The Social Ecology of Parental Monitoring: Parent-Child Dynamics in a High-Risk Peruvian Neighborhood.

While parental monitoring is understood to protect adolescents from engaging in risk behaviors, little is known about how the family dynamics involved in parental monitoring differ across sociocultural contexts. We sought to gain an in-depth understanding of parent-child relationship dynamics and parental knowledge of adolescents' activities in an urban Peruvian neighborhood with high levels of crime and adolescent substance use. We conducted 15 in-depth interviews and two focus groups with adolescents and 12 in-depth interviews with mothers sampled from a secondary school in Callao, Peru. Our findings emphasize the importance of parent-child confianza (trust) as a foundation for parental awareness of adolescents' lives and activities. Participants in our sample characterized confianza as encouraging adolescent disclosure and shaping how parental solicitation and rules were interpreted by adolescents. Participants described how confianza was rooted in features of the parent-child relationship, including shared parent-child time, parental affection, adolescent perceptions of parents' ability to give good advice, and awareness of how parents would react to delicate topics. Participants linked these family dynamics, in turn, to economic hardship, parental feelings of sacrifice and stress, perceptions of neighborhood risk, and gender norms limiting fathers' involvement in caregiving. Results have implications for the planning and adaptation of family-based prevention programs for use in high-risk contexts in Latin America.

Si bien existe una comprensión en relación a que la supervisión de los padres protege a los adolescentes de participar en comportamientos de riesgo, se sabe poco acerca de cómo la dinámica familiar involucrada en la supervisión difiere en distintos contextos socioculturales. Se buscó obtener una comprensión profunda de la dinámica de la relación entre padres e hijos y el conocimiento parental acerca de las actividades de los adolescentes en un barrio urbano peruano con altos niveles de delito y de abuso de sustancias por adolescentes. Realizamos 15 entrevistas a profundidad y dos grupos focales con adolescentes, y 12 entrevistas a profundidad con madres, que fueron seleccionadas en una escuela secundaria en Callao, Perú. Nuestros hallazgos enfatizan la importancia de la confianza entre padres e hijos como la base del conocimiento de los padres sobre la vida y actividades de los adolescentes. Los participantes en este estudio caracterizaron a la confianza como alentadora de la revelación por los adolescentes de lo que les pasa, y que da forma a cómo las reglas y las indagaciones que hacen los padres a sus hijos, fueron interpretadas por los adolescentes. Los participantes describieron cómo la confianza se encuentra arraigada en las características de la relación entre padres e hijos, incluyendo el tiempo compartido entre padres e hijos, el afecto de los padres, las percepciones de los adolescentes sobre la capacidad de los padres de dar buenos consejos y el conocimiento de cómo los padres reaccionarían a temas delicados. Los participantes asociaron esta dinámica familiar, a su vez, con la dificultad económica; los sentimientos de sacrificio y el estrés de los padres; las percepciones de riesgo del barrio; y las normas de género que limitan el involucramiento de los padres en el cuidado. Los resultados tienen implicancias para la planificación y adaptación de programas de prevención basados en la familia con el fin de utilizarlos en contextos de alto riesgo en América Latina.

Empowering women to breastfeed: Does the Baby Friendly Initiative make a difference?

The Baby-Friendly Hospital Initiative (BFI) is currently presented worldwide as the gold standard model of care for promoting and supporting breastfeeding. However, there is a lack of understanding about the ways in which health services, including the BFI, address the cultural change from a disembodied practice (formula feeding) to an embodied one (breastfeeding) in contexts where formula feeding is the norm. We used a qualitative case study methodology to compare the embodied experience of breastfeeding and the maternal experience of breastfeeding promotion and support services between mothers receiving care from institutions with low and high levels of BFI implementation in Québec, Canada. A total of 11 focus groups were conducted with mothers from six institutions-three with high and three with low levels of BFI implementation. We found the flexible approach to breastfeeding duration, characteristic of BFI services in our study, helped to avoid maternal guilt and shame; the shift to focusing on potential barriers and strategies for overcoming them empowered women to negotiate changes in infant feeding with others and self by addressing the embodied experience of a practice that may not feel natural at the beginning. Findings have implications for the concept of habitus and the construction of the breastfeeding body; we suggest that habitus can change if agents are provided with discursive tools to negotiate this embodied change. Implications for BFI services include the need to implement the 10 steps in a flexible, family-centred way that focuses on empowering women rather than simply reaching outcomes.