Social Support in the "Fourth Trimester": A Qualitative Analysis of Women at 1 Month and 3 Months Postpartum.

Social support is essential in the postpartum period when support is positively associated with infant care and maternal adaptation and its absence is associated with postpartum depression. The aim of this qualitative study was to explore how postpartum women experience social support and variations in the type and quantity received. Researchers conducted two semistructured interviews with a convenience sample of 22 participants at approximately one month and three months postpartum. Social support varied in quality and quantity. Respondents indicated that the presence of support made the postpartum period easier, less stressful, and more enjoyable. Efforts to help women plan for postpartum social support during pregnancy should focus on relationships and social networks as well as individual behaviors and community services.

Tobacco cessation outcomes: The case for milestone-based services.

INTRODUCTION: This study focuses on a Midwest State's tobacco quitline. The purpose was to understand possible relationships between services provided and cessation rates. METHODS: The data examined in this study came from aggregated intake/treatment data and follow-up interview data. The overall response rate was 22.9%. Measures included quit rate, quit duration, length of services, number of services, stage of change, confidence to quit, and source of referral. RESULTS: The dataset included 1452 cases; 77% enrolled in services only once, 17% enrolled twice and 6% enrolled three or more times. Use of medication was higher among those who quit [χ2(1)=7.1, p=0.009, Cramer's V=0.07] than among those who did not. Use of e-cigarettes was lower among those who quit at the time of follow-up [χ2(1)=31.5, p<0.001, Cramer's V=0.15]. Respondents who had quit at the time of the follow-up were significantly more likely to have reported a higher confidence to quit at intake [χ2(1)=24.1, p<0.001, Cramer's V=0.13]. Among those who improved their stage of change during treatment, 35% had quit at follow-up, compared with 18% among those who did not improve. CONCLUSIONS: Study findings related to stage of change and associations between confidence and cessation may have meaningful implications. Cessation success may depend on what is accomplished during treatment and the intersection of clients' motivation, satisfaction, confidence, and cessation status at the end of treatment.

"Reforms Looked Really Good on Paper": Rural Food Service Responses to the Healthy, Hunger-Free Kids Act of 2010.

BACKGROUND: The Healthy, Hunger-Free Kids Act of 2010 (HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS: Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS: Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS: Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success.

Using nominal technique to inform a sexual health program for black youth.

OBJECTIVES: To describe how nominal group technique (NGT) was used to inform the development of a sexual health education program for black high school youth in the South. METHODS: NGT was used with a community advisory board (CAB) to obtain information regarding the key components of a sexual health program for youth in their community. RESULTS: The CAB identified 5 priorities to include in the program: sex education, "keeping it real," responsibility/consequences, self-esteem, and female aggressiveness. CONCLUSIONS: Findings can be useful in modeling the successful use of NGT as a formative step toward developing health education programs for minority youth.

Attitudes and sociocultural factors influencing vaginal douching behavior among English-speaking Latinas.

OBJECTIVES: To describe the practice/correlates of douching among a national sample of English-speaking Latinas. METHODS: Three hundred twenty-five (325) computer-assisted telephone interviews were completed. Analyses compare ever douchers to never douchers and identify correlates of douching. RESULTS: Of respondents, 50% had ever douched; 15% douched at least monthly. Douching practices among respondents were similar to those of other groups. Age at sexual debut was the strongest correlate of ever douching. Regular douching significantly increased as the perceived benefits of douching and the number of sources recommending douching increased. CONCLUSIONS: Interventions to prevent douching and to support cessation should be tailored to characteristics and perceptions of Latinas. Targeting secondary audiences may prove valuable.