Community Mothers Research Articles

The Effect Of Parenting Training Strategies And Education Levels On Mother's Communication Ability

The purpose of this study was to determine the effect of parenting training strategies and level of education on mother’s communication ability to children aged 4-5 years. The study used an experimental method with a 2x2 factorial design. The study sample was 34 mothers who had early childhood in DKI Jakarta Non-Formal Early Childhood Education. Parenting strategies for Problem Based Learning (PBL) and Experiential Learning (EL) training were carried out eight times in 90 minutes each meeting for two months. Higher education level that is high school. Low levels of education are the junior and elementary school. The results showed that the communication ability of parenting trainees in PBL strategies were higher than those of EL parenting strategy participants. There was an interaction effect between parenting training strategies and education level on mother’s communication ability. Communication ability of highly educated mothers were better through parenting PBL strategies and communication ability of low-educated mothers are better if they take part in EL parenting training. This study suggests that choice of a parenting training strategy needs to be adjusted to the level of education to produce good communication ability.

EFFECTIVENESS OF HEALTH EDUCATION AMONG MOTHERS TO REDUCE UNINTENTIONAL HOME INJURIES OF UNDER-FIVE YEAR OLD CHILDREN IN RURAL COMMUNITY

Background: Unintentional home injuries among under five year old children in rural community is a common issue which lead serious health problems and increase disability rate in children under five year of age. The aim of study was to assess the effectiveness of health education among mothers to reduce unintentional home injuries of under-five year old children in rural community. Methods: A study design was quasi experimental, one group pre and post test design was used and data was collected at Ali Raza Abad community, Raiwand Road Lahore. Convenient sampling technique was used. Sample size was 71 community mothers who have children under 5- year of age with age group 18 years to 45 years. Data was collected by administering knowledge and practice questionnaire before and after the health education programme. The post data was collected after four week intervention after pre data collection. Results: The current study shows that the overall mean score of pre-test is .4907 and overall mean score of post-test knowledge was .8422. The overall mean score of pretest was .4930 and overall mean score of post-test practice was .8003. These results show that health education is effective to enhance the knowledge and safety practice of mothers. Conclusion: Based on the findings of this study, it concluded that health education is so effective to bring significant change in knowledge and practice among mothers of under under-five year of old children.

Validation of the Inventaire du Milieu Familial Questionnaire (French version of the Infant/Toddler Home) into the Brazilian Portuguese language

ObjectiveTo validate the Brazilian Portuguese version of the Family Environment Assessment questionnaire (Inventaire du Milieu Familial). MethodsThe validation process was carried out in two stages. First, translation and back‐translation were performed, and in the second phase, the questionnaire was applied in 72 families of children between 0 and 24 months for the validation process. The tool consists of the following domains: mother's communication ability; behavior; organization of the physical and temporal environment; collection/quantity of toys; maternal attitude of constant attention toward her baby; diversification of stimuli; baby's behavior. The following was performed for the scale validation: 1 – content analysis (judgment); 2 – construct analysis (factorial analysis – Kaiser‐Meyer‐Olkin, Bartlett, and Pearson's correlation tests); 3 – criterion analysis (calculation of Cronbach's alpha coefficient, intraclass correlations, and split‐half correlations). ResultsThe mean age of the children was 9±6.7 months, and of these, 35 (48.6%) were males. Most correlations between items and domains were significant. In the factorial analysis of the scale, Kaiser‐Meyer‐Olkin values were 0.76, Bartlett's test showed a p‐value<0.001, and correlation between items and domains showed a p‐value<0.01. Regarding the validity, Cronbach's alpha was 0.92 (95% CI: 0.89–0.94). The intraclass correlation among the evaluators was 0.97 (0.96–0.98) and split‐half correlations, r: 0.60, with p<0.01. ConclusionsThe Portuguese version of the Inventaire du Milieu Familial showed good to excellent performance regarding the assessed psychometric properties.

Long-term sequelae of mothers' and fathers' mind-mindedness in infancy: A developmental path to children's attachment at age 10.

Rapidly growing research on parental mind-mindedness, a tendency to treat one's young child as a psychological agent and an individual with a mind, internal mental states, and emotions, has demonstrated significant links among parents' mind-mindedness, their parenting, and multiple aspects of children's development. This prospective longitudinal study of 102 community mothers, fathers, and infants, followed from 7 months to 10 years, contributes to research on mind-mindedness by addressing several existing gaps and limitations. We examine mechanisms that account for associations between parents' early mind-mindedness and children's future attachment security, using robust behavioral measures. Teams of trained observers coded parents' mind-minded comments to their infants at 7 months during naturalistic interactions, parents' responsiveness in naturalistic interactions and in elicited imitation tasks at 15 months, and children's security, using Attachment Q-Set at 2 years and Iowa Attachment Behavioral Coding at 10 years. Sequential mediation analyses supported a model of a developmental path from parents' appropriate mind-minded comments in infancy to children's security at age 10. For mothers and children, the path was mediated first through responsiveness at 15 months and then security at 2 years. For fathers and children, the path was mediated through attachment security at 2 years. Parents' nonattuned mind-minded comments had no effects on responsiveness or security. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Políticas públicas educacionais contraditórias: a alfabetização em foco

In this article, contradictions between public policies that cover literacy, particularly between the National Education Plan – PNE and the National Curricular Common Base – BNCC are address. It is emphasizing the importance of the literacy as a support so that the citizen can fully develop, exercise citizenship and qualify for work. It is evident that the PNE establishes that the children's literacy must occur by the end of the 3rd year of Elementary School – EF, while the BNCC determines that students must be literate by the 2nd year of the EF. This disconnection demonstrates a conflict between legal norms that are hierarchically different, because the PNE is a Law, while the BNCC is a Resolution. Finally, it is emphasized that literacy continues as one of the serious problems of Brazilian education and that its resolution passes, in large part, by the effective work of the school community (management teams, teachers, students, fathers and mothers, etc.) in the schools.

Integrating reproductive and child health services enables access to modern contraception in Sierra Leone.

From mid-2015, reproductive and child health interventions were integrated into a routine 6-month contact point: vitamin A supplementation, nutrition counseling with the mother's participation in the preparation of a complementary food, and confidential family planning counseling with provision of modern forms of contraceptives. By mid-2017, these services had reached 28% of health facilities nationwide. To evaluate awareness and uptake of modern contraception and complementary feeding practices. All health facilities were visited, and the health worker "in-charge" were interviewed to ascertain their training status and supply chains. Within each catchment, community mothers of children 6 to 23months of age were interviewed. Interviews were conducted with 321 "in-charges" and 670 mothers. Advantages and different types of contraception were understood by 99.0% of mothers, and 52.7% reported they were utilizing depot injections, hormonal implants, or oral contraceptive pills (45.1%, 34.6%, and 20.6% of users, respectively). Uptake was higher among Christians (62.1%) versus Muslims (48.6%) and among those with secondary/tertiary (61.5%) or primary education (60.5%) versus no education (43.3%) (P<0.005 and P<0.05, respectively). Complementary feeding practices included minimal meal diversity, 49.2% (fed three or more of six food groups), and recommended minimal meal frequency appropriate for age, 52.6%. Health workers reported frequent stockouts of vitamin A capsules (8%), male condoms (1%), oral contraceptives (10%), depot injections (20%), and hormonal implants (30%). In communities served by these integrated services, awareness and uptake of modern contraception exceeded national targets despite weak supply chains, and complementary feeding practices were favorable compared with the national survey.

Validation of the Maternal Identity Scale for Primiparous Thai Teenage Mothers

PurposeThe Maternal Role Attainment Scale Form B (MRAS-Form B) was developed based on Mercer's theory and widely used to assess maternal role attainment among Thai mothers in hospitals. To assess the maternal identity among primiparous adolescent mothers in communities, MRAS-Form B remains indistinguishable due to differences in both mothers' ages and circumstances and was modified to the Maternal Identity Scale (MIS). Therefore, the aim of this study was to examine the validity and reliability of the MIS. MethodsA cross-sectional study was conducted among 397 primiparous Thai teenagers residing with their infants aged 4–12 months. Data were collected using self-administered questionnaires. Confirmatory factor analysis was performed to confirm the construct validity using Mplus Software. ResultsThe overall model provided fit well to the empirical data (χ2/df = 2.23, comparative fit index = .93, Tucker–Lewis index = .92, root mean square error of approximation = .06, standardized root mean square residual = .05). About 33–66% of the variance among MIS items could be explained by three constructs of maternal identity. Convergent validity showed item loadings ranging from .58 to .81; in addition, average variance extracted and composite reliability ranged from .44 to .54 and .82 to .92, respectively. Discriminant validity correlations between constructs were ranging from .74 to .87. The MIS exhibited very good item discrimination values (.52 ≤ corrected item-total correlation ≤.70) and an excellent reliability (Cronbach's α = .95). ConclusionAppropriately for community health nursing, the MIS was a valid and reliable tool, assessing maternal identity among primiparous teenage mothers one year after delivery.

Adapting the 2015 Mother-Baby Friendly Birth Facility Guidelines for Semi-nomadic Pastoralist Communities in Laikipia and Samburu Counties of Kenya.

Purpose To adapt the 2015 International Federation of Gynecologists and Obstetricians (FIGO), International Confederation of Midwives (ICM), White Ribbon Alliance (WRA), International Pediatric Association (IPA), and WHO auspiced Guidelines on Mother-Baby Friendly Facilities to a particular sub-population; seminomadic pastoralist communities of Laikipia and Samburu Counties, Kenya. We anticipate an increased utilization of childbirth services by improving their acceptability. Description We drafted a Pastoralist Friendly Birthing Facility Checklist based on the FIGO/ICM/WRA/IPA/WHO guidelines and previous research in this context. We employed mixed methods to finalise the adaptation: a workshop with 27 local stakeholders; interviews with ten health planners and skilled birth attendants (SBAs); and ten focus group discussions (FGDs) with health committee members, community health workers, mothers and traditional birth attendants (TBAs). A facility audit of dispensaries across five group ranches was also undertaken. Assessment The final Checklist was divided into: characteristics of care and the environment; care during labour and birth; post-partum care; and community staff relationships. It was endorsed by the Ministries of Health in the relevant counties, and by women, SBAs and TBAs. No facility currently satisfies all the criteria specified in the Checklist. Conclusion The FIGO/ICM/WRA/IPA/WHO Guidelines were successfully adapted and can be used to ensure health facilities meet the needs of pastoralist women.

Human milk sIgA antibody in relation to maternal nutrition and infant vulnerability in northern Kenya.

BackgroundThe maternal buffering hypothesis posits that human lactation biology can buffer milk against the mild-to-moderate malnutrition that occurred routinely in evolutionary history through the mobilization of maternal body reserves. This perspective may provide insights for understanding human milk immune content variation, such as milk sIgA, which protects infants’ intestines from microbial colonization and prevents diarrheal disease.ObjectiveTo investigate how maternal delivery of sIgA to milk may vary in a way that can buffer milk against maternal malnutrition, while taking into consideration infants’ varying needs for immune protection across age or by sex.MethodologyA cross-sectional study analyzed archived milk specimens from breastfeeding mothers in Ariaal communities of northern Kenya surveyed during the 2006 Horn-of-Africa drought. Multiple regression models for ln-transformed sIgA were constructed using maternal nutrition, infant age/sex and their interactions as predictors. Maternal nutrition variables included iron-deficiency anemia (IDA), vitamin A deficiency (VAD) and mid-upper arm circumference (MUAC). Infant vulnerability was considered high in young age and/or male sex.Results and implicationsMilk sIgA did not significantly differ by maternal IDA. Milk sIgA increased with infant age and maternal MUAC (n = 202). Significant interactions were observed between infant age and maternal VAD and between infant sex and maternal MUAC, such that milk sIgA content was low for younger infants particularly among VAD mothers, while among mothers with low MUAC, sIgA was lower for male infants. Results imply that mothers’ ability to deliver/buffer milk sIgA may be lowered when nutritional stress is combined with high infant vulnerability to infection.Lay SummaryHuman milk sIgA antibody content was low for younger infants among vitamin A deficient mothers. Among mothers with small arm-circumference, milk sIgA was lower for sons. Double burden of raising young or male infants with high needs for immune protection and being malnourished, might lower maternal sIgA delivery to milk.

Evidence for childhood origins of conscientiousness: Testing a developmental path from toddler age to adolescence.

We tested empirically a theoretical model of early origins of conscientiousness proposed by Eisenberg, Duckworth, Spinrad, and Valiente (2014). The model posited a developmental interplay between children's early effortful control (EC) and internalized or committed compliance with parents as leading to future conscientiousness. We followed a community sample of 102 community mothers, fathers, and children from toddlerhood to adolescence. Observers coded children's EC in batteries of behavioral tasks (at ages 2 and 3) and committed compliance in lengthy discipline interactions with each parent, observed from preschool to early school age (at ages 4.5, 5.5, and 6.5). Parents rated adolescents' conscientiousness using an established personality questionnaire (at age 14). We supported several components of the theoretical model. Mediation analyses, conducted at the family level (across mother-child and father-child dyads) and separate analyses for mother-child and father-child dyads all supported the mediated path, from child EC to committed compliance to conscientiousness. Analyses for mother-child dyads additionally revealed that the indirect effect was present only for children with relatively low EC scores but not those with relatively high EC scores (moderated mediation), also as anticipated in the theoretical model. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effectiveness of Health Education Among Mothers to Reduce Unintentional Home Injuries of Under- Five Year Old Children in Rural Community

Background: Unintentional home injuries are common in children. Unintentional home injuries are main causes of disability, morbidity and mortality in children, results show that every year 630,000 children died due to unintentional home injuries. Unintentional injuries occur in homes due to lack of awareness and due to improper knowledge, attitude and lifestyle of primary caregiver in homes. Aim of study: The aim of study was to assess the effectiveness of health education among mothers to reduce unintentional home injuries of under-five year old children in rural community. Method: A study design was quasi experimental, one group pre and post test design was used and data was collected at Ali Raza Abad community, Raiwand Road Lahore. Convenient sampling technique was used. Sample size was 71 community mothers who have children under 5- year of age with age group 18 to 45 years. Data was collected by administering knowledge and practice questionnaire before and after the health education programme. Results: The current study shows that the overall mean score of pretest is .4907 and overall mean score of post-test knowledge was .8422. The overall mean score of pretest was .4930 and overall mean score of post-test practice was .8003. These results show that health education is effective to enhance the knowledge and safety practice of mothers. Conclusion: Unintentional home injuries are commonly occur in children and unintentional home injury is also a global health issue in communities. Health education is very important to enhance the general knowledge and safety practice of mothers toward home injuries. On community level health education program is effective to improve the knowledge and safety practice of mother. Keywords: Effectiveness, Health Education, Mothers and Under Five – year old Children, Rural Community. DOI : 10.7176/JHMN/58-03

Estrategia educativa en el reconocimiento de signos de alarma respiratorios por parte de madres comunitarias del programa Familia, Mujer e Infancia del ICBF

Objetivo: identificar el nivel de conocimiento antes y después de una estrategia educativa en el reconocimiento de signos de alarma respiratorios por parte de madres comunitarias del programa Familia, Mujer e Infancia, del Instituto Colombiano de Bienestar Familiar, entre los meses de junio y julio del 2017. Materiales y Método: cuantitativa, cuasi experimental, con preprueba y posprueba. Estrategia educativa extracurricular, de tipo participativa, dirigida a madres comunitarias del programa Familia Mujer e Infancia en el reconocimiento de los signos de alarma respiratorios. Una Muestra de 33 madres comunitarias pertenecientes a la sede Norte. Se creó una base de datos, analizada en el formato SPSS versión 20, sometida a revisión, validación y consistencia de datos. Los instrumentos de medición, fueron validados en una prueba piloto que contaban con las mismas características de la población de estudio. Resultados: se encontró que existe una diferencia significativa después de aplicar la estrategia educativa, el nivel de conocimiento fue medido a través de un cuestionario que evalúa el nivel de conocimiento en signos de alarma respiratorios, encontrando una diferencia de media de 2,03 entre la preprueba y el posprueba, un intervalo de confianza del 95% (0,81- 3,92) y un valor de P 0,004. Conclusiones: los programas educativos en salud se convierten en la estrategia perfecta para minimizar complicaciones asociadas al desconocimiento de las buenas prácticas de cuidado en el individuo, especialmente cuando el cuidado se desarrolla en población de la primera infancia.

Factors associated with social support in child-rearing among mothers in post-disaster communities

BackgroundNatural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed.MethodsAn anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined.ResultsWe analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03–3.44) and 2.84 (95% CI 1.46–5.52) compared with mothers who did not have any pre-disaster acquaintances.ConclusionsFactors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.

Nuestras Historias- Designing a novel digital story intervention through participatory methods to improve maternal and child health in the Peruvian Amazon.

BackgroundIn rural areas of the Loreto region within the Peruvian Amazon, maternal mortality rate is above the national average and the majority of women deliver at home without care from a trained health care provider.MethodsTo develop community-tailored videos that could be used for future interventions, we conducted Photovoice and digital storytelling workshops with community health workers (CHW) and mothers from 13 rural communities in the Parinari district. Through Photovoice we recognized local barriers to healthy pregnancies. Participants (n = 28) were trained in basic photography skills and ethics. They captured photos representing perceived pregnancy-related road-blocks and supports, and these photos identified central themes. Participants recorded personal stories and “storyboarded” to develop digital stories around these themes, and a Digital Story Curriculum called Nuestras Historias (Our Stories), was created. An acceptability survey of the digital stories was then conducted including 47 men (M) and 60 women (F).ResultsAccording to the PhotoVoice workshops, pregnancy-related problems included: lack of partner support, domestic violence, early pregnancies, difficulty attending prenatal appointments, and complications during pregnancy and delivery. Over 30 stories on these themes were recorded. Seven were selected based on clarity, thematic relevance, and narrative quality and were edited by a professional filmmaker. The acceptability survey showed that local participants found the digital stories novel (M = 89.4%, F = 83.3%), relatable (M = 89.4%, F = 93.2%), educational (M = 91.5%, F = 93.3%) and shareable (M = 100%, F = 100%). Over 90% of respondents rated the digital stories as “Excellent” or “Good”, found the videos “Useful” and considered them “Relevant” to their communities.ConclusionsThe digital stories address community-specific problems through narrative persuasion using local voices and photography. This combination had a high acceptability among the target population and can serve as a model for developing educational strategies in a community-tailored manner. This package of seven videos will be further evaluated through a cluster randomized trial.

Quantifying the excess risk of infant mortality based on race/ethnicity at the county level to inform Michigan's home visiting outreach plans.

ObjectiveMichigan’s infant mortality rate is consistently higher than the national rate, with persistent and significant racial/ethnic disparities. In Michigan, nine counties account for more than 80% of all infant deaths. A home visiting program serving low-income, first-time mothers in high-risk communities is one strategy to reduce infant mortality. The objective of this study was to quantify the risk of infant mortality based on race/ethnicity within Michigan’s highest-risk counties to guide outreach for home visiting services in these counties.MethodsTo maximize the efficiency of limited resources and to identify women at highest risk, we used decomposition to develop risk-based, county-specific estimates of excess infant deaths in nine Michigan counties using data from the 2007 to 2009 Michigan resident infant death file linked to the live birth/file.ResultsThe sample size for these counties was 200,610 live births and 1,836 infant deaths and for the reference population it was 195,180 live births and 1,133 infant deaths The study found that excess mortality varies among populations at the county level when compared to the reference population of infants born to Michigan mothers who attained more than a high school education and were at least 20 years of age at the infant’s birth. The excess risk of mortality was highest for African American infants in seven of the nine counties (56.5% to 132.8%) and for Hispanic infants (86.6%) and white infants (48.2%) in one county each.ConclusionEven with a longstanding commitment and legal mandate to reduce disparities and with efforts to improve outreach into high-risk areas, disparities persist. An improved understanding of the racial/ethnic disparities within communities was useful to focus outreach efforts on reaching women at highest risk as part of subsequent program enrollment.

Explanatory models of suicidality among women of Turkish descent in Germany: A focus group study.

Women of Turkish descent in Germany show higher rates of suicidal behavior compared to their host populations and men of Turkish descent. This indicates a demand for a better understanding of suicidality in this group. Nine focus groups ( N = 61) were conducted to assess explanatory models including patterns of distress, perceived causes, course/consequences of and reactions towards a suicidal crisis, help-seeking behavior, and potential intervention and prevention strategies. All participants were of Turkish descent living in Berlin, Germany. The focus groups included two with professionals such as psychiatrists or psychotherapists, two with Community Mothers, three with women from the community (ages: 18 -34, 35 -49, 50+), and of three suicide attempters (ages: 18 -33, 38 -66). Data were analyzed using the methodology of thematic analysis. Results show that suicide-related behaviors, attitudes, and help-seeking behavior have gender and culture-specific characteristics. Two central themes were identified: the impact of family and community and the impact of German society. Participants stated that they believe that family and community pressures as well as discrimination and lack of acceptance cause social isolation. Fear of stigmatization and dishonoring themselves or their family, as well as shame and self-stigma decrease the likelihood of reaching out for help. Recommended strategies are community and family interventions, promotion of integration and social inclusion, awareness campaigns to destigmatize suicidality and the use of mental health services, empowerment of women, as well as the improvement of cultural sensitivity and competency of services.

Implementation of a community-based intervention in the most rural and remote districts of Zambia: a process evaluation of safe motherhood action groups

BackgroundA community-based intervention known as Safe Motherhood Action Groups (SMAGs) was implemented to increase coverage of maternal and neonatal health (MNH) services among the poorest and most remote populations in Zambia. While the outcome evaluation demonstrated statistically significant improvement in the MNH indicators, targets for key indicators were not achieved, and reasons for this shortfall were not known. This study was aimed at understanding why the targeted key indicators for MNH services were not achieved.MethodsA process evaluation, in accordance with the Medical Research Council (MRC) framework, was conducted in two selected rural districts of Zambia using qualitative approaches. Focus group discussions were conducted with SMAGs, volunteer community health workers, and mothers and in-depth interviews with healthcare providers. Content analysis was done.ResultsWe found that SMAGs implemented much of the intervention as was intended, particularly in the area of women’s education and referral to health facilities for skilled MNH services. The SMAGs went beyond their prescribed roles to assist women with household chores and personal problems and used their own resources to enhance the success of the intervention. Deficiencies in the intervention were reported and included poor ongoing support, inadequate supplies and lack of effective transportation such as bicycles needed for the SMAGs to facilitate their work. Factors external to the intervention, such as inadequacy of health services and skilled healthcare providers in facilities where SMAGs referred mothers and poor geographical access, may have led SMAGs to engage in the unintended role of conducting deliveries, thus compromising the outcome of the intervention.ConclusionWe found evidence suggesting that although SMAGs continue to play pivotal roles in contribution towards accelerated coverage of MNH services among hard-to-reach populations, they are unable to meet some of the critical sets of MNH service-targeted indicators. The complexities of the implementation mechanisms coupled with the presence of setting specific socio-cultural and geographical contextual factors could partially explain this failure. This suggests a need for innovating existing implementation strategies so as to help SMAGs and any other community health system champions to effectively respond to MNH needs of most-at-risk women and promote universal health coverage targeting hard-to-reach groups.

CONTRATO REALIDAD DE MADRES COMUNITARIAS: PARADIGMA DE LA SENTENCIA T480/16 DE LA CORTE CONSTITUCIONAL

La primacía de la realidad sobre las formas, es un principio de origen constitucional que se aplica en diferentes aristas del derecho laboral, no obstante, este articulo analiza la aplicación del mismo, pero únicamente desde la perspectiva de la prestación de servicios efectuada por las madres comunitarias, las cuales constituyen un sector significante de la población colombiana, que ha sido marginado y violentado en sus derechos mínimos e irrenunciables. Se pretende evidenciar las circunstancias laborales deplorables en que esta población se encontraba inmersa tanto antes como después de la promulgación de la sentencia T-480 de 2016, mediante la cual la Corte Constitucional declaró la existencia de un verdadero vinculo empleaticio entre las madres comunitarias y el Instituto Colombiano de Bienestar Familiar, sentencia que fue declarada parcialmente nula por esa misma corporación.

Validation of the Inventaire du Milieu Familial Questionnaire (French version of the Infant/Toddler HOME) into the Brazilian Portuguese language

ObjectiveTo validate the Brazilian Portuguese version of the Family Environment Assessment questionnaire (Inventaire du Milieu Familial). MethodsThe validation process was carried out in two stages. First, translation and back-translation were performed, and in the second phase, the questionnaire was applied in 72 families of children between 0 and 24 months for the validation process. The tool consists of the following domains: mother's communication ability; behavior; organization of the physical and temporal environment; collection/quantity of toys; maternal attitude of constant attention toward her baby; diversification of stimuli; baby's behavior. The following was performed for the scale validation: 1 – content analysis (judgment); 2 – construct analysis (factorial analysis – Kaiser-Meyer-Olkin, Bartlett, and Pearson's correlation tests); 3 – criterion analysis (calculation of Cronbach's alpha coefficient, intraclass correlations, and split-half correlations). ResultsThe mean age of the children was 9±6.7 months, and of these, 35 (48.6%) were males. Most correlations between items and domains were significant. In the factorial analysis of the scale, Kaiser-Meyer-Olkin values were 0.76, Bartlett's test showed a p-value<0.001, and correlation between items and domains showed a p-value<0.01. Regarding the validity, Cronbach's alpha was 0.92 (95% CI: 0.89–0.94). The intraclass correlation among the evaluators was 0.97 (0.96–0.98) and split-half correlations, r: 0.60, with p<0.01. ConclusionsThe Portuguese version of the Inventaire du Milieu Familial showed good to excellent performance regarding the assessed psychometric properties.

“They Gave Me Life”: Motherhood and Recovery in a Tribal Community

ABSTRACTObjective: This study explored factors related to substance misuse and recovery among Native mothers in a Pacific Northwest tribe, focusing on motherhood as a motivating factor in seeking treatment and sustaining recovery. Method: Using a community-based participatory research approach, we conducted a thematic analysis of 20 in-depth interviews and one focus group (N = 12) with Native women 18 years and older living on or near the reservation. Results: Qualitative findings highlighted challenges, motivations and strategies for seeking treatment and recovery in four major themes: (a) the close relationship between interpersonal violence and substance misuse; (b) traditional healing in recovery; (c) community-specific challenges to recovery; and (d) the motivating role of motherhood in seeking treatment and successful recovery. Conclusions: A central finding of this work is that pregnancy and motherhood may be underexplored factors in Native women's substance use. Results support previous work suggesting that Native women are at high risk of interpersonal trauma and that trauma contributes to substance misuse. Findings offer several rich implications for treatment and recovery among Native mothers in tribal communities including the necessity of trauma-informed treatment, community and culturally-based interventions, more integration of treatment services with Child Protective Services, and drawing on motherhood as a motivation for seeking and succeeding in recovery.