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Introduction: Increased access to midwifery care is one strategy that could improve perinatal health outcomes and help address the maternal health crisis in the United States. A modifiable barrier to increasing the workforce is greater access to midwifery preceptors for clinical training. The objective of this research is to use the socioecological framework to identify midwives' perceptions of the barriers and facilitators to precepting students in clinical areas. Methods: Midwives attending a preceptor education and training workshop series responded to 3 different questions at the end of each session: (1) What makes precepting midwifery students challenging? (2) What makes precepting midwifery students possible? and (3) What makes precepting midwifery students worthwhile? Responses were coded to align with the socioecological framework, which distinguishes individual, interpersonal, community, institutional, and policy‐level influences. Results: Midwives' responses were spread across the levels of the socioecological model except for policy. Participants identified institutional influences such as support as factors that made precepting feasible, both individual and interpersonal factors such as time constraints as areas that presented challenges to precepting, and community factors, like the joy of sharing midwifery, contributing to what made precepting worthwhile. Discussion: Multiple levels of influence were identified in the preceptor process. Participants were internally motivated to precept while also articulating that to make precepting possible, there is a need for support from both colleagues and the greater systems within which they worked. Further studies are needed to investigate an ecosystem that facilitates an effective and sustainable model for midwifery precepting. Additionally, there is a need for efforts to engage and educate midwives in clinical practice about government advocacy that could actualize policy initiatives to support clinical midwifery education. [ABSTRACT FROM AUTHOR]

This research seeks to understand the challenges faced by settlement service providers (SSPs) in assisting humanitarian migrants to secure appropriate employment. In‐depth interviews with 26 SSPs identified that current impediments to facilitating humanitarian migrants' employment related to employment support programmes; settlement service partnerships; cultural appropriateness of services; employment readiness, experience, skills and knowledge; social support and networks; and limitations of funding and service agreements. While employment is recognised as key to effective settlement, the findings of this study show that employment services are not currently a focus of settlement services, that is, most employment services delivered by settlement services were coordinated as part of job preparedness or readiness programmes. The paper argues for government to ensure financial and human resources to enable SSPs to deliver services that can formally recognise and overcome barriers to humanitarian migrants' employment. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio‐ecological perspective. Design: A questionnaire survey was conducted in three secondary schools and three colleges in China. Sample: A total of 1756 students aged 14–22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors. Measurements: Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self‐efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured. Results: Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self‐efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine. Conclusions: Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake. [ABSTRACT FROM AUTHOR]

Every counselor–client interaction is an opportunity for mutual learning through inquiry, listening, exploring, and understanding about a client's experiences with development and well‐being. Given the convergence of multiple sociopolitical events and systems that impact mental health and well‐being, we issue a call to increase promotion and uptake of preventative mental health strategies by assessing the social determinants of mental health (SDMH) in counseling practice. We contend that counselors are uniquely prepared to assess the SDMH at the intrapersonal, interpersonal, and environmental levels. Therefore, we review the parallels between counseling frameworks and the SDMH with the aim of explaining why and how counselors should assess the SDMH. Specifically, we describe ways that counselors can use their foundational skills and expertise in assessment procedures to identify client needs, as well as potential individual and community interventions. We outline a four‐phased approach for assessing the SDMH in counseling practice and provide implications for improving counseling outcomes. [ABSTRACT FROM AUTHOR]

This study examined the adoption and implementation process in early efforts to implement ecological ("outer layer") sexual violence (SV) prevention strategies. Interviews with 28 preventionists from 26 local sites within a large, midwestern state, were conducted to examine individual preventionists' problem definitions of SV and ecological factors surrounding implementation. Findings suggest that SV prevention in the state is primarily implemented at the individual‐level; when preventionists described engaging in or anticipating outer layer interventions, they were often tertiary (i.e., responding after perpetration; e.g., Sexual Assault Response Teams). A majority expressed problem definitions rooted within the individual (e.g., perpetration due to a lack of consent education), and a majority of implemented efforts matched this individual‐level conceptualization. Yet, contradictions between problem definitions (e.g., SV stemming from oppression) and implemented activities (e.g., single‐session educational interventions) emerged. Such contradictions may be best understood in light of contextual implementation influences: diverse preventionist job responsibilities, less training/support for outer layer prevention, preventionist autonomy, leadership messaging, time requirements, partner reticence, and extensive work with schools. Inner layer influences, including identification with job roles, preference for, and a sense of urgency toward inner layer work, appeared to interact with contextual factors. Implications across community psychology domains are discussed. Highlights: Sexual violence (SV) prevention can be at approached inner (e.g., increasing personal knowledge) and outer layers (e.g., addressing inequities).A focus on outer layer prevention efforts requires a shift for some SV preventionists.Preventionists often paired inner layer SV understandings with implemented inner layer prevention.Contradictions emerged when outer layer understandings were paired with inner layer prevention implementation.Moving to ecologically informed prevention requires attention to the ecology of prevention work itself. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Little is understood about dental student perspectives providing care to people with serious mental illness (SMI), a population with significant oral health disparities. This study explored student perceptions, questions and beliefs about people with SMI using the Social Ecological Model as a framework to better understand perspectives and identify potential educational needs in dental medicine curricula for providing care to this population. Methods: Survey data was collected in spring of 2021 from predoctoral dental students (n = 126) enrolled in a required course at a mid‐Atlantic university. Ninety‐nine percent of the students completed the survey. The IRB approved qualitative study examined student responses to a six question survey using content analysis. An iterative coding process was used and included reflexivity memos, data dictionaries and consensus building among the four coding researchers to identify recurring concepts and ultimately identify themes. Results: Four primary themes were identified: Concerns and Stereotypes; Uncertainties; Professional Role and Responsibilities; and Learning Preferences. Participants expressed fear and discomfort in working with people with SMI. They also noted multiple questions about providing clinical care, referrals and the interaction of oral health and mental health. Lastly, they offered ideas about educational strategies to improve learning on the topic. Conclusion(s): Pre‐doctoral dental students have concerns about providing care to people with SMI and limited understanding of dental professional role and responsibilities about care for this vulnerable population. Predoctoral dental curriculum should be expanded to address professional roles when working with this population to improve student competency and comfort, and ultimately improve care to people with SMI. [ABSTRACT FROM AUTHOR]

In this work, we propose a socioecological model to describe the effects of visiting tourists in biological attractive sites. We model conditioned interactions between the forest resources and the wildlife with the tourists. This allows us to describe the net benefits–costs rates that the species and their habitats receive from the interaction with tourists. We show that when a scenario of sustainable tourism exists, it is always at risk. This occurs because there is at least a component of the socioecological system that can go to zero when the initial conditions belong to the basin of attraction of a border equilibrium. However, a sustainable equilibrium can be reached when the initial conditions belong to the basin of attraction of a positive attractor. The analysis of the model shows that increasing the tourism carrying capacities can lead to different dynamical patterns. Sometimes, these patterns describe scenarios of unsustainable tourism. When this is the case, by decreasing the negative impact due to the nature and wildlife‐based tourism industry, a tourism sustainability can be reached. Among the scenarios of unsustainable tourism, there are scenarios without wildlife and/or tourists or without both; scenarios in which the ecological and the social variable show sustained oscillations, or scenarios with chaotic patterns for these variables. We show numerical solutions of the model to display different scenarios when the touristic carrying capacities are varied. Recommendations for Resource Managers: Sustainable tourism is possible if one proposes moderated values for the carrying capacities of the touristic site.The socioecological system is sustainable if the initial conditions belong to the basin of attraction of a positive attractor (a sustainable scenario). When this is not the case, an extinction scenario of the wildlife or a scenario without tourist or a scenario without wildlife and tourists occurs.An increase in the carrying capacity of the forest resources and the wildlife of the touristic site can lead to sustained oscillations. This undesirable scenario can be avoided if the tourists are more friendly with nature. [ABSTRACT FROM AUTHOR]

Substance use disorders are increasingly prevalent among veterans in the United States. Veterans in recovery face unique challenges, such as high rates of psychiatric comorbidities, difficulties adjusting to civilian life, and inadequate housing and mental health services. While prior research has explored veterans' experiences in recovery, studies have not implemented a multilevel perspective in their analyses. The current qualitative study examined how individual veteran experiences intersect with interpersonal and systemic factors. Semistructured focus groups were conducted with veterans who were former or current residents of recovery homes (N = 20). Thematic analysis was utilized to explore veterans' personal experiences through the CHIME‐D framework (connectedness, hope & optimism, identity, meaning in life, empowerment, and difficulties). The data were further analyzed within a socioecological model (intrapersonal, interpersonal, and community). Each component of the CHIME‐D framework was salient across all focus groups, with connectedness, empowerment, and difficulties being the most prominent themes that occurred across all socioecological levels. Results suggest that recovery initiatives can effectively assist veterans by promoting empowerment, facilitating social connections, and addressing cooccurring difficulties across multiple socioecological contexts. Additionally, treatment programs should encourage veterans to take on meaningful roles in their communities. Future research should continue to explore veterans' recovery experiences using a socioecological model. Highlights: Veterans have specific characteristics that hinder or benefit their substance use recovery.Applying a socioecological model to the connectedness, hope & optimism, identity, meaning in life, empowerment, and difficulties framework captures veterans' recovery experiences.Individual, interpersonal, and community‐level support are all paramount to recovery.Veterans who are empowered and connected within their communities help peers in recovery. [ABSTRACT FROM AUTHOR]

In Uganda, almost half of children under 5 years old suffer from undernutrition. Undernutrition, a common form of malnutrition in children, encompasses stunting, wasting and underweight. The causes of child undernutrition are complex, suggesting that interventions to tackle malnutrition must be multifaceted. Furthermore, limited access to healthcare for vulnerable populations restricts the potential of hospital‐based strategies. Community‐based management of acute malnutrition (CMAM), which includes nutritional counselling, ready‐to‐use therapeutic foods and the outpatient management of malnutrition by caregivers, is recognised as an effective approach for children's recovery. However, evaluations of CMAM programs are largely based on biomedical and behavioural health models, failing to incorporate structural factors that influence malnutrition management. The objective of this evaluation was to understand the factors influencing malnutrition management in a CMAM program in rural Uganda, using the socioecological model to assess the multilevel determinants of outpatient malnutrition management. This evaluation used qualitative methods to identify factors related to caregivers, healthcare providers and societal structures that influence children's outpatient care. Data were collected at a community health clinic in 2019 through observations and interviews with caregivers of malnourished children. We observed 14 caregiver‐provider encounters and interviewed 15 caregivers to examine factors hindering outpatient malnutrition management. Data were thematically analysed informed by the socioecological model. Findings showed that caregivers had a limited understanding of malnutrition. Counselling offered to caregivers was inconsistent and insufficient. Poverty and gender inequality limited caregivers' access to healthcare and their ability to care for their children. Factors at the caregiver and healthcare levels interacted with societal factors to shape malnutrition management. Results suggest that CMAM programs would benefit from providing holistic interventions to tackle the structural barriers to children's care. Using a socioecological approach to program evaluation could help move beyond individual determinants to address the social dynamics shaping malnutrition management in low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among youth in the United States. Data from the 2015 Youth Risk Behavior Survey of 9th–12th grade students in New Hampshire (N = 14,837) were utilized. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models to evaluate associations between suicidal ideation, adverse childhood experiences (ACEs), and other risk factors including using opioids/drugs without a prescription and food insecurity. We also examined whether potentially protective behaviors may attenuate the relationship between ACEs and suicidal ideation. The prevalence of suicidal ideation was 15.4% (girls 20.15; boys 10.67). In unadjusted models, the crude odds ratio reflecting the relationship between suicidal ideation and higher ACE scores was 1.85 (95% CI 1.76–1.94). In adjusted models, suicidal ideation remained positively associated with higher ACE scores (aOR 1.61, 95% CI 1.52–1.70). Risk and protective behavioral factors identified in relation to suicidal ideation and ACEs are discussed within the context of community–academic partnerships and policy. [ABSTRACT FROM AUTHOR]

The transition from solitary life to sociality is considered one of the major transitions in evolution. In primates, this transition is currently not well understood. Traditional verbal models appear insufficient to unravel the complex interplay of environmental and demographic factors involved in the evolution of primate sociality, and recent phylogenetic reconstructions have produced conflicting results. We therefore analyze a theoretical model for the evolution of female social philopatry that sheds new light on the question why most primates live in groups. In individual‐based simulations, we study the evolution of dispersal strategies of both resident females and their offspring. The model reveals that social philopatry can evolve through kin selection, even if retention of offspring is costly in terms of within‐group resource competition and provides no direct benefits. Our model supports the role of predator avoidance as a selective pressure for group‐living in primates, but it also suggests that a second benefit of group‐living, communal resource defense, might be required to trigger the evolution of sizable groups. Lastly, our model reveals that seemingly small differences in demographic parameters can have profound effects on primate social evolution. [ABSTRACT FROM AUTHOR]

Summary: Sedentary behaviour tracks from early to middle childhood, suggesting the need to intervene early. The aim of this systematic review was to identify determinants of change in accelerometer‐assessed sedentary behaviour in young children, with a view to informing interventions. Ten electronic databases were searched. Longitudinal and intervention studies were included if they (a) targeted sedentary behaviour in young children (less than of equal to 6 years), (b) assessed change in accelerometer‐assessed sedentary behaviour, and (c) reported on at least one determinant of change in sedentary behaviour. Intervention components were coded according to clusters of behaviour change technique (BCT) (ie, grouping similar BCTs components). Data synthesis was guided by the socioecological model. Sixteen studies (four longitudinal; 12 intervention) met the inclusion criteria. Two (out of five identified determinants) were associated with an increase in sedentary behaviour in longitudinal studies: the after childcare/school period and transition from childcare to school. Three (out of 21 identified determinants) were associated with a decrease in sedentary behaviour in intervention studies: "goals and planning" (ie, "behavioural contract"), "repetition and substitution" (ie, "graded tasks"), and "reward and treat" (ie, "incentives"). The environmental and interpersonal determinants identified in this review may help to inform behavioural strategies, timing, and settings for future interventions. [ABSTRACT FROM AUTHOR]

We investigated child, family, and environmental factors associated with young children's perceptions of locomotor (LM) and object control (OC) skills. The participants comprised 472 children (6.22 ± 0.63) and their parents. The children were assessed for their perception of motor competence in LM and OC skills (using the pictorial scale of Perceived Movement Skill Competence for young children), and actual motor competence (Test of Gross Motor Development 3rd edition and Körperkoordinationstest Für Kinder). Anthropometrics were calculated using the children's body mass index standard deviation scores. A parent questionnaire included questions about child factors (sex, child's independent walking age, time spent sedentary and outdoors, participation in organized sport activities, and access to electronic devices), family factors (parent educational level, physical activity frequency, and sedentary behavior), and environmental factors (access to sport facilities). Variance analysis sought to identify age‐related differences, and a linear regression model examined correlates of children's perception of LM and OC skills. The children's movement skill perceptions were found to be generally high. Four factors explained 5.7% of the variance in perceptions of LM skills and 7.5% of the variance in perceptions of OC skills. Two factors, lower age and higher actual motor competence, explained most of the children's skill perceptions. Access to electronic devices (less) and Body mass index (BMI) (higher) were associated with perceptions of LM skills. Participation in organized sport activities (higher) and parental education (lower) were associated with perceptions of OC skills. When promoting children's physical activity and motor competence, perceptions of motor competence are an important consideration. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to explore multilevel factors affecting older Korean immigrants' health-seeking behaviours. Background: Although studies have documented significant issues related to healthcare access and utilisation issues among older immigrants, a noted limitation of current research is its failure to explore multiple factors related to their health-seeking behaviours. Design: A qualitative study using interview data from two previous studies. Methods: We performed a qualitative analysis of focus groups and individual interviews using inductive coding methods. The socioecological model provided a useful framework to guide this study. The sample included 17 community-dwelling older Korean immigrants aged 65 years living in the metropolitan area of Seattle, WA, USA. Results: Findings revealed various factors at the individual (e.g., perception of health and illness, mistrust, cultural values and norms, length of residency in the United States, language barriers and ageing experiences), interpersonal (e.g., peers, family and primary care physicians), community (e.g., ethnic community centres and organisations, home care helpers and interpretation services) and policy (e.g., lack of affordability and health benefits coverage) levels. Each of these factors played a role as either a barrier to or facilitator of older Korean immigrants' health-seeking behaviours. Several factors, such as language barriers and lack of available information, were intertwined. Conclusions: Findings indicate the importance of considering four major areas when designing culturally appropriate, community-based interventions for older immigrants. Also, utilising peers or trusted human resources in the community is critical to the design and implementation of health promotion interventions for older immigrants. Implications for Practice: Examining intrapersonal, interpersonal, community, and policy level factors that affect older immigrants' health-seeking behaviours informs the design of community-based health promotion interventions for older immigrants. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The socioecological model (SEM) is a popular collection of controversial models purporting to explain mating systems in terms of ecological and social parameters. Despite its guise of objectivity, several of its hypotheses assume Victorian gender stereotypes of active, competing males heedlessly sowing their seeds, and cautious, passive females, imprisoned by greater costs of reproduction and their consequent resourceߚdependence. Methods: We enter this debate by taking a previously neglected explanatory approach borrowed from species theory. According to the Recognition Concept of sexual species, the unit of reproductive success/fitness is irreducible to fewer than two integrated subparts (minimally a male and a female). Phyletic changes in mating systems logically effect changes in fertilization systems, leading to reproductive isolation. We take our primary assumption of the average equivalence of female and male contributions to successful reproduction from the writings of the natural philosopher, Antoinette Blackwell. Results: We revisit the SEM with its contradictions and extrapolations, and develop a genderߚneutral alternative hypothesis termed SpecificߚMate Contact (SMC), centered on two fundamental mating strategies: sexual animals may behave as synchronous mateߚattractors or asynchronous mateߚseekers, generating four possible mating system combinations (monogamy: two attractors; promiscuity: two seekers; polygyny: male attractor and female seeker; polyandry: female attractor and male seeker). Conclusions: Our approach predicts all known primate mating systems using a neutral (nonߚsexist) principle. The approach is also neutral in the sense that it does not invoke either competition or cooperation: fertilization success is considered a posteriori and males and females are coߚadapted to this end rather than cognitively cooperative. [ABSTRACT FROM AUTHOR]

Objective Rural Australians have a higher likelihood of chronic disease and lower levels of physical activity than urban Australians. Little is known of the factors associated with physical activity among rural-dwelling Australians. This study sought to determine the correlates of physical activity among men and women of the South Australian Riverland region. Design Cross-sectional survey. Setting Regional area. Participants There are 299 randomly selected 18-65 year olds. Main outcome measures Determinations of insufficient and sufficient physical activity levels based on public health recommendations. Results Using logistic regression: in men, sufficient physical activity was associated with reporting perceived sufficient physical activity for health (odds ratio 3.194 [1.703-5.989]), and having friends who encouraged physical activity (3.641 [1.450-9.141]). Men who reported insufficient time (0.350 [0.151-0.812]) and getting enough physical activity at their job (0.374 [0.199-0.702]) were less likely to be sufficiently active. In women, sufficient physical activity was associated with not being employed (2.929 [1.063-8.066]), higher self-efficacy (2.939 [1.118-7.726]) and having a regular physical activity routine (3.404 [1.829-6.337]). Older age (0.960 [0.929-0.995]), poorer self-rated health (0.233 [0.060-0.900]) and weekend sitting time (0.823 [0.692-0.980]) were negatively associated with sufficient physical activity for women. Conclusions Factors associated with physical activity in this rural adult population differed by sex. Sex-specific approaches to promote physical activity might have utility for this population. Strategies to enhance social connectedness among men and encourage physical activity outside of work can be warranted. Women can require programs to help them develop a regular physical activity routine and improve self-efficacy. [ABSTRACT FROM AUTHOR]

Efforts to understand the variation in primate social systems and their underlying interaction patterns have focused on both intrinsic and extrinsic factors. In the socioecological model, food distribution and abundance have been argued to be the primary influences on the social behavior of primate species. We examined the relationship of food resources and two intrinsic factors-kinship and proximity-with patterns of affiliative and agonistic relationships in two semi-free ranging ringtailed lemur, Lemur catta, social groups (N=14) at The Duke Lemur Center in Durham, NC. In analyzing these three factors concurrently within the same system, we attempt to establish their relative power in explaining the characteristics of social relationships. Patterns of affiliation and high-intensity agonism were best explained by kinship. Proximity also explained affiliation but did not explain agonism, which varied considerably between groups. The influence of food on social interactions was highly variable between the two groups and, therefore, did not convincingly account for the social behavior patterns we observed. Finally, different intensities of agonism have different patterns and should be analyzed individually. The variation between social groups makes it difficult for us to conclude that any one factor is primarily and universally responsible for patterns of social behavior in this species. Am. J. Primatol. 72:981-991, 2010. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]