Protective Services Research Articles

Research capacity building, networks, define research strategy, and funding opportunities in RECOOP HST Association

I built research capacity and networks for the first ten years in the RECOOP Research Consortium from 2002 to 2012. The RECOOP HST Consortium, with the financial support of Cedars–Sinai Medical Center­ (CSMC), applied for the International Visegrad Fund (IVF) grants. We applied for 20 Standard Grants and won 14 Standard Grants to support forming and managing research networks and multinational–multidisciplinary research projects. The IVF grants won by CSMC – RECOOP helped move toward the 21st Century and broaden the scope of activities in RECOOP. Also, the IVF grants helped to build support networks for biosafety and biosecurity, animal use in research, clinical research management, and research and Innovation management training. RECOOP HST Association implemented the Common Mechanism of Diseases (CMD) research program for innovative life science research in member countries. The objectives were to increase the number of young scientists participating in creative research. Knowledge sharing is the most essential element of collaborative research. Within the context of RECOOP, my final endeavor will focus on investigating the diagnosis and management of Post-Traumatic Stress Disorder (PTSD) in Ukraine. As of January 2024, an estimated 6.3 million people have been forced to flee Ukraine, with 94 percent of them hosted in European countries, representing 5.9 million refugees. In Ukraine, an estimated 7.8 million people need health assistance, and 11.5 million need protection assistance and services. Studies of PTSD report volume abnormalities in multiple regions of the cerebral cortex. However, findings for many regions, particularly regions outside commonly studied emotion-related prefrontal, insular, and limbic regions, are inconsistent and tentative. We, as researchers, must continually share our research findings and diligently replicate established methods and protocols. These tasks can often feel akin to the labor of Sisyphus. Moreover, within the scientific community, integrity is paramount; dishonesty is swiftly met with consequences akin to the justice administered by Zeus. Therefore, we researchers must roll a boulder up a hill again and again, and after we have proved that the published scientific work is sound, the “boulder” and the scientist will stay on top of the hill. Keywords: burden of Sisyphus, define research stra­tegy, funding opportunities, Post Traumatic Stress Disorder (PTSD) in Ukraine, RECOOP HST Association, research capacity building and networks, sciences and arts

Esengo ya Bosembo ("Joy of Equity"): Development of an Advocacy Video to Reduce Stigma and to Promote Sexual and Reproductive Health and Rights of Women Sex Professionals in Pointe-Noire, Congo Republic.

Sex workers experience elevated risks of sexual and gender-based violence (SGBV) from intimate partners, clients, and community members that harms health and human rights. While SGBV contributes to poorer sexual and reproductive health (SRH) outcomes among sex workers, including elevated human immunodeficiency virus (HIV) vulnerabilities, stigma targeting sex workers reduces SRH service access and uptake. The Congo Republic is an exemplar context to address stigma toward sex workers. Sex workers' HIV prevalence (8.1%) in Congo Republic is double the national prevalence, yet research indicates that nearly one-fifth (17.2%) of sex workers in Congo Republic avoid health care because of stigma and discrimination. This Resources, Frameworks, & Perspectives article describes the process of developing Esengo ya Bosembo ("Joy of Equity"), a culturally tailored advocacy video that aims to reduce health care and community stigma toward women sex professionals (e.g., sex workers) in Pointe-Noire, Congo Republic. This knowledge translation product stems from a participatory mapping intervention with sex professionals in Pointe-Noire that revealed the need for sensitization tools and activities to reduce sex work stigma among health care providers and community members. The video incorporates three overarching key messages: (1) sex professionals are human beings with equal rights to dignity, protection, and health services; (2) elevated risks of SGBV and stigma targeting sex workers reduce SRH service access and uptake; and (3) participatory mapping is a potential way to empower sex professionals to share their experiences and recommendations for change. This article details how health promotion practitioners and sex professionals may use the video to advocate for change.

Dynamics of the experience of sexual violence and its impact on girls in Ogan Komering Ulu Regency

The aim of this research is to obtain an overview of the dynamics of the experience of sexual violence and its impact on children in Ogan Komering Ulu Regency. This research method uses qualitative research with a descriptive phenomenological approach. The number of informants was five main informants and six supporting informants. The main informants are children who have experienced sexual violence and supporting informants, parents or guardians, people closest to them who are trusted by the informants and officers from the Women's Empowerment and Child Protection Service. The results of research on the dynamics of the experience of sexual violence in children show that all perpetrators come from familial abuse which is accompanied by physical and psychological pressure. Factors that influence the occurrence of sexual violence in children are family factors, environmental factors, cultural factors and individual factors. The impact of sexual violence that arises is pain in the body, fear of seeing items related to the perpetrator, despair and shame about the environment. Health workers can disseminate reproductive health education on how to prevent sexual violence to parents to reduce the rate of sexual violence against children so that a child-friendly city program can be realized.

Interrater reliability of the violence risk assessment checklist for youth: a case vignette study

BackgroundFacilities providing health- and social services for youth are commonly faced with the need for assessment and management of violent behavior. These providers often experience shortage of resources, compromising the feasibility of conducting comprehensive violence risk assessments. The Violence Risk Assessment Checklist for Youth aged 12–18 (V-RISK-Y) is a 12-item violence risk screening instrument developed to rapidly identify youth at high risk for violent behavior in situations requiring expedient evaluation of violence risk. The V-RISK-Y instrument was piloted in acute psychiatric units for youth, yielding positive results of predictive validity. The aim of the present study was to assess the interrater reliability of V-RISK-Y in child and adolescent psychiatric units and acute child protective services institutions.MethodsA case vignette study design was utilized to assess interrater reliability of V-RISK-Y. Staff at youth facilities (N = 163) in Norway and Sweden scored V-RISK-Y for three vignettes, and interrater reliability was assessed with the intraclass correlation coefficient (ICC).ResultsResults indicate good interrater reliability for the sum score and Low-Moderate-High risk level appraisal across staff from the different facilities and professions. For single items, interrater reliability ranged from poor to excellent.ConclusionsThis study is an important step in establishing the psychometric properties of V-RISK-Y. Findings support the structured professional judgment tradition the instrument is based on, with high agreement on the overall risk assessment. This study had a case vignette design, and the next step is to assess the reliability and validity of V-RISK-Y in naturalistic settings.

Restoring Children From Out‐of‐Home Care: Insights From an Aboriginal‐Led Community Forum

ABSTRACTRestoring children from out‐of‐home care (OOHC) to their families is the preferred outcome for all children removed by child protection services, yet little is known about how restoration processes are experienced by families and services supporting them. This paper provides important insights about Aboriginal child restoration from 40 practitioners and stakeholders at a community forum led by Aboriginal Community Controlled Organisations in regional New South Wales (NSW), Australia. This is one component of larger Aboriginal‐led research, which investigates child protection experiences and pathways to successful restoration in NSW and the data source for this paper. The community forum explored the issues for families navigating family preservation, OOHC and restoration within child protection and legal systems. Findings include the need for a continuum of support for families throughout their engagement with child protection systems and crucially following the removal of their children. Barriers to effective restoration practice included a lack of access to meaningful and ongoing preservation services, insufficient cultural care planning and family finding efforts that are often too late, the pressure on services to support families without adequate capabilities or enough resourcing, the lack of transparency and the complexities in navigating the restoration process, and the lack of culturally informed support for children and their families while children are in care. Implications for policy and practice are discussed. This paper contributes to understanding practice, processes and barriers for restoration, particularly focused on the perspectives of Aboriginal families and communities, with potential insights for practice within Australia and internationally.

Exploring Ecological, Morphological, and Environmental Controls on Coastal Foredune Evolution at Annual Scales Using a Process-Based Model

Coastal communities commonly rely upon foredunes as the first line of defense against sea-level rise and storms, thus requiring management guidance to optimize their protective services. Here, we use the AeoLiS model to simulate wind-driven accretion and wave-driven erosion patterns on foredunes with different morphologies and ecological properties under modern-day conditions. Additional sets of model runs mimic potential future climate changes to inform how both morphological and ecological properties may have differing contributions to net dune changes under evolving environmental forcing. This exploratory study, applied to represent the morphological, environmental, and ecological conditions of the northern Outer Banks, North Carolina, USA, finds that dunes experiencing minimal wave collision have similar net volumetric growth rates regardless of beach morphology, though the location and density of vegetation influence sediment deposition patterns across the dune profile. The model indicates that high-density, uniform planting strategies trap sediment close to the dune toe, whereas low-density plantings may allow for accretion across a broader extent of the dune face. The initial beach and dune shape generally plays a larger role in annual-scale dune evolution than vegetation cover. For steeper beach slopes and/or low dune toe elevations, the model generally predicts wave-driven dune erosion at the annual scale.

Effect of Routine Child Physical Abuse Screening Tool on Emergency Department Efficiency.

Physical abuse is a significant cause of morbidity and mortality for children. Routine screening by emergency nurses has been proposed to improve recognition, but the effect on emergency department (ED) workflow has not yet been assessed. We sought to evaluate the feasibility of routine screening and its effect on length of stay in a network of general EDs. A 2-question child physical abuse screening tool was deployed for children <6 years old who presented for care in a system of 27 general EDs. Data were compared for the 6 months before and after screening was deployed (4/1/2019-10/2/2019 vs 10/3/2019-3/31/2020). The main outcome was ED length of stay in minutes. There were 14,133 eligible visits in the prescreening period and 16,993 in the screening period. Screening was completed for 13,404 visits (78.9%), with 116 (0.7%) screening positive. The mean ED length of stay was not significantly different in the prescreening (95.9 minutes) and screening periods (95.2 minutes; difference, 0.7 minutes; 95% CI, -1.5, 2.8). Among those who screened positive, 29% were reported to child protective services. On multivariable analysis, implementation of the screening tool did not impact overall ED length of stay. There were no significant differences in resource utilization between the prescreening and screening periods. Routine screening identifies children at high risk of physical abuse without increasing ED length of stay or resource utilization. Next steps will include determining rates of subsequent serious physical abuse in children with or without routine screening.

A Privacy Protection Method Based on Trajectory Location Point Association

Location-based services (LBS) technology provides personalized services for users. However, private location information faces the risk of being leaked while users are enjoying the LBS services. In order to prevent this from occurring, this study proposes an anonymous privacy protection method based on trajectory location association, abbreviated as AS-AP, which considers the association between the user’s current location and the background information. The association between locations is mined from time and query preferences, and then fake locations and queries are generated as part of the anonymous interference requests. This conforms to the k-anonymity feature, which prevents attackers from inferring the user's real intent from the network information, thereby enhancing the credibility of network technology, and protecting data privacy. The experimental results indicate that AS-AP can provide more personalized privacy protection services while ensuring that users' sensitive data is protected.

Aboriginal Children Placed in Out-of-Home Care: Pathways Through the Child Protection System

ABSTRACT The overrepresentation of Aboriginal and Torres Strait Islander (respectfully referred to hereafter as “Aboriginal”) children in the child protection system is a concern in Australia, with Aboriginal children placed in out-of-home care at a rate 11 times that of non-Aboriginal children. This study utilised linked administrative data to determine the longitudinal child protection pathways from birth to age 10 years for a cohort of 15,815 Aboriginal children born in Western Australia between 2000 and 2006. In total, 9,269 (59%) children did not have any contact with child protection between one year prior to birth and their 11th birthday. Conversely, 6,546 (41%) Aboriginal children were involved with child protection during the study period, with 1,405 (9%) children placed in out-of-home care. Infants who had a child protection notification were more likely than other age groups to have a substantiated notification of abuse and neglect and placed in out-of-home care. More than half (56%) of all children were predominantly placed in kinship care; however, only 22% had their first placement with kinship carers. Aboriginal-led strategies together with the support and commitment of all levels of government are required to reduce entry into care and improve outcomes for Aboriginal children in care. IMPLICATIONS Aboriginal-led strategies and wholistic responses can reduce the overrepresentation of Aboriginal children reported to child protection systems, and support families and communities. Infancy stands out as a key point of system involvement. This stage offers an opportunity where early intervention and family support strategies may prevent first time involvement with the child protection services and promote kinship placement, reunification with parents, and community-led supportive care.

96 The Influence of Consulting Child Protective Care Services on Patients’ Length of Stay in Burns

96 The Influence of Consulting Child Protective Care Services on Patients’ Length of Stay in Burns

Understanding Intimate Partner Femicide and Attempted Intimate Partner Femicide During and After COVID-19: A Comprehensive Strain-Based Approach

Intimate partner femicide (IPF) and attempted intimate partner femicide (AIPF) are severe forms of violence and global phenomena occurring in all societies worldwide. However, explaining IPF and AIPF is a complex and challenging endeavor. This article delves into the evolution of IPF and AIPF in Portugal during and after COVID-19, seeking to comprehend the underlying explanatory factors through a comprehensive strain-based approach. IPF rates during the COVID-19 pandemic have remained relatively stable, comparable to those observed before the pandemic, following a pattern akin to that documented in other countries. However, a significant increase in AIPF occurred during the COVID-19 pandemic, and a slight uptick in IPF indicators was noted toward the end of the pandemic period (2022). Perpetrators faced various strains, such as separation and financial difficulties, along with experiencing emotions like anger, jealousy, anxiety, and depression, leading to instances of IPF and AIPF. The COVID-19 crisis and associated restrictions introduced additional strains, including social isolation, economic losses, anxiety, and widespread fear, which may contribute to psychological distress, stress, and depression, thereby heightening the likelihood of committing IPF and AIPF. The pandemic restrictions also resulted in limited access to support and protection services, hindering victims from seeking help. Establishing a contingency plan for use in future crises (including pandemics) is imperative to promote support for victims and prevent situations of IPF and AIPF.

Similar rates of denial in NICHD and control interviews with alleged child abuse victims in the Netherlands

AbstractPurposeIn the current study, we investigated whether denial and avoidance rates differed statistically significantly based on the interview protocol used.MethodWe examined 38 National Institute of Child Health and Human Development (NICHD) interview transcripts, and 30 control transcripts from interviews from an earlier study (Applied Cognitive Psychology, 2022, 36, 7) conducted with alleged child victims of abuse at Dutch child protection services.ResultsWe detected 57 denial and 282 avoidance statements across the 68 interviews. No statistically significant differences emerged between (1) the proportion of denials using NICHD (42%, n = 16/38) and control interviews (30%, n = 9/30), and (2) the average number of denial statements between NICHD (M = 0.84) and control interviews (M = 0.83). Furthermore, denials (and avoidances) were not more or less likely to occur in response to certain types of questions, even though the majority of denials in our sample occurred in response to option‐posing questions (60%, n = 34/57). Denials did occur statistically significantly less often within the first half of the individual interviews in NICHD than in control interviews.ConclusionsOur findings call attention to the difficulties child protection services face in investigative interviews with alleged child victims.

Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service

BackgroundPublic health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat.MethodsThis qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration.ResultsRelational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners’ behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed.ConclusionsWhen managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.

“Instead of just taking my baby, they could've actually given me a chance”: Experiences with plans of safe care among birth parents impacted by perinatal substance use

BackgroundFederal legislation mandates healthcare providers to notify child protective service (CPS) agencies and offer a voluntary care plan called a “plan of safe care” (POSC) for all infants born affected by prenatal substance use. While POSCs aim to provide supportive services for families impacted by substance use, little is known about birth parents' perceptions and experiences. ObjectiveTo examine birth parents' perceptions and experiences regarding POSC. Participants and settingParents offered a POSC in Philadelphia in the prior year were included. MethodsThis is a qualitative interview study. Participants were recruited from birth hospitals and community-based programs with telephone consent and interview procedures. Transcripts were analyzed using an inductive, grounded theory approach to identify content themes. ResultsTwelve birth parents were interviewed (30.7 % of eligible, contacted individuals). Fear of CPS involvement and stigma were common. Some birth parents reported that the increased scrutiny related to POSCs negatively impacted their attitudes toward healthcare providers and medications for opioid use disorder (MOUD). While parents found the consolidated resource information helpful, many did not know how to access services. Finally, parents desired more individualized plans tailored to their unique family needs. ConclusionsStigma, confusion, and fear of CPS involvement undermine the goal of POSCs to support substance-exposed infants and birth parents. Providers serving this population should be transparent regarding CPS notifications, provide compassionate, non-stigmatizing care, and offer coordination services to support engagement after discharge. Policymakers should consider separating POSCs from CPS to avoid exacerbating fear and mistrust.

What may encourage or deter health services utilization by people living with or at the risk of HIV/AIDS in special health centers? Qualitative evidence from a stigmatized community

BackgroundBehavioral Diseases Counseling Centers (BDCCs) and Vulnerable Women’s Counseling Centers (VWCCs) in Iran are the main peripheral centers that offer educational, counseling, diagnostic, preventive, curative and protective services to individuals living with or at high risk of contracting HIV/AIDS and female sex workers respectively. Due to the social stigma surrounding HIV in Iran, this study aims to identify the factors that may hinder or encourage HIV/AIDS patients and women with risky sexual behaviors from visiting these centers.MethodsConducted in 2023, this qualitative study involved individuals visiting BDCCs and VWCCs in two western provinces of Iran, Ilam and Kermanshah. The study participants included 21 health staff members working in BDCCs and VWCCs and 20 HIV/AIDS patients and vulnerable women with unsafe sexual behaviors referring to these centers. Purposive, snowball and maximum variation sampling techniques were applied to interview the participants. Interviews were conducted between January 5th and May 21st, 2023, using a semi-structure guideline. Interviews were transcribed and content analysis approach was applied to analyze data using MAXQDA20 software.ResultsAccording to the findings, the barriers and facilitators of visiting specialized centers for HIV/AIDS patients and vulnerable women were categorized into three main categories, 10 subcategories and 35 sub-subcategories including: Medical and operational processes (4 subcategories and 12 sub-subcategories), mutual interactions between the personnel and visitors (people living with and at the risk of getting HIV/AIDS) (3 subcategory and 13 sub-subcategories), and physical characteristics of the centers (3 subcategories and 10 sub-subcategories).ConclusionsTo improve the performance of BDCCs and VWCCs and encourage people living with and at the risk of contracting HIV/AIDS to visit these centers regularly, health policy makers should consider modifying clinical processes, physical features, personnel behaviors and visitors’ concerns raised by the interviewees and the issues identified in this study.

Problems and prospects of prevention of family problems: the results of the author's research (based on the materials of the Republic of Mordovia)

The article presents the results of the author's sociological research on the identification of problems and prospects for the prevention of family problems in the Republic of Mordovia. The authors analyzed the opinions of competent employees of social protection and social service institutions of the Republic of Mordovia, which allowed not only to identify current problems in the prevention of family problems in the Republic of Mordovia, but also to identify promising areas. The authors conclude that the further prospects for the modernization of the state family policy in the field of prevention of family problems depends on the solution of a number of tasks related to its theoretical and methodological, regulatory, organizational, managerial and resource support.

Morphoagronomic descriptors of rice landraces varieties (Oryza sativa L.) from the state of Maranhão

Rice landrace varieties are adapted to the most diverse environmental conditions, which is clearly important in periods of great climatic and sanitary uncertainties. However, there is a gap in their description in the literature. Maranhão, Brazil, has wide diversity in landrace seeds, with rice varieties that can significantly contribute to the genetic breeding of the species. Based on this information, the objective of the present study was to characterize the landraces rice varieties, through the description of the morphological and agronomic profile. The study analyzed 23 qualitative heredity descriptors and three quantitative descriptors in 21 rice landrace varieties from different locations in the state of Maranhão, according to the methodological procedures recommended by the National Cultivar Protection Service. A randomized block e experimental design was used (DBC), with 21 treatments and four replications. Considering complementing To complement the study, a multicategorical analysis was carried out between the 21 accessions, based on qualitative data obtained from the 22 morphological descriptors, which generated a dendrogram. The results showed that there are differences between the qualitative descriptors. Quantitative descriptors are highly significant, with regard to the number of tillers, with emphasis on the Edinho variety. The Quechi variety was responsible for one of the factors that most influences the rice yield, with the highest number of grains per panicle. The varieties Codozinho, Edinho, Palha Murcha and Pé Roxo, are more productive in number of panicles. The dendrogram formed three clusters with evidence of dissimilarities between the varieties. The results show that the landrace varieties differ in their morphoagronomic characteristics and can be valuable materials in the construction of a new, more sustainable agriculture.

Digital micro-banking as a health and protection intervention for street-connected children and youth? Analysis from a Togolese pilot

BackgroundThe SaVa pilot offered street-connected children and youth (C&Y) access to digital micro-banking services to help them save money and thus avoid the violence associated with theft at night. It...

Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district.

An earthquake with a magnitude of 7.7 occurred in Pazarcık District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaraş Earthquake and who were living in Nurdağı District of Gaziantep after the earthquake. Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdağı District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims. The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05). General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.

Perceptions of Cannabis Use and Its Benefits and Risks Among Breastfeeding Mothers.

Approximately 5% of breastfeeding women report using cannabis. Little is understood about perceived benefits and risks of cannabis use; thus, this study aimed to fill this gap. An anonymous online survey was conducted from 2018 to 2019 among breastfeeding women (n = 1516) who used cannabis. Data collected included demographics, frequency and timing of cannabis use, perceived effects in infants, and repercussions experienced. Analyses included descriptive statistics; chi-square and t-tests were used to test differences between groups (SPSSv28). A subset (n = 413) left open-text responses about cannabis and its perceived risks and benefits. Content analysis and ATLAS.ti were used for open-ended responses. Two-thirds (67%) of participants were "not at all" concerned that cannabis use while breastfeeding affected their baby. Only 3% attributed symptoms in their infants to cannabis use; symptoms were perceived as positive or negative. Interestingly, 45% (n = 603) altered timing of cannabis use relative to breastfeeding to avoid exposing their infant to cannabis. Most mothers (85.8%) reported no changes in their breast milk supply. Few respondents were investigated by Child Protective Services (6.9%) or arrested (3.8%) for cannabis use. In open-ended responses, three themes emerged about the perceptions of cannabis use while breastfeeding: (1) cannabis preferred to address medical concerns, (2) positive impact of cannabis on quality of life for mothers and their children, and (3) concerns about negative consequences. Breastfeeding mothers who used cannabis reported positive perceptions of cannabis as a safer alternative to medications, yet concerns existed about legal repercussions. Understanding maternal perceptions may be useful in developing successful approaches to counseling mothers about cannabis use.