Reliability and validity of a short form household food security scale in a Caribbean community

BACKGROUND: We evaluated the reliability and validity of the short form household food security scale in a different setting from the one in which it was developed. METHODS: The scale was interview administered to 531 subjects from 286 households in north central Trinidad in Trinidad and Tobago, West Indies. We evaluated the six items by fitting item response theory models to estimate item thresholds, estimating agreement among respondents in the same households and estimating the slope index of income-related inequality (SII) after adjusting for age, sex and ethnicity. RESULTS: Item-score correlations ranged from 0.52 to 0.79 and Cronbach's alpha was 0.87. Item responses gave within-household correlation coefficients ranging from 0.70 to 0.78. Estimated item thresholds (standard errors) from the Rasch model ranged from -2.027 (0.063) for the 'balanced meal' item to 2.251 (0.116) for the 'hungry' item. The 'balanced meal' item had the lowest threshold in each ethnic group even though there was evidence of differential functioning for this item by ethnicity. Relative thresholds of other items were generally consistent with US data. Estimation of the SII, comparing those at the bottom with those at the top of the income scale, gave relative odds for an affirmative response of 3.77 (95% confidence interval 1.40 to 10.2) for the lowest severity item, and 20.8 (2.67 to 162.5) for highest severity item. Food insecurity was associated with reduced consumption of green vegetables after additionally adjusting for income and education (0.52, 0.28 to 0.96). CONCLUSIONS: The household food security scale gives reliable and valid responses in this setting. Differing relative item thresholds compared with US data do not require alteration to the cut-points for classification of 'food insecurity without hunger' or 'food insecurity with hunger'. The data provide further evidence that re-evaluation of the 'balanced meal' item is required.

Reproductive Health Policies and Programs in eight countries: Progress since Cairo

Looks at reproductive health policies and programs in eight countries. In-depth interviews in 1997 with stakeholders in Bangladesh, India, Nepal, Jordan, Ghana, Senegal, Jamaica and Peru; Adoption of the 1994 International Conference on Population and Development in six of the eight countries studied; Discussion of implementation problems.(AU)

Aggressive behaviour in children and adolescents. Part 1: a review of the effects of child and family characteristics

Interpersonal violence is a major public health concern throughout the West Indies, particularly in Jamaica. Many factors contribute to a youth's violent or aggressive behaviour, ranging from individual temperamemt, to family structure, to large sociocultural influences. In Part 1. we review the incidence and severity of violence, and discuss the effects of individual characteristics, and of family structure and discipline. In Part 11, the reported effects of school structure, peer relationships and interaction, corporal punishment and the media on violenct behaviour in children and adolescents are reviewed, and potential policy implication are discussed.(AU)

Some effects of sex, age, and household structure on family drawings of Barbadian children

An analysis of the family drawings of a nonclinical sample of 502 Barbadian children aged 7-11 years is reported. The inclusion or omission of figures and the size and positioning of the figures of parents and self were examined with reference to sex, age, and household structure. The view that cultural values about the structure of the family unit and parental roles are reflected in children's representations of their parents in family drawings was supported. (AU)

The identity of mixed parentage adolescents

Theories about black identity are discussed in relation to a study of adolescents with one white and one African or African-Caribbean parent. Interview findings on their racial self-definition, attitudes to their mixed parentage, and allegiance to black and white people and cultures reveal a wide range of racial identities and cultural allegiances. Differences are related to type of school, social class, and the degree of politicisation of the young person's attitudes to race. The findings are discussed in relation to the issue of interracial adoption and fostering, and to recent debates about the concept of an essential black identity.(AU)

Factors associated with weight for height and skinfold thickness in British children

STUDY OBJECTIVES- to examine the associations of social and biological factors with measures of obesity in children. PARTICIPANTS - The subjects were primary school children aged mainly 5-11 years living in England and Scotland. The "representative" sample included 10 628 children - 6463 living in England and 4165 living in Scotland. The "inner city" sample included 7049 children - 2183 white, 1124 Afro-Caribbean, 2696 Indian subcontinent, and 1046 from other groups. Due to missing values on continuous variables, 8374 children were included in the analyses. MEASUREMENTS AND MAIN RESULTS - the relation between the social environment and childhood overweight was studied using several indicators of obesity. Triceps, subscapular, the sum of triceps and subscapular skinfolds, and weight for height were used as dependent variables. The analyses were carried out in two stages. Firstly, multiple linear regression analyses were used to assess the factors associated with dependent variables treated as continuous. Secondly, multiple linear logistic regression analyses were used to examine the association between independent factors and and overweight and fatness defined as binary variables. Birth weight , mother's body mass index (BMI), and father's BMI were consistently associated (p<0.001) in all models and were the variables that contributed most to the explained variation in the dependent variables. In the multiple regression analyses there was a consistent interaction between the effects of ethnic origin and family size on each outcome variable. In the logistic regression analyses the interaction was not significant, and highly significant association between both overweight and fatness with the number of children were shown. Ethnic group was not significantly associated with overweight but it was with fatness. The strengths of the remaining significant associations were slight and inconsistent in relation to the dependent variables or the type of analysis. CONCLUSION - very few variables were associated with measures of overweight and fatness. The only useful factor that was highly associated with all mesaures of fatness was the parents' BMI. Strategies to prevent childhood obesity should be aimed at the total population and special emphasis should be placed on families in which one or both parents are overweight. (AU)

Profile of two child guidance clinics looking at referral patterns, family characteristics and diagnoses

A retrospective study was conducted which comprised 212 patients who attended the Comprehensive Health Center Child Guidance Clinic and 107 who attended the University of the West Indies Child Guidance Clinic. Both clinics were similar in most areas. The mean age was 10.5 ñ 3 with 48.3 percent in the age group 11-15 years. 62. 4 percent of the patients were male and 87.1 percent were from the Kingston Metropolitan area. 37.5 percent of the patients were attending primary schools. 20.4 percent of the patients were from two-parent families. The most common diagnosis was conduct disorder (32.3 percent). The most common presenting complaints were stealing (36.4 percent), learning problems (32.6 percent) and aggressive behaviour (26.6 percent). Psychotheraphy was the favored mode of therapy. The attrition rate was greater than 70 percent. One major difference between the clinics was that there were more referrals (31.1 percent vs. 9.3 percent) from family members and less referrals (25.0 vs 44.9 percent) from health professionals at the Comprehensive Clinic in comparison to the University Clinic. Another difference was that some findings at the Comprehensive Clinic were statistically significant while similar findings at the University Clinic were not. There was a significantly higher percentage of patients receiving individual (61.8 percent vs 39.3 percent), group psychotheraphy (21.8 percent vs 11.2 percent) as well as laboratory investigations (8.5 percent vs 2.8 percent) at the Comprehensive Clinic and referrals to other agencies (15.0 percent vs 6.6 percent) at the University Clinic. There was a higher prevalence (10.4 percent vs 0 percent) of sexual abuse at the Comprehensive Clinic. These findings of high attrition rates and high percentage of conduct disorder indicate the important need for a major study of the Child Guidance Clinics in the island looking at clinic utilization, especially at outcome of patients diagnosed with conduct disorder and the factors affecting attrition from the clinics. It is recommended that a community survey assessing prevalence rates of psychiatric disorders in children should be done to give a picture of the mental health needs of children in Jamaica.(AU)

Nuturing by male kin among female university students in Jamaica: some preliminary findings

Looks at the behaviours of males who were psychologically present in the life of their family. Looks at the relationship between women and the males in both the nuclear and extended family systems in Jamaica, examining in particular, the ways in which females experience nurturing behaviour shown to them by their male kin(AU)

Show, no show and sterilization

The study investigates the factors involved in the decision of a sample of women to break appointments for sterilizations at the Fertility Management Unit of the University of the West Indies. A case control study involved 50 women who did not show up (no-shows) and an equal number who did show up (shows) over the same period. The no-shows had spent a shorter time in their current union than the shows, and some had no children for their partners at the time the appointments were made. Marriage was the single most important event that would encourage the no-shows to consider sterilization in the future. As long as poor women see child bearing as a precondition for financial assistance from spouses, they will hesitate to give up this capability (AU)

Factors affecting weaning in rural and urban areas of south eastern Nigeria

A total of 512 mothers were interviewed in Anambra State, Nigeria to study factors related to weaning, using 254 (49 percent) from rural areas and an urban sample of 258 mothers (50.45). A validated pretested structured questionnaire was used to obtain background information, weaning patterns and health history. The results showed that most mothers (985) breastfed their infants but gave supplementary bottles simultaneously. Rural mothers (69.7 percent) breastfed infants longer (12-18 months) than urban mothers (37.6 percent) who breastfed for 0-6 months. The lower the income level and socio-educational background of the mothers, the longer the duration of breastfeeding. There was a positive correlation (r = 0.991) between amount budgeted for food and income level. Older mothers weaned infants earlier than younger ones; working urban mothers weaned infants earlier than non-working rural mothers. Mothers with smaller families weaned infants earlier than those with larger families. Urban mothers substituted other foods as a weaning method while rural mothers weaned by discouraging from breastfeeding. Urban mothers introduced protein rich food, fruit and vegetables earlier than rural mothers, who introduced starchy foods earlier. There was a high correlation between income level and introduction of protein foods (r = 0.846) and (r = 0.858), in urban and rural areas, respectively. High incidences of diarrhoea in most infants and inadequate water supplies in the communities were noted. (Au)

The meaning of sexual partnerships: re-examining the Jamaican family system

This paper seeks to re-examine some of the fairly accepted notions about Caribbean family and mating relationships. The situation in Jamaica is similar to that found in most other Caribbean countries. Data from a recently concluded study in this country is therefore utilized in this review. Specifically, this paper looks at the phenomena of multiple partnerships, union stability and longevity, and the alleged evolution of relationships from a visiting to marital status. Data from detailed union histories of men and women, aged 15 to 50 years in Jamaica are presented. It is argued that the dominant pattern appears to be one in which serial, as distinct from simultaneous partnering is the norm, and that the average length of relationships is short. It is further suggested that marriage rates may in fact be falling, that marriage is not normally a terminal state for unions, and that they may be entered into only when they are not perceived to represent a threat to the economic networks useful and necessary for the organisation and rationalisation of resources. (Au)

Conjugal behaviour and child development in Rural Jamaica - abstract

The effects of maternal conjugal behaviour on child development were studied in rural Jamaica using ethnographic methods and standardized measurments of development and the environment. Fifty-nine children and their caregivers were recruited pre-natally and followed for five years. The children's cognitive and physical development was assessed at age five using the McCarthy Scales of Child Assessment and weight/height ratio. School attendance and the Home Observation for Measurment of the Environment were used as indicators of the environment. The findings suggested that multiple mating, father absence and out of wedlock status did not result in poorer development outcomes and, in many fact may have provided some development advantages for these children. A large number of siblings, however, appeared to be developmentally disadvantaged regardless of mother's conjugal behaviour. (au)

Determinants of contraceptive use in Belize

Drawing from perspectives of wealth flows and opportunity structures, a path model comprised of socioeconomic status, education age, labor force participation, and family size is formulated. It is hypothesized that these variables are positive predictors of contraceptive use directly; and indirectly through woman's attitude regarding power in reproductive decision making. Residence (urban versus rural) and breastfeeding are used as control variables. These hypotheses are tested with data on currently married/in union women of reproductive age from the 1991 Belize Family Health Survey. Ordinary least squares regression and logistic regression are used to estimate each relationship in the model, first including a variable measuring current family size relative to a desired or ideal family size. The attitude that women should have power in reproductive decision making is a significant determinant of contraceptive use when current family size is included in the model but loses significance when current family size relative to an ideal is used. This model is then run separately for the two largest ethnic groups, Mestizos and Creoles, as identified by the language spoken in the household. The attitude that women should have power in reproductive decision making is a significant determinant of contraceptive use for women who speak Spanish whereas education and labor force participation are not. For the Creole, however, labor force participation and education are significant predictors of contraceptive use but attitude toward decision making is not. These relationships hold when current family size and current relative to ideal family size are not used in the models. The analysis demonstrates that groups of women, i.e., the Mestizo, with overall less education and lower labor force participation rates are more dependent upon their own attitudes to control their fertility. On the other hand, the higher status associated with more educated women who have higher labor force participation rates, i.e., the Creole, assumes and absorbs any effect of attitude in controlling fertility. It is speculated that attitudes are significant for Mestizos because they are part of a more traditional culture in which women have less opportunity for education and employment. In contrast, the creole women are so autonomous, as evidenced by their labor force participation and educational attainment, that attitude becomes irrelevant. (AU)

Family Planning users poll: Grenada

Explains the methodology and results of a survey among women aged 15-44 in Grenada, to determine existing levels and patterns of contraceptive use. The parishes of St. John and St. Mark were excluded from the analysis after difficulties were experienced in obtaining correct information from these areas. A total of four hundred and ninety-nine households were contacted in twenty-eight enumeration districts in the four remaining parishes polled. The poll examined a number of areas including family size, child planning, contraceptive use and birth control methods. Findings show that a large number of women in Grenada still need to be educated on birth spacing and reduction in the rate of pregnancy, contraceptive use is much higher than it was in 1985. Notes that there is a continuing need for adolescent programmes in birth control measures and that family planning service providers need to increase their public education programme, especially for teenages and non-contraceptors

Male attitudes toward family planning and gender equity in Grenada

Presents findings of a survey on male attitude towards the family, family planning and fertility within the context of their reproductive relationships. The men surveyed ranged between the ages of 15 and 40. The survey examines male opinions on family size, the use and methods of contraceptives, family responsibility and other significant issues. Statistical data is used to explain findings throughout the book. Concludes that most men surveyed, thought that decisions regarding childbirth, family planning and related matters must rest jointly in the hands of both parents. Fewer men were found committed to household chores and grocery shopping. The condom and the pill are the most commonly used contraceptives

Nocturnal enuresis in sickle cell haemoglobinopathies

The prevalence of nocturnal enuresis (wet at least two nights a week) was investigated in children, aged 8, who were being followed up as part of a prospective cohort study. There were 175 children with homozygous sickle cell disease, 106 with sickle cell haemoglobin C disease, and 150 controls with a normal haemoglobin genotype. In homozygous sickle cell disease, 48 boys (52 percent) and 31 girls (38 percent) were enuretic, a significantly higher prevalence than in those with sickle cell haemoglobin C disease - five boys (10 percent) and 11 girls (20 percent) - or in normal children - 16 boys (22 percent) and 13 girls (17 percent). There was no significant difference between children with sickle cell haemoglobin C disease and the normal genotype. Boys with homozygous sickle cell disease were significantly more likely to be enuretic if they came from large families; there was a similar trend for girls with homozygous sickle cell disease, although it did not reach significance. Enuresis was more common in boys with homozygous sickle cell disease who had low concentrations of fetal haemoglobin and in girls with sickle cell haemoglobin C disease who had high mean corpuscular haemoglobin concentrations. Similar associations were not shown for girls with homozygous sickle cell disease or boys with sickle cell haemoglobin C disease. (AU)

The impact of fertility on sexual union transitions in Jamaica: an event history analysis

The family system in Jamaica is extremely unstable, with high rates of dissolution of sexual unions and high levels of fertility outside marriage. The 3 commonly recognized types of fertile sexual unions are visiting, common-law and marriage. Of these, visiting unions are most predominant, overall as well as in every age group, and marriage the least. By age 49, most Jamaican women have 2 partners and have been involved in 3 unions. Empirical studies of the relationship between fertility and union stability in Jamaica have shown strong support for a positive association between the number of partners and/or unions and cumulative fertility. This study tests the hypothesis that fertility may stabilize a partnership by increasing the probability of a transaction to a more stable form of sexual union. The study data were collected in interviews with a sample of women between the ages of 15 and 49, from the Jamaica Fertility Survey (1975-76) which was part of the World Fertility Program. The 1st union of everyone in the sample was a visiting one, and no one had children prior to the start of that 1st union. The main reason for limiting the analysis to this sample is that, given the high frequency with which Jamican women begin their union histories with the visit version, it would be the appropriate starting point from which to study transition to more stable unions. The study findings show that for women whose 1st sexual union was a visiting one, fertility operates in 2 opposing directions. While it significantly lowers the likelihood of a move into the stabler unions of common-law and marriage, it also lowers a partnership turnover into single status or with a new partner. In other words, fertility raises the stabilty of the existing visiting union. Further research aimed at analyzing transitions out of higher-order unions should be able to shed more light on the issue (AU)