancy [OR 4.82 (95% CI 2.33–10.00)], were significantly more likely to terminate the pregnancy. Despite increased coverage of antiretroviral treatment, effective provision of reproductive healthcare services to HIV-infected women remains challenging. A high prevalence of unwanted pregnancies and induced abortions and a low level of knowledge about prevention of mother to child transmission (PMTCT) underscore the need for preconception counseling and provision of comprehensive family planning services to HIV-infected women. Enrolling all HIV-infected pregnant women, irrespective of their decision to continue with their pregnancy, in the PMTCT program and discussing with HIV-infected women and their partners at HIV diagnosis a full array of contraceptive methods and not just consistent use of condoms might be helpful in reducing unwanted pregnancies.

Developing Federal Clinical Care Recommendations for Women.

The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S.

EFFECTS OF A CHANGING ORGANIZATIONAL ECOLOGY ON RACIAL DISPARITIES IN INFANT MORTALITY

For a seven‐year period, the disparity in birth outcomes between Blacks and non‐Hispanic Whites in one Wisconsin county closed for reasons not epidemiologically explainable. Examination of the ecology of organizations offered promise for considering the environmental factors influencing African American mothers and birth outcomes during this time. Qualitative analysis of interview data from representatives of health, social service, and advocacy organizations in the county focused on three themes: organizational and network change, organizational philosophies and orientations, and organizational coordination and competition. Results suggest that organizations collaborated variably during this time as adaptations to a changing ecology of funding, political influence, and dominant philosophical orientations. Peak levels of organizational collaborations fostered systems‐level orientations to relational, community‐centered work and coordinated, holistic service provision for underserved mothers and families. Ecological factors promoting collaboration among organizations, and the development of an interorganizational collaborative in particular, influenced further system changes with implications for birth outcomes. Additional analyses discuss systems‐level implications for interorganizational endeavors from the lens of organizational ecology.

Health professional and family perceptions of post-stroke information

Introduction and BackgroundThe global burden of stroke is increasing. Despite a decrease over past twenty years in stroke mortality rates there is an increase in terms of absolute number of people affected every year (Feigin et al., 2014). There are an estimated 60,000 stroke survivors in New Zealand, many of whom live with impairment and need significant daily support (Stroke Foundation of New Zealand, 2015). Stroke can have negative consequences on health, wellbeing and quality of life of both stroke survivor and their extended family (Ellis, Grubaugh, & Egede, 2013; Yu, Hu, Efird, & McCoy, 2013). Care and support needs are variable, can be complex and are dependent on severity, origin and location of cerebral trauma, timeperiod post-stroke, socioeconomic variables and ethnicity (Cecil, Thompson, Parahoo, & McCaughan, 2013; Harwood et al., 2012a, 2012b; Moloczij, 2009). Nurses play a pivotal role in stroke care and management across all phases of stroke trajectory and, along with other health professionals, can help alleviate stresses experienced by families caring for their whanau member who is a stroke survivor (Cecil et al., 2013). There is strong evidence for efficacy of a co-ordinated multidisciplinary team (MDT) approach to stroke care (Clarke, 2013). Core members of a MDT in stroke care include nurses (often stroke nurse specialists), stroke physicians, physiotherapists (PTs), occupational therapist (OTs), speech language therapists (SLTs) and therapy assistants (trained to support PTs and OTs). Multidisciplinary teams may also include social workers, needs assessors, and community-based support workers such as Community Stroke Advisors (CSAs) from Stroke Foundation of New Zealand. Trained CSAs assist stroke survivors and their families with any stroke-related problems. They make hospital and home visits, support families and can advise on accessing carer-relief services and funding. Some MDTs include stroke cocoordinators (usually a nurse, PT or OT) within team whose role is to co-ordinate in-patient rehabilitation and services for patients and their families post-stroke. At participating DHB for this study these stroke coordinators are known as key workers.The importa nee of information and education provision, alongside right support, for stroke survivors and their families is well documented (Cameron & Gignac, 2008; Cameron, Naglie, Silver, & Gignac, 2013; Draper & Brocklehurst, 2007; Eames, Hoffmann, Worrall, & Read, 2010; Larson et al., 2005; Temize & Gozum, 2012; Wallengren, Segesten, & Friberg, 2010; Wright et al., 2012). A recent Cochrane review (Forster et al., 2012) showed that information provision for stroke survivors and families improved their knowledge of stroke and aspects of patient satisfaction. A reduction In depression scores was also noted. Three Cochrane reviews (Forster et al., 2012; Forster et al., 2001; Smith, Forster, & Young, 2009) have concluded that while there is evidence that provision of information is beneficial the best way to provide information is still not clear (Forster et al., 2012, p. 16).Despite what is known about information provision post-stroke, stroke survivors and their families continue to report a lack of knowledge and difficulty In accessing it (Perry & Middleton, 2011) and feel unprepared for scope and scale of life changes and life after discharge from hospital (Forster et al., 2012; Perry & Middleton, 2011).Research DesignAimThe mixed methods descriptive survey was to ascertain information and education needs of families of those who experience a stroke (stroke survivors) through identifying current practice and resources, and appropriateness, accessibility, method of delivery, timeliness and gaps in education and information giving. Specifically, we wanted to know:What information and resources were provided to/received by families across care continuum? …

The Role of Federally Qualified Health Centers in Delivering Family Planning Services to Adolescents

PurposeThe purpose of this article was to examine the role of community health centers (CHCs) in providing comprehensive family planning services to adolescents, looking at the range of services offered and factors associated with provision of these services. MethodsThis study employed a mixed methods approach comprising a national survey of CHCs and six in-depth case studies of health centers to examine the organization and delivery of family planning services. We developed an adolescent family planning index comprising nine family planning services specifically tailored to adolescents. We analyzed the influence of state-level family planning policies, funding for adolescents, and organizational characteristics on the provision of these services in CHCs. The case studies identified barriers to the provision of family planning to adolescent patients. ResultsThe survey found substantial variation in the provision of family planning services at CHCs, with a mean of 6.33 out of a maximum score of 13 on the family planning adolescent services index. Title X funding and location within a favorable state policy environment were significantly associated with higher scores on the family planning adolescent services index (p value < .001 and .002, respectively). Case studies revealed barriers to adolescent family planning, including lack of funding, lack of knowledge, and limitations on school-based clinical services. ConclusionsCHCs have the opportunity to play a significant role in providing high-quality family planning to low-income, medically underserved adolescents. Additional funding, resources, and a favorable policy climate would further improve CHCs' ability to serve the family planning needs of this special patient population.

Do Hospital Web Sites Describe Available and Institutionally Restricted Family Planning Options? [188

INTRODUCTION: Women face institutional restrictions related to the provision of family planning care at Catholic hospitals. We sought to determine whether hospitals (Catholic and non-Catholic) comprehensively describe available family planning options on their web sites. METHODS: We reviewed websites of 39 Catholic hospitals and 39 non-Catholic hospitals from the 25 largest health care systems in 2011. We searched for women's health care services and family planning options. We specifically compared whether Catholic hospitals identified the provision of natural family planning care and non-Catholic hospitals identified the provision of at least one short- or long-term contraceptive option. RESULTS: More than 90% of all web sites examined identified provision of women's health services, prenatal and maternity care, and mammography and 58% identified the provision of robotic hysterectomy. Catholic hospitals were less likely to identify the provision of natural family planning when compared with non-Catholic hospitals that identified the provision of contraceptive options (23.1% compared with 53.8%, P<.01). Five Catholic hospitals (13%) identified the provision of at least one short- or long-term contraceptive option. None of the Catholic hospitals explicitly stated that other contraceptive options were not offered. IMPLICATION: Current hospital web sites do not sufficiently detail available contraceptive options, and Catholic hospitals do not detail restrictions to family planning care. The omission of available care options limits women's ability to act as well-informed consumers of health care.