ABSTRACT
Infant Mental Health Home Visiting (IMH-HV) is a needs-driven, relationship-based home visiting intervention with demonstrated positive outcomes for parents and young children. Prior research found that higher therapeutic alliance (TA) was associated with improved program retention and provider race affected TA and retention for clients. The objective of this quality improvement project was to inform improvements to IMH-HV provider trainings to better prepare providers to effectively engage and support diverse families. Focus groups or individual interviews were completed with 18 providers and 7 clients (parents/caregivers). Participants self-selected into one of three groups offered separately to providers and clients: White identifying, Black identifying and Non-Specified identity groups. A racially diverse, interdisciplinary team facilitated focus groups and interviews and conducted thematic analysis of the data. Analysis identified barriers and opportunities for effective engagement of clients: when providers and clients are of different racial/ethnic backgrounds, provider attempts to forge a connection may make families feel 'othered'; providers may not see their racial identity as salient, yet it influences their practice and the establishment of rapport with families; patience, tolerating discomfort, and allowing a family to determine whether the provider can be trusted are key. Effective IMH-HV practice with clients of diverse backgrounds requires a high level of self-understanding on the part of providers. Enhancing training to promote deeper consideration of both the perspectives of diverse clients and the salience of one's own identity has potential to reduce barriers to TA, improve program retention, and address health disparities.
ABSTRACT
The Recipe 4 Success preventive intervention targeted multiple factors critical to the health and well-being of toddlers living in poverty. This randomized controlled trial, which was embedded within Early Head Start home visits for 12 weeks, included 242 racially and ethnically diverse families (51% girls; toddler mean age = 2.58 years; data collected 2016-2019). Compared to parents in usual practice home visits, parents in Recipe 4 Success displayed greater sensitive scaffolding of toddlers' learning and more responsive food parenting practices (Cohen's d = .21-.30). Toddlers in Recipe 4 Success exhibited greater self-regulation and had healthier eating habits (Cohen's d = |.16-.35|). Results highlight the value of Recipe 4 Success in promoting parent and toddler behavior change that could have life-long benefits.
Subject(s)
Parenting , Self-Control , Female , Humans , Child, Preschool , Infant , Male , Diet, Healthy/methods , Parents , Habits , Feeding Behavior , PovertyABSTRACT
OBJECTIVE: To understand communities' perceptions, beliefs, and health-related behavior choices related to COVID-19 in order to guide public health nursing communication and interaction with patients and the community. DESIGN: A qualitative study, guided by the Health Belief Model (HBM), strove to comprehend the perceptions and reactions to COVID-19 among Wisconsinites. SAMPLE: Twenty-five diverse Wisconsin residents aged 18 or older. MEASUREMENTS: Semi-structured interviews provided information about individuals' attitudes, perceptions, and reactions to COVID-19. Interviews were audio-recorded, transcribed, and thematic analysis was conducted to identify themes. RESULTS: We identified three major themes: (1) "health care starts way before you ever enter the doors of a healthcare facility"; (2) "to live in a society is to help each other"; and (3) mental health as impacted by COVID-19. CONCLUSIONS: This study demonstrated the need for greater public health support, as well as the role of Social Determinants of Health. Understanding perceptions and reactions to COVID-19 can help public health nurses understand and better respond to future pandemics.