Peer Communication Research Articles

Nurses’ experiences during the COVID-19 pandemic: A secondary data analysis examining interdisciplinary and peer communication

BackgroundCommunication with interdisciplinary team members was impacted during the start of the COVID-19 pandemic. Bedside nurses managed communication challenges with interdisciplinary team members while working under extremely stressful conditions created by a new and unknown infectious disease. This study examined data collected from a pre-existing qualitative study to answer the question: What communication challenges occurred among nurses and interdisciplinary team members during the beginning months of the COVID-19 pandemic? MethodsA qualitative secondary analysis of an existing dataset was undertaken. The original data were collected using semi-structured interviews conducted with a purposive sample of bedside nurses (n = 17). ResultsUsing thematic analysis, five themes related to communication among nurses and the interdisciplinary team emerged: 1) acknowledging PPE as a communication barrier, 2) questioning how to perform nursing tasks along with increasing workload, 3) developing innovative ways to deliver safe care, 4) experiencing frustrations about lack of communication with interdisciplinary team members, and 5) experiencing both support and criticism that affect working relationships. ConclusionsChallenges associated with communication during the early days of the COVID-19 pandemic became opportunities to build policies and procedures to support collaboration within the healthcare team. Support is necessary to prepare team members to collaborate efficiently during crisis situations. Developing a strategic plan to improve communication, lessen nurse burden, provide mental health support for nurses, while maintaining safe care are priorities in managing future emergency situations.

The Exploration of Youth School Refusal Problem: Causes, Intervention, and Case Study from Ecological Perspective

兒童青少年拒學問題一直以來都是複雜和難解的課題。研究者基於生態系統觀點探討拒學原因與介入方法，並認為若能分別主要與次要影響因素，先針對主要影響因素進行介入，將更能在有限的時間和資源內改善出席率，故提出三個層次的原因與介入模式。此模式中不同層次差別在主要影響因素的數量不同，層次一包含兩個因素的相互影響，如：個人與家庭。層次二包含三個因素的相互影響，如：個人、家庭與學校。層次三包含四個因素的相互影響。原因部分，個人因素包含身體狀況、心理狀況和特質；家庭因素包含五點，即家長特質與身心健康、家庭功能與動力、家庭期待與參與度...等；學校因素包含六點，即轉換學校、學校氛圍、管教與出席...等；社會因素包含五點，即經濟拉力、文化價值觀、政策或法規...等。介入部分，個人因素包含醫療介入、提升行為技巧、增進認知技巧、提供專業資源；家庭因素包含五點，即進行意外或風險管理訓練、提供諮詢或家訪、提供認知訓練...等；學校因素包含七點，即辨識和轉介高風險學生、推動反霸凌政策、鼓勵學習社群與生涯活動...等；社會因素包含社區資源、警政與司法、社會機構與媒體、教育、諮商與醫療。最後提出中年級拒學案例說明如何改善拒學。Problematic school refusal in youth has long been a complex and vexatious issue. This article reviews the literature that affect school refusal based on ecological perspective. It is believed that if we can differentiate between primary and secondary influencing factors and first intervene with the primary influencing factors, we can better improve school attendance within limited time and resources. Furthermore, a three-level model that emphasizes on comprehensive causes and user-friendly systematic intervention recommendations is proposed. Level one includes the interaction of two factors, such as the individual and the family. Level two includes the interaction of three factors, namely the individual, family, and school. Level three includes the interaction of four factors. Among the causes, personal factors can be addressed through physical condition, mental condition and trait. Family factors include five points, such as parents’ trait, mental and physical health, family function and family dynamic, family expectations and involvement... etc... School factors include six points, namely transferring schools, school atmosphere, discipline and attendance policies...etc.. Social factors include five points, such as economic pressures, cultural values, policies or regulations...etc.. Regarding interventions, personal factors can be addressed through medical treatment, enhancing behavioral skills, increasing cognitive skills, and providing professional resources. Family factors include five points, namely conducting accident or risk training, consultation and home visits, providing cognitive training...etc.. School factors include seven points, such as identifying and referring high-risk students, promoting an anti-bullying policy, encouraging learning groups and career activities...etc... Social factors include community resources, policing and Justice, social organizations and media, education, counseling and medical services. In the end, there is a case example of a fourth-grade child, explains how to address school refusal.

Developing Children's Social Empathy as a Means of Preventing Bullying

Empathy is one of the risk factors and solutions to bullying behavior, This can be an alternative for some parties in handling bullying cases, namely by fostering social empathy by parents, communities and schools. Social empathy must be introduced and trained from early childhood including elementary school age, Considering that bullying cases occur quite a lot in the environment of elementary school-age students. This study aims to identify bullying behavior among Madrasah Ibtidaiyah students, Dealing comprehensively with the cultivation of social empathy attitudes and to know the role of family and environment in influencing the development of empathy. The strategy we use in this study is to first find the problems that exist in the institution, Then we study to be able to get solutions to existing problems. In finding and reviewing existing problems, we use qualitative descriptive methods. Based on the results of the study, there are still children who have low empathy. This happens partly because; the presence of errors in the parenting process, the influence of the community environment and peers, and because children have experienced physical and psychological violence. Therefore, from the school side, there needs to be steps that are able to increase children's social empathy

Self-control, peer assistance, and satisfaction of online learning among Chinese social work students

ABSTRACT Online learning is a new type of learning practice based on information and communication technologies. It has gained great popularity in higher education in China in recent years, especially during the COVID-19 pandemic, because it can reach more students over long distances and achieve cost-benefit maximization. Compared with the traditional classroom-based learning model, online learning reduces the control of instructors, thus highlighting the students’ self-management ability and peer assistance. Based on the data collected from an online learning survey of undergraduate (BSW) and graduate social work (MSW) students in China in 2022, this study reveals the effects of social work students’ self-control and peer assistance on online learning satisfaction. The results show that 72.95% of BSW and MSW students have participated in online learning in the previous academic year, and they are generally satisfied with their online learning. Students’ self-control ability significantly affects their satisfaction with online learning. At the same time, peer assistance is a significant mediating variable. It is suggested that in addition to promoting students’ self-control ability and self-study management, making full use of online resources to promote peer assistance and communication among students is also a way to improve social work students’ satisfaction with online learning.

Individual, family, peer, and religious community predictors of adolescent religious deidentification

This study examined individual, family, and peer religiosity, and religious community supportiveness as predictors of adolescent religious deidentification. The longitudinal study involved two waves of data, two years apart, from U.S. families (1,021 families; religious adolescents from 11–17 years of age), with measures of dimensions of religiosity at Time 1 and changes in religious identification from Time 1 to Time 2. Within each domain, at least one dimension of religiosity at Time 1 predicted religious deidentification at Time 2. Specifically, youth higher in individual, family, and peer religiosity, and religious community supportiveness, were less likely to leave religion. These relations were not moderated by religious affiliation. When using domain composite scores as predictors, individual and family religiosity uniquely predicted religious deidentification. Individual religiosity partially mediated relations of family religiosity, peer religiosity, and religious community supportiveness with religious deidentification. These results align with a relational developmental systems approach to religious deidentification.

Revisiting the Motivated Denial of Mind to Animals Used for Food: Replication Registered Report of Bastian et al. (2012)

Bastian et al. (2012) argued that the meat paradox—caring for animals yet eating them—creates a tension between people’s moral standards (caring for animals) and their behavior (eating them) that can be resolved via mechanisms of motivated moral disengagement. One disengagement mechanism that is thought to play a central role is the denial of food-animal minds and therefore their status as moral patients. This idea has garnered substantial interest and has framed much of the psychological approach to meat consumption. We subjected Studies 1 and 2 of Bastian et al. (2012) to high-powered direct replications and found support for the target article’s hypotheses, concluding a successful replication. Perceptions of animals’ minds were negatively related to their perceived edibility (original: r = –.42 [–.67, –.08]; replication: r = –.45 [–.69, –.12]), positively related to moral concern for them (original: r = .77 [.58, .88]); replication: r = .83 [.68, .91]) and positively related to negative affect related to eating them (original: r = .80 [.63, .90]; replication: r = .80 [.62, .90]). Learning that an animal will be used for food led people to deny its mental capabilities (original: d = 0.40 [0.15, 0.65]; replication: d = 0.30, 95% CI [0.24, 0.37]), with the affect slightly weaker than the original. Our findings support the idea that the meat paradox is resolved through people’s motivated denial of food animals’ minds. Materials, data, and code are available on the OSF: https://osf.io/h2pqu/. This Registered Report has been officially endorsed by Peer Community in Registered Reports: https://doi.org/10.24072/pci.rr.100545.

The effects of social media usage on vicarious traumatization and the mediation role of recommendation systems usage and peer communication in China after the aircraft flight accident

ABSTRACT Background: Previous research has indicated that continuous exposure to disaster-related information through social media can lead to vicarious trauma. However, scholars have recognized the need for further in-depth research into the underlying mechanisms influencing this relationship. Objective: The purpose of this study is to investigate the impact mechanism of social media usage on vicarious traumatization in users and analyze the roles of recommendation systems and peer communication. Methods: This study was conducted with college students in China, focusing on the context of the MU5735 aircraft flight accident in China in which 123 passengers and 9 crew members died. Data were collected through an online questionnaire. The partial least square structural equation modelling (PLS-SEM) method was used to test the data and model. Results: This study obtained valid responses from 1317 participants. The study findings revealed a significant positive correlation between social media usage(β = 0.180，P < .001), recommendation systems usage (β = 0.172, P < .001), peer communication (β = 0.303, P < .001), and the development of vicarious traumatization. Recommendation systems usage (specific indirect effect = 0.063, P < .001) and peer communication (specific indirect effect = 0.138, P < .001) mediated the relationship between social media use and vicarious trauma. Additionally, the impact of peer communication on vicarious trauma was found to be higher compared to the effects of continuous social media use and recommendation system use. Conclusion: The study found that the use of social media to obtain information about accidents, the frequent pushing of accident information by recommender systems, and the frequent discussion of accidents among peers during unexpected accidents contribute to vicarious traumatization. The study suggests that users’ reduced retrieval of accident information via social media, as well as reduced peer-to-peer discussions about accidents, and social media platforms’ adjustment of recommender system algorithm rules to reduce accident information pushes, may help reduce the likelihood of users experiencing vicarious traumatization.

The moral economy of land markets in the Nicaragua highlands

AbstractThis article explores how small‐scale farmers' shared moral understandings of land shape both land sales and land rental markets, in the context of the commoditization of agriculture in Nicaragua. The results here presented are based on ethnographic fieldwork conducted in a subsistence farming community in the highlands of Nicaragua. This research shows that even in relatively commoditized market economies, shared yet contested ideas around the ethics of a community moral economy stall and constrain the local marketization of land. Social relationships, ideas of a sacred origin of land, and expectations about the duties of landholders toward their community peers undermine the capitalist dynamics of supply and demand. This ethical challenge to capitalist market expansion into land markets enables the survival of small‐scale subsistence farming. These findings are important, as they show how land markets are shaped by differing perspectives on historical dynamics of land tenure, class differentiation, and the everyday moral economies in which competing ideas of obligation, solidarity, and fair prices are articulated.

Organizing Primary Care Clinicians to Expand Reproductive Health Access: A Qualitative Program Evaluation.

Comprehensive sexual reproductive health care (SRH) in the United States, including abortion, is siloed from primary care, making it more difficult to access. The crisis in access has drastically worsened following the overturning of Roe v Wade, 410 US 113 (1973). Primary care clinicians (PCC) are well-positioned to protect and expand SRH access but do not receive sufficient training or support. The Reproductive Health Access Network ("Network") was created to connect like-minded clinicians to engage in advocacy, training, and peer support to enhance access to SRH in their communities and practices. This evaluation explores PCC leaders' experiences within this SRH organizing network. In 2021, we conducted 34 semistructured phone interviews with a purposive sample of current (n=27) and former (n=7) PCC leaders in the Network (N=87). The program's theory of change and network evaluation framework guided reflexive thematic analysis. Participants viewed Network support as critical to ending isolation through three mechanisms: connecting to a supportive community of like-minded peers, empowering leadership, and providing infrastructure for local organizing. They viewed mentorship as critical in building a sustainable and equitable pipeline of PCC leaders. Participants identified challenges to engaging fully, such as burnout and discrimination experienced both within and outside the Network. Community-building, peer support, and mentorship are critical to building and sustaining PCC leadership in SRH-organizing communities. Efforts are needed to mitigate burnout, support SRH education and mentorship for PCCs, and transform into a truly inclusive community. The Network structure is promising for amplifying efforts to enhance SRH access through clinician leadership.

Pattern of video game usage and video game disorder in Portugueses adolescents: A study about parental and peer attachment, parenting styles, and communication in parenting

Introduction Video game disorder has been a subject of increasing interest, being associated with patterns of insecure attachment and authoritarian and permissive parenting styles. However, there is still a gap concerning the relationship between video game disorder and parent-child communication, one of the fundamental components of attachment to parents. Particularly in the Portuguese context, research on these topics and their interrelations is still scarce, thus remaining relatively unexplored.ObjectivesTo explore the pattern of video game usage and video game disorder, as well as their relationships with parental and peer attachment, parenting styles, and communication in parenting within a sample of Portuguese adolescents.Methods 150 Portuguese teenagers, recruited at public Portuguese schools, aged between 10 and 19 years old (mean age = 14.37, DP = 3.12; 52.7% girls (n = 79), and mostly living with both parents (79.7%, n = 106) fulfilled a sociodemographic and an academic questionnaire, a questionnaire on video game use patterns, the Video Game Disorder Scale - Short Version 9, the People in My Life Questionnaire, the Portuguese hetero-report version of the Parenting Styles and Dimensions Questionnaire: Short Versionand the Perception Scale of Parenting Communication.ResultsThe majority of the sample indicated 3rd childhood (n = 81, 54.0%), specifically at 8 years old, as the age of video game initiation and a playtime of less than or equal to 2 hours (n = 111, 74.0%), with only 2 participants found to have a video game disturbance index (1.3%). A positive association was found between video game disturbance and the average hours of gameplay, as well as a negative association with the age of game initiation. Additionally, relationships were explored, revealing that video game disturbance is negatively related to lower quality of attachment to parents and peers, positively related to an authoritative parenting style, and negatively related to less available, open, and affectionate parent-child communication.ConclusionsThis study provides an in-depth understanding of adolescents’ behavior regarding video games, contributing to the knowledge of the topic in the Portuguese context. Furthermore, the identification of factors associated with video game disturbance allows for the development of remediation and prevention programs for this addictive disturbance, which are essential tools in psychological practice.Disclosure of InterestNone Declared

초등학생의 공격성과 지각된 인기의 종단적 관계

Objectives This study investigated the prospective associations of aggression at the beginning of the school semester and perceived popularity at the end of school semester with the sample of 1,404 grade 3rd to 6th students in elementary school using Multi-Level Analysis. In addition, the study the contextual effects of peer community and friendship centralization in the prospective associations of aggression and popularity.&#x0D; Methods At student level, aggression and perceived popularity were measured through peer nominations. At classroom level, peer community consciousness was measured by aggregating the individual students’ a sense of peer community. Friendship centralization was measured by peer network survey.&#x0D; Results The results indicated that at the student level, relational aggression at the beginning of the semester was negatively related to perceived popularity at the end of the semester. At the class level, peer community was positively associated with perceived popularity at the end of semester, Moreover, peer community and friendship centralization moderated the prospective associations of relational aggression and perceived popularity.&#x0D; Conclusions According to our findings, higher peer community and lower friendship centralization mitigated the prospective associations of relational aggression and perceived popularity. This finding suggests that intimacy among peers and egalitarian friendship serves a crucial factor to foster health classroom peer ecology.&#x0D;

Research on the Present Situation and Cultivation Strategy of Children's Social Communication Ability from the Perspective of Family-Kindergarten Coeducation

Family and kindergarten are the most vital places for children's life and education. Only by implementing family-kindergarten coeducation can we create a better growing environment for children and empower their peer communication. This study found three main problems, including children's poor peer communication ability, parents' insufficient sense of responsibility, and the severely limited development of family-kindergarten coeducation. Based on the above problems, this study puts forward that teachers should conduct targeted guidance according to the social communication needs of children in different age classes. Parents should improve their educational awareness and scientifically guide children to establish correct communication concepts. Meanwhile, kindergarten takes a dual approach to break through the communication barriers of family-kindergarten coeducation.

Peer appraisal, participatory surveillance, and experiential mentoring: explicating communicative practices of participatory learning in an online support group for people with binging experiences

Much research has examined how participants in online support groups (OSGs) seek information or exchange social support while neglecting peer learning among users. Applying the perspective of community of practice (CoP), we conceptualize peer communications in OSGs as a participatory learning process of sharing and managing experiential knowledge. To explicate this learning process, we thematically analyzed 1,084 discussion threads in an anonymous Chinese OSG formed around binge eating. Our findings identified three informal strategies of participatory learning: (a) peer appraisal to validate shared suffering, (b) participatory surveillance to monitor peer progress, and (c) experiential mentoring to corroborate coping practices. This study elucidates the process by which OSGs generate, validate, and consolidate experiential knowledge through peer communication practices. It highlights the collaborative nature of knowledge construction within OSGs, in which members engage in bottom-up, trial-and-error approaches supported by their own experiential self-disclosures. Such a CoP allows participants to explore and test various coping strategies, fostering a participatory learning environment in which they can solicit or provide feedback based on their experiences.

The effects of online simulation-based collaborative problem-solving on students’ problem-solving, communication and collaboration attitudes

Despite national curricula and instructional reforms calling for collaborative problem-solving skills (CPS), however, there is an absence of a theory-laden model showing how to effectively construct CPS for science learning. We therefore developed and validated a simulation-based CPS model that exploits its constructs, sequences, and causal relationships, and evaluating its effectiveness on students’ problem-solving. Over the span of a two-week physics science course, 57 ninth-grade students were recruited from two intact middle school classes to engage in this online simulation-based collaborative problem-solving (CPS) program. This program consisted of nine electrochemistry problem-solving lessons spread across four class sessions, each lasting 45 min. Results indicated that the simulation-based CPS model was validated and proven to contribute to effective problem-solving by linking PS solution proposing, peer communication, implementing PS solutions with simulation, and providing evidence-based explanations. The simulation-based CPS model successfully improved the performance of both high- and low-achieving students. With the support and presence of high-achievers, low-achievers’ collaboration attitude was boosted, which lead them to achieve similar learning success.

Empowering collaborative knowledge construction through the implementation of a collaborative argument map tool

Collaborative knowledge construction has been used in higher education to support student groups' collaborative learning activities through students' exchange, negotiation, and reflection of perspectives through peer communications. To support this process, collaborative learning analytics tools have been designed to collect and analyze collaborative process and performance data with a goal to provide actionable feedback and improve learning quality. However, few tools have demonstrated the mechanism and details about how students develop their perspectives during the collaborative knowledge construction process in higher education. To fill this gap, this research proposed a tool named Collaborative Argument Map (CAM) that creatively visualized different types of perspectives students proposed from the individual, peer, and group levels. This tool was further implemented in a graduate-level course in online collaborative writing activities in China's higher education, with a goal to support students' knowledge construction with peers. The summative and process-oriented learning analytics approaches were conducted to reveal the effects of CAM on students' collaborative perceptions, processes, and final products. Results showed that most students made substantive use of the CAM tool and reported positive perceptions of the tool. Further examinations verified the tool's positive effects on improving the students' cognitive engagement levels and the quality of their final collaborative writing products. This research provided practical implications for future CLA tool design and instructional implications for using this type of tool in collaborative learning in higher education.

The Opportunities, Challenges, and Rewards of “Community Peer Research”: Reflections on Research Practice

This article shares reflections from a group of academic researchers at the same University on their experience of conducting “community peer research” projects involving nonacademics in social research. We review a range of literature that has influenced the development of our practice, stressing the importance of co-production and power relations. We present six case studies that represent the breadth of our different engagements with community peer research, and then go on to reflect on the challenges and benefits of this approach. We identify a number of practical challenges, ways in which we overcame them, and in particular stress the importance of providing well-designed training for community peer researchers. We conclude with some recommendations for other researchers looking to conduct similar research.

States' investment in recovery support services: An exploratory analysis

IntroductionRecovery support services (RSS), while not yet precisely defined, nevertheless have a longstanding role in managing chronic illnesses including substance use disorders (SUDs). This exploratory study is the first to identify the amounts of money that states invest from Substance Abuse and Mental Health Services Administration (SAMHSA) Block Grants; SAMHSA discretionary grant and state-appropriated sources; the types of organizations from which RSS are purchased; and the non-financial supports states provide for RSS. MethodsThe study is a mixed method exploratory analysis, based on three data sources: content analysis of all 51 (Washington, D.C. included) Substance Abuse Block Grant (SABG) state applications; in-depth interviews with a purposive sample of ten states and one territory; and a structured electronic survey sent to all SABG recipients. Forty states and 2 territories returned a total of 42 questionnaires from 56 possible states and territories (75%). Thirty-two of the responding states provided complete FY2022 financial data. ResultsStates reporting financial data spent $412 million from SABG, SAMHSA discretionary grants, and state appropriations for RSS. An estimate based on extrapolating regionally grouped per capita spending averages to non-responding state populations projected $775 million spent from these sources for all states. The study also calculated per capita and SUD prevalent population expenditures from these sources for each state. States purchase services from recovery community organizations and SUD treatment organizations in equal proportions, as well as from statewide recovery support organizations, educational institutions, hospitals, community health centers, and justice system organizations. Purchased services are not uniformly defined, but include community centers, peer staff, housing, and other support services. States provide non-financial support in forms that include technical assistance, community engagement, practice guidelines, and regulatory frameworks. ConclusionsThis first report of states' investments establishes a baseline to serve as a reference point for future analysis of these expenditures, as well as a foundation to which other sources of RSS funding such as Medicaid and other state and federal (e.g. HRSA, CDC, DOJ) dollars may be added. Uniform definitions for RSS will be necessary to support future reporting, accountability, and research. Finally, newly formed peer-based provider organizations need particular attention in order to be sustainable.

Promoting Transparent, Fair, and Inclusive Practices in Grantmaking: Lessons from the Open and Equitable Model Funding Program

This report presents the insights of the Open &amp; Equitable Model Funding Program, a pilot of a cohort of eleven research funders interested in refining their grantmaking to foster open and equitable practices. Launched in April 2021 by the Open Research Funders Group (ORFG) with grants ranging from $5 to $560 million, this initiative brought together experts across various fields to create thirty-two interventions to promote open research and equitable grantmaking. The funders cohort fostered a collaborative learning environment through monthly meetings, allowing participants to share insights and tackle challenges. Supported by the ORFG's resources and guidance, this structured approach facilitated the tailoring of interventions to each funder's specific needs, emphasizing early identification of challenges to integrate these practices seamlessly into existing funding mechanisms. Despite facing challenges such as staff turnover, limited time, and resources, which impacted the full engagement with and implementation of the interventions, the pilot was appreciated for its organized and guided framework and its collaborative learning environment. Participants who met their pilot goals attributed their success to the clear, achievable interventions and the structured design of the pilot, which allowed for focused implementation and executive-level support. The initiative also encouraged collaboration among peers, fostering a community of like-minded organizations exploring common challenges. The ORFG's documentation of lessons learned and the testing of intervention suitability offers valuable insights for future funders to refine their grantmaking strategies, underscoring the importance of continuous effort and commitment to achieve lasting change. These recommendations were refined for relevance and completeness from direct engagement with applicants, grantees, and researchers from underserved communities, ensuring the incorporation of insights from historically marginalized groups and with the goal of tailoring more inclusive and practical improvements.

Community perceptions and attitudes toward serious mental illness in Cambodia

BackgroundWorldwide, approximately 64 million people are living with serious mental illnesses (SMI), such as schizophrenia and bipolar disorder. Because community perceptions and attitudes can impact help-seeking and the course of illness, understanding and incorporating these perspectives, and addressing misconceptions and harmful attitudes, is a critical component of comprehensive mental health support. These concepts are deeply rooted in local culture and belief systems, yet research to provide local understanding is often lacking, particularly in low- and middle-income countries. ObjectiveThe aim of this study was to assess relative caregivers' and other key community members’ perceptions and attitudes towards people with SMI in Cambodia. MethodsA brief survey that included open-ended assessment of mental health knowledge and beliefs was interviewer-administered to 115 relative caregivers of people with SMI. Additionally, 20 community members considered knowledgeable about mental health (e.g., traditional healers, local authorities, family caregivers) participated in semi-structured qualitative interviews that explored perceptions and attitudes toward SMI in Cambodia. ResultsParticipants included 56 men and 79 women. While respondents were able to identify signs and symptoms of SMI, the most commonly perceived causes were spiritual (e.g., spells, ghosts); family crisis (e.g., domestic violence); and physical health problems. Both respondent groups showed empathy for people with SMI (e.g., pity) but also reported feelings of fear and shame (e.g., perceived tendency toward violence and not wanting to live with such a person). ConclusionBoth caregivers likely to seek help and respected local figures likely to be involved in initial help-seeking efforts demonstrated limited understanding of SMI as a medical disorder suitable for management within the formal healthcare system. Commonly reported misperceptions are likely to lead to delayed access to care and poorer treatment within the community. Strengthening mental health knowledge among caregivers and key community leaders may hold promise for improving peer support and community referral pathways.

Causes of preventable death among children of female sex worker mothers in low- and middle-income countries: A community knowledge approach investigation.

Female sex workers (FSW) in low- and middle-income countries (LMIC) are disproportionately vulnerable to poor health, social, and economic outcomes. The children of female sex workers (CFSW) experience health risks based on these challenging circumstances and the unique conditions to which they are exposed. Although country child mortality data exist, little is known about the causes of death among CFSW specifically, thereby severely limiting an effective public health response to the needs of this high-risk group of children. The Community Knowledge Approach (CKA) was employed between January and October 2019 to survey a criterion sample of 1280 FSW participants across 24 cities in eight LMIC countries. Participants meeting pre-determined criteria provided detailed reports of deaths among the CFSW within their community of peers. Newborn deaths were gleaned from FSW maternal death reports where the infants also died following birth. Of the 668 child deaths reported, 589 were included in the analysis. Nutritional deficiencies comprised the leading cause of mortality accounting for 20.7% of deaths, followed closely by accidents (20.0%), particularly house fires, overdoses (19.4%), communicable diseases (18.5%), and homicides (9.8%). Other reported causes of death included neonatal conditions, respiratory illnesses, and suicides. The causes of CFSW death in these eight countries are preventable with improved protections. Governments, intergovernmental organisations like the United Nations, nongovernmental stakeholder organisations (e.g. sex worker organisations), and funders can implement targeted policies and programmes to protect CFSW and assist vulnerable FSW who are pregnant and raising children. Further research is needed to identify effective child welfare safeguards for CFSW.