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1.
Artículo en Inglés | MEDLINE | ID: mdl-34291978

RESUMEN

Objective: This article problematizes the use of resilience as a psychological and developmental indication of well-being. We base our argument on the possibility that resilience theories internalize responsibility for survival within the individual, and that survival is dependent on the ability to assimilate to injustice. Resistance, on the other hand, represents acts of intentional, active, and often collective survival which can expose and oppose social injustice. Method: Bringing together transdisciplinary scholarship on resistance, we propose a conceptual framework of sociocultural resistance. This framework seeks to forward studies of health that acknowledge the complexity of relationships, culture, and power constitutive of the human condition. Results: We provide examples of sociocultural resistance in the psychological and developmental sciences and suggest the use of diverse theory and methods in the study of resistance. Conclusions: Resistance research is a timely, necessary, and critical turning point in the social sciences with the potential to change unjust systems and promote a nuanced view of health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

2.
Public Health Nutr ; 21(17): 3271-3280, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30101733

RESUMEN

OBJECTIVE: To understand low-income adults' expectations and experiences using an innovative smartphone and theory-based eLearning nutrition education programme, entitled Food eTalk. DESIGN: Longitudinal mixed-methods single case study including a series of focus group and individual interviews, demographic and Internet habits surveys, and user-tracking data. Interviews were transcribed verbatim, analysed using the constant comparative method and digitalized using Atlas.ti. Descriptive statistics were analysed for demographics and user-tracking data. SETTING: Community-based locations including libraries, public housing complexes, schools, safety-net clinics and food pantries. SUBJECTS: Low-income Georgian adults aged ≥18 years (n 64), USA. RESULTS: Participants found Food eTalk easy to navigate and better designed than expected. Primary themes were twofold: (i) motivation to engage in eLearning may be a formidable barrier to Food eTalk's success but improved programme content, format and external incentives could mitigate this barrier; and (ii) applying knowledge to change nutrition-related behaviour is challenging. To encourage engagement in eLearning nutrition education, programme format should highlight interactive games, videos, be short in length, and feature content that is relevant and important from the perspective of the priority audience. Examples of these topics include quick and easy recipes, chronic disease-specific diet information and tips to feed 'picky' children. Additionally, external incentives may help mitigate barriers to healthful eating behaviour and increase engagement in the programme. CONCLUSIONS: The findings suggest eLearning nutrition education programmes are best designed to match low-income adults' typical smartphone habits, include content considered particularly relevant by the intended audience and highlight solutions to barriers to healthful eating.


Asunto(s)
Dieta , Conducta Alimentaria , Conductas Relacionadas con la Salud , Educación en Salud/métodos , Promoción de la Salud/métodos , Pobreza , Teléfono Inteligente , Adulto , Femenino , Grupos Focales , Abastecimiento de Alimentos , Georgia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Motivación , Ciencias de la Nutrición , Estado Nutricional , Instalaciones Públicas , Características de la Residencia , Encuestas y Cuestionarios
3.
J Cancer Educ ; 33(3): 640-648, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-28093703

RESUMEN

This study describes how a concurrent exploratory mixed methodology (CEMM) approach was used to investigate perceptions of prostate cancer (CaP) fear and facilitators of screening behavior in African-American (AA) and Caribbean-born (CB) black men for instrument development. A quantitative paper-based questionnaire was modified, adapted, and administered to participants from the Personal Integrative Model of Prostate Cancer Disparity Survey and the Powe Fatalism Inventory. Focus groups and individual interviews were conducted and analyzed using thematic analysis. Of the 31 participants, 17 (55%) were CB black men and 14 (45%) were AA men. CB black men reported significantly higher mean perception of CaP treatment scores compared to AA men (8.23 versus 6.14, p < 0.05). Overall, the focus group and interview data revealed highly interrelated key themes. These themes included perceived barriers to CaP screening (e.g., health-care affordability), misconceptions about CaP (e.g., limited knowledge), and misinformation about CaP (e.g., conflicting CaP screening information from health-care providers). Feeling responsible to make sure family members were taken care of and the role of a significant other were reported as motivation for visiting the doctor. As a result of the CEMM design, a reliable survey instrument was developed to measure CaP fear and facilitators for screening behavior within subpopulations of AA men, which is important because despite their shared genetic ancestry, AA and CB black males may have very different lifestyles.


Asunto(s)
Negro o Afroamericano/psicología , Detección Precoz del Cáncer/psicología , Miedo/psicología , Aceptación de la Atención de Salud/psicología , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/psicología , Adulto , Negro o Afroamericano/estadística & datos numéricos , Anciano , Actitud Frente a la Salud , Región del Caribe/etnología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/prevención & control , Encuestas y Cuestionarios , Estados Unidos
4.
Eval Program Plann ; 92: 102068, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35298955

RESUMEN

Evaluation must transform to center equity. Yet, while recent scholarship critiques evaluation at the macro level for reproducing societal inequities and calls the profession and individual evaluators to change, this research overlooks evaluation ecosystems - though dynamic interactions among evaluation teams, workplaces, community stakeholders, funders, and informal professional networks form crucial connections between the macro and micro levels and can be spaces for promoting equity within and through evaluations. Addressing this gap, this exploratory study proposes and uses an adapted socioecological framework to organize thematic analysis of data from interviews with evaluators in New England (n = 21) about factors that help and hinder equity-oriented evaluation practices. We identify nine domains and twenty-three factors across macro, meso, and micro levels that influence these evaluators' capacity to practice equity-oriented evaluation in regional, national, and international contexts. The study contributes a framework that future research can adapt to explore the relevance of identified domains and factors to other geographical settings. We also provide questions to guide evaluators, program leaders, and others in reflecting on leverage points for change within their own contexts and outline future directions for research on equity and evaluation.


Asunto(s)
Ecosistema , Humanos , New England , Evaluación de Programas y Proyectos de Salud
5.
Child Obes ; 2022 Dec 26.
Artículo en Inglés | MEDLINE | ID: mdl-36576994

RESUMEN

Introduction: Sugar-sweetened beverages (SSBs) are a major contributor to obesity among young children 0 to 5 years of age. In addition, parental beverage intake influences children's beverage intake. Objective: This study explores Black parents' perceptions about and barriers to limiting SSBs among young children. Methods: Twenty-seven Black parents participated in six focus groups conducted across the state of Georgia. Questions grounded in Social Cognitive Theory (SCT) assessed perceived health impacts of SSBs and water consumption, influences of beverage choices, barriers to limiting SSB intake, and resources needed to overcome barriers. Before the focus group sessions, participants completed a demographic survey. Quantitative data were analyzed using R statistical software. Focus group sessions were analyzed using NVivo. Results: Family and cultural norms, price, taste, flavor, water safety, tantrums, and product placement at grocery stores primarily influenced beverage choice and consumption. Restaurant refills, price, lack of confidence, advertisements, cravings, tantrums, and budget were perceived barriers to drinking more water and fewer SSBs daily. Resources Black parents noted would help in promoting and serving healthy beverages to their young children included education on beverage recommendations, training on how to read nutrition labels, healthy alternatives, and the presence of support systems. Conclusion: Findings from this study will inform interventions to reduce SSB intake among Black families with young children.

6.
Transcult Psychiatry ; : 13634615211014347, 2021 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-34041962

RESUMEN

The multifaceted context of Aotearoa / New Zealand offers insight into the negotiation of cultural discourses in mental health. There, bicultural practice has emerged as a theoretically rights-based delivery of culturally responsive and aligned therapies. Bicultural practices invite clinicians into spaces between Indigenous and Westernized knowing to negotiate and innovate methods of healing. In this article, we present findings from a qualitative study based on one year of ethnographic fieldwork. Drawing on negotiated spaces theory and critical interactionism, we report results of a situational analysis of interviews conducted with 30 service providers working within the bicultural mental health system. Through iterative map-making, we chart the discursive positions taken in the negotiated spaces between Indigenous and Western lifeworlds. In total, we identified five major positions of negotiated practices within the institutionalized discourses that constitute bicultural mental health. Findings indicate that negotiations from Westernized systems of care have been, at best, superficial and that monoculturalism continues to dominate within the bicultural framework. Implications are made for genuine engagement in the negotiated spaces, so treatment has resonance for clients living in multi-cultural, yet Western-dominant societies.

7.
J Nutr Educ Behav ; 52(7): 732-741, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32276882

RESUMEN

OBJECTIVE: To determine the eLearning preferences of early care and education (ECE) teachers for an effective beverage policy training. METHODS: Mixed methods study conducted with ECE directors and teachers in 6 regions throughout Georgia. Researchers used an eLearning survey (n = 646) along with focus groups (n = 6) and interviews (n = 24) to determine eLearning preferences and preferred eLearning format. Descriptive statistics and qualitative content analysis were used for data analysis. RESULTS: Most ECE teachers in Georgia (85%) have never had a beverage policy training. Participants (48%) reported they would definitely use the Internet for training. Qualitative analysis revealed key themes; training should be engaging, concise, hold the trainees accountable, and be interactive. Interactive video is the preferred eLearning format. CONCLUSIONS AND IMPLICATIONS: Interventions that promote national beverage recommended in the ECE setting are critically needed. Study findings may inform other states about the feasibility of using eLearning to provide beverage policy training for ECE providers in other states.


Asunto(s)
Bebidas/legislación & jurisprudencia , Cuidadores/educación , Guarderías Infantiles/organización & administración , Intervención Educativa Precoz/organización & administración , Educación a Distancia , Preescolar , Promoción de la Salud , Humanos , Lactante , Aprendizaje , Enseñanza/educación
8.
J Hum Lact ; 35(3): 569-582, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30889373

RESUMEN

BACKGROUND: Lack of breastfeeding support is a common barrier reported by African American mothers, whose breastfeeding rates remain significantly below the national average. Despite mothers' reported use of social network sites to access support on topics relating to child rearing, few studies have examined their use to exchange breastfeeding support. RESEARCH AIMS: To describe (1) the experiences of African American mothers who participate in breastfeeding support groups on Facebook and (2) the breastfeeding beliefs, practices, and outcomes for this population of mothers. METHODS: This was a prospective, cross-sectional qualitative study with an online focus group design. The study was guided by Black Feminist Thought and an integrated model of behavior prediction. Four online focus groups (N = 22) were conducted using video conferencing during September 2017 with African American mothers who were participating in breastfeeding support groups on Facebook. RESULTS: Thematic analysis was used to develop four themes and two subthemes, including creating a community for Black mothers, online interactions and levels of engagement, advantages of participating in online support groups, critiques of online support groups, empowerment of self and others, and shifts in breastfeeding perceptions and decisions. Among participants in this study, positive imagery of African American breastfeeding mothers and ongoing support from women with shared experiences improved confidence with public breastfeeding and prolonged goals for breastfeeding duration. CONCLUSION: Receiving peer support within Facebook communities may positively influence breastfeeding norms and confidence in breastfeeding, help mothers to overcome breastfeeding challenges, and ultimately extend intended breastfeeding duration.


Asunto(s)
Lactancia Materna/etnología , Conocimientos, Actitudes y Práctica en Salud , Madres , Redes Sociales en Línea , Atención Posnatal , Adulto , Negro o Afroamericano , Estudios Transversales , Femenino , Grupos Focales , Humanos , Recién Nacido , Estudios Prospectivos , Estados Unidos
9.
Digit Health ; 5: 2055207619853397, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31218076

RESUMEN

OBJECTIVES: For breastfeeding mothers, online support groups through Facebook may be a more convenient and preferred source for accessing breastfeeding information and support, but few studies exist that examine the use of Facebook groups specifically for breastfeeding support. This study explores the sources of support among users of Facebook breastfeeding support groups and a possible mechanism by which support received on Facebook may translate to behavioral outcomes among breastfeeding mothers. METHODS: From July-September 2017 a survey was distributed online to African American mothers (N = 277) who participate in breastfeeding support groups on Facebook. The survey assessed network support from Facebook and other sources of breastfeeding support, perceived breastfeeding norms, breastfeeding self-efficacy and breastfeeding attitudes. Correlations and linear regression analysis were used to examine the relationship between covariates and outcome variables. RESULTS: The average intended breastfeeding duration among participants in this study was 19 months. Participants reported the highest amount of breastfeeding support received from their Facebook support group, in comparison to other sources of support, and Facebook support was significantly correlated with intended breastfeeding duration (p < 0.05). Self-efficacy and breastfeeding attitudes remained significant predictors of intended breastfeeding duration within the final regression model. CONCLUSIONS: Breastfeeding support received within Facebook groups may compensate for inadequate support received within mothers' networks. More research is needed to understand the mechanism through which Facebook support may contribute to prolonged breastfeeding durations.

10.
J Hum Lact ; 33(1): 128-139, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28061039

RESUMEN

BACKGROUND: According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. METHODS: African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. RESULTS: Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. CONCLUSION: Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.


Asunto(s)
Lactancia Materna/psicología , Madres/psicología , Factores de Tiempo , Adolescente , Adulto , Negro o Afroamericano/etnología , Negro o Afroamericano/psicología , Lactancia Materna/etnología , Femenino , Grupos Focales , Asistencia Alimentaria/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Atención Posnatal/psicología , Atención Posnatal/estadística & datos numéricos , Embarazo , Investigación Cualitativa , Clase Social , Estados Unidos/etnología
11.
Front Public Health ; 4: 196, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27699164

RESUMEN

Chronic conditions and falls are related issues faced by many aging adults. Stanford's Chronic Disease Self-Management Program (CDSMP) added brief fall-related content to the standardized 6-week workshop; however, no research had examined changes in Fall-related self-efficacy (SE) in response to CDSMP participation. This study explored relationships and changes in SE using the SE to manage chronic disease scale (SEMCD Scale) and the Fall Efficacy Scale (FallE Scale) in participants who successfully completed CDSMP workshops within a Southern state over a 10-month period. SE scale data were compared at baseline and post-intervention for 36 adults (mean age = 74.5, SD = ±9.64). Principal component analysis (PCA), using oblimin rotation was completed at baseline and post-intervention for the individual scales and then for analysis combining both scales as a single scale. Each scale loaded under a single component for the PCA at both baseline and post-intervention. When both scales were entered as single meta-scale, the meta-scale split along two factors with no double loading. SEMCD and FallE Scale scores were significantly correlated at baseline and post-intervention, at least p < 0.05. A significant proportion of participants improved their scores on the FallE Scale post-intervention (p = 0.038). The magnitude of the change was also significant only for the FallE Scale (p = 0.043). The SEMCD Scale scores did not change significantly. Study findings from the exploratory PCA and significant correlations indicated that the SEMCD Scale and the FallE Scale measured two distinct but related types of SE. Though the scale scores were correlated at baseline and post-intervention, only the FallE Scale scores significantly differed post-intervention. Given this relationship and CDSMP's recent addition of a 10-min fall prevention segment, further exploration of CDSMP's possible influence on Fall-related SE would provide useful understanding for health promotion in aging adults.

12.
J Hum Lact ; 31(1): 99-110, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25480019

RESUMEN

BACKGROUND: African American women have the lowest breastfeeding rates among all racial/ethnic groups in the United States. Peer counseling is an effective intervention in improving breastfeeding in this population. However, little is known on peer counselors' perceptions of breastfeeding in African American women. OBJECTIVE: As part of a larger qualitative study, the goal of this study was to understand the contextual factors influencing breastfeeding decisions of low-income African American women from the perspective of breastfeeding peer counselors (PCs). METHODS: Three focus groups were conducted with 23 PCs from the Women, Infants, and Children program in a southeastern state. All focus group discussions were audio-recorded, professionally transcribed, and analyzed using thematic analysis. Bronfenbrenner's socioecological model was used to group categories into themes. RESULTS: Of the sample, 47.8% were African American, 78.2% were married, and 56.5% had some college education. Five main themes emerged to describe factors at multiple levels influencing breastfeeding in PCs' low-income African American clients: individual, microsystem, exosystem, macrosystem, and chronosystem. Novel findings included (1) having breast pumps may give African American women a "sense of security," (2) cultural pressures to be a "strong black woman" can impede breastfeeding support, and (3) breastfeeding "generational gaps" have resulted from American "slavery" and when formula was "a sign of wealth." CONCLUSION: As PCs described, low-income African American women's breastfeeding decisions are affected by numerous contextual factors. Findings from this study suggest a need to broaden the public health approach to breastfeeding promotion in this population by moving beyond individual characteristics to examining historical and sociocultural factors underlying breastfeeding practices in African American women.


Asunto(s)
Actitud del Personal de Salud , Lactancia Materna/etnología , Servicios de Salud Materno-Infantil , Adulto , Negro o Afroamericano/estadística & datos numéricos , Consejeros , Femenino , Grupos Focales , Georgia , Programas Gente Sana , Humanos , Recién Nacido , Grupo Paritario , Pobreza
13.
Eval Program Plann ; 45: 151-6, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24836997

RESUMEN

Since many educational researchers and program developers have limited knowledge of formative evaluation, formative data may be underutilized during the development and implementation of an educational program. The purpose of this article is to explain how participatory, responsive, educative, and qualitative approaches to formative evaluation can facilitate a partnership between evaluators and educational researchers and program managers to generate data useful to inform program implementation and improvement. This partnership is critical, we argue, because it enables an awareness of when to take appropriate action to ensure successful educational programs or "kairos". To illustrate, we use examples from our own evaluation work to highlight how formative evaluation may facilitate opportune moments to (1) define the substance and purpose of a program, (2) develop understanding and awareness of the cultural interpretations of program participants, and (3) show the relevance of stakeholder experiences to program goals.


Asunto(s)
Conducta Cooperativa , Educación/organización & administración , Evaluación de Programas y Proyectos de Salud/métodos , Investigación/organización & administración , Concienciación , Competencia Cultural , Toma de Decisiones , Humanos , Investigación Cualitativa
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