Search

Objectives Home visiting is a popular approach to improving the health and well-being of families with infants and young children in the United States; but, to date, no home visiting program has achieved population impact for families in rural communities. The current report includes evaluation results from the dissemination of a brief, universal postpartum home visiting program to four high-poverty rural counties. Methods The study utilized a quasi-experimental design. From Sept. 1, 2014-Dec. 31, 2015, families of all 994 resident births in four rural eastern North Carolina counties were assigned to receive Family Connects (FC; intervention group). A representative subsample of families participated in impact evaluation when the infants were 6 months old: 392 intervention group families and 126 families with infants born between Feb. 1, 2014-July 31, 2014 (natural comparison group). Data were analyzed preliminarily for reporting to funders in 2016 and, more comprehensively, using propensity score matching in 2020. Results Of FC-eligible families, 78% initiated participation; 83% of participating families completed the program (net completion = 65%). At age 6 months, intervention parents reported more community connections, more frequent use of community services, greater social support, and greater success with infants sleeping on their backs. Intervention infants had fewer total emergency department and urgent care visits. Intervention parents had more total emergency department and urgent care visits and (marginally) fewer overnights in the hospital. Conclusions for practice FC can be implemented successfully in high-poverty rural communities with broad reach and positive benefits for infants and families., Author(s): W. Benjamin Goodman [sup.1] , Kenneth A. Dodge [sup.2] , Yu Bai [sup.1] , Robert A. Murphy [sup.1] , Karen O'Donnell [sup.1] Author Affiliations: (1) grid.26009.3d, 0000 0004 1936 [...]

Objective: Young people living with HIV (YPLWH) experience increased morbidity and mortality compared to all other age groups. Adolescence brings unique challenges related to sexual reproductive health, the elevated importance of peer groups, and often, emerging symptoms of emotional distress. Failure to address this unique life stage for YPLWH can lead to worse HIV and mental health outcomes. Herein lies the protocol for a hybrid-type-1 effectiveness-implementation trial designed to evaluate a mental health and life skills intervention that aims to address these needs for YPLWH in Tanzania. Methods: This is an individually randomized group-treatment trial designed to evaluate the effectiveness of Sauti ya Vijana (SYV: The Voice of Youth) toward improving viral suppression (HIV RNA <400 copies/mL) and mental health outcomes and to assess implementation including acceptability, feasibility, fidelity, and cost-effectiveness of the manualized intervention. The trial is being conducted across four geographically distinct regions of Tanzania. Peer group leaders (PGL) with lived HIV experience deliver the 10-session group-based intervention and two individual sessions during which participants describe their disclosure narrative (when they learned they live with HIV) and value-based goal setting. Caregiver or chosen supportive adults are encouraged to attend two specific group sessions with their youth. Participants are 10–24 years of age, prescribed antiretroviral therapy for at least 6 months, fully aware of their HIV status, able to commit to session attendance, and able to understand and meaningfully contribute to group sessions. Participant study visits occur at 5 time points for evaluation: baseline, 4-, 6-, 12-, and 18-months post baseline. A single booster session is conducted before the 12-month visit. Study visits evaluate mental health, adverse childhood events, interpersonal violence, resilience, stigma, HIV knowledge, substance use, sexual relationships, ART adherence, and HIV RNA. Implementation outcomes evaluate feasibility and acceptability through attendance, intervention session notes, focus discussion groups and qualitative interviews. Fidelity to the intervention is measured using fidelity checklists by a PGL observer at each group session. Cost effectiveness is calculated using an incremental cost-effectiveness ratio that utilizes a patient cost questionnaire and financial records of study costs. Significance: Few mental health interventions for YPLWH have demonstrated effectiveness. Results from this study will provide information about effectiveness and implementation of a peer-led intervention for delivering a mental health and life skills intervention in low-income settings. Trial identifier: This trial is registered at clinicaltrials.gov NCT05374109. [ABSTRACT FROM AUTHOR]

How do we hold the tension between the doctrine of Providence and the purpose of intercessory prayer? What is it we are praying for in the light of God’s Providence? In this article, I critique the doctrine of Providence from the perspective of feminist theology, reimagining Providence away from monarchical power into softer, relational forms of power. I will then draw this reimagining into dialogue with intercessory prayer, particularly in response to trauma. Using both feminist and trauma theologies, I will offer a re-visioned understanding of intercessory prayer that does justice to trauma experiences and to the love of God. [ABSTRACT FROM AUTHOR]

Existing GCSE and A-level syllabuses include modules on religion and the media, but these have not been widely or well studied for a variety of reasons. The modules may be considered difficult to teach well, and teachers have few good resources to use in comparison with more popular topics such as medical or environmental ethics. The newly launched specifications for RS GCSE and A-level examinations have eliminated, almost entirely, any study of religion and the media. The absence of this theme is troubling. There is a strong case to be made that critical appreciation of the ways media depicts religion is especially important for forming responsible, educated citizens in modern Britain, many of whom will not participate directly in religious communities but will see much depiction of such communities and their ideologies in the media. We propose key principles and questions that might help equip teachers to tackle critically and intelligently issues about religion in the media as they arise. We illustrate this approach by considering media responses to the Charlie Hebdo attacks in Paris.

Objective: This manuscript describes the Day‐in‐the‐Life (DIL) method for assessing child caregiving activities, its implementation, and findings regarding family members' roles and associations with maternal depression symptoms. Background: Infant caregiving activities are most commonly performed by the mother, although there is increasing acknowledgement of others' contribution. Few methods exist to measure the diverse caregiving activities that mothers and others perform. Method: Method development occurred within the Bachpan Cohort Study in rural Pakistan (N = 1154 maternal–child dyads) when the child was 3 months old. The DIL was designed as a semi‐structured interview in which the mother describes her child's day from their perspective. Regression analyses were then used to explore the correlation between the DIL and depression symptoms, using the Patient Health Questionnaire‐9 (PHQ‐9) measure. Results: The DIL method was easy to administer and displayed excellent interrater agreement. The findings indicated that instrumental caregiving was mostly provided by the mother alone, others in the household tended to contribute more to infant social interactions, and there was more support from others when the mother was less able to provide care (e.g., when ill). Depression symptoms were higher among women who experienced less contribution from family members when the mother was less able to provide care. Conclusions: The DIL can be deployed to measure infant caregiving activities and associations with maternal mental health. Implications: This method is promising for researchers interested in disentangling the contribution of multiple family members toward child caregiving and its impacts on maternal and child health. [ABSTRACT FROM AUTHOR]

This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI's goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing the healthy parent-child relationship. A community collaborative of government agency directors has signed a memorandum of agreement to implement the PSoC principles. The researchers will use multiple methods to evaluate DFI's efficacy.