Evaluation of a Mother-Infant Dyadic Video-Feedback Intervention in a Community Health Center in South Bronx, New York City.

OBJECTIVE: This study evaluates a video-feedback program's effectiveness in promoting responsive and sensitive parenting for families in care in a community health center located in the South Bronx, New York City. METHODS: Change in measures of parent responsiveness/sensitivity (Global Rating Scale), depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder 7), and parenting stress (Parenting Stress Index-Short Form) were analyzed for mother-infant dyads (N=34) completing a six-session videofeedback program between 2014 and 2016. RESULTS: Participants were primarily mothers of color (30% African American; 63% Hispanic) with young infants (mean age 8 months). At program completion, mothers demonstrated a significant improvement of 19% in maternal responsiveness and fewer depressive and anxious symptoms. CONCLUSION: Cost-effectiveness studies are needed to compare parenting interventions by setting (community health center, home, or mental health facility) for acceptability and effectiveness to determine best practice models for communities challenged by poverty, trauma, and health disparities.

"A Woman in A Man's World": A Pilot Qualitative Study of Challenges Faced by Women Veterans During and After Deployment.

Women Veterans face gender-specific challenges to military life and post-deployment readjustment, including gender-based discrimination and military sexual trauma. Despite recent military initiatives to address these issues, women still experience unique challenges during military service. This study examines spontaneous comments about gender-specific challenges to military life that were made by participants in a qualitative study of women's transitions to civilian life after deployment to Iraq or Afghanistan. METHODS: Women Veterans who were enrolled at a New England VA hospital and who had deployed to the U.S. conflicts in Iraq and Afghanistan participated in this qualitative study (N = 22). Interview queries and initial coding structure were developed through an extensive literature review. An iterative coding process generated additional themes identified in the data. For this project, codes regarding self-initiated reports of gender-specific challenges that fell outside the scope of the study's initial interview agenda were reviewed for thematic analysis. RESULTS: The following three self-initiated themes emerged among 12 respondents: 1) gender-based scrutiny and discrimination; 2) the military's inadequate position and response to military sexual trauma; and 3) disadvantages to women service members living in a male-dominated environment. Across all three themes emerged a sub-theme in which women perceived their unique needs to be inconvenient and/or disregarded. Respondents described how these challenges disrupted their lives during and after military service. CONCLUSION: Results imply gender-specific challenges and military sexual trauma remain critical concerns for women Veterans well after deployment had ended, and that improved policy may have long-term health implications.

The Ethical and Public Health Implications of Family Separation.

When immigrant children are separated from their parents, inexorable medical and legal harms result. Family separation violates a fundamental right of parents to participate in medical decisions involving their children. This paper reviews and contributes to evolving analyses of the public health, legal, and ethical consequences of immigration policy.

From Clinic to Classroom: A Community Health Center-Based Program to Assist Families in Accessing Pre-K in New York City.

Medical homes are an underused resource to promote enrollment in high-quality early education in urban areas. This report summarizes a newly implemented, unique, and replicable community health center-based outreach program designed to help families apply to and enroll in Pre-K programs in the South Bronx region of New York City.

A Qualitative Study of Women's Recall of Content and Skills Developed in Group Prenatal and Well-Baby Care 2 Years Later.

INTRODUCTION: Group prenatal and well-baby care is a system of health care visits that occur in a group setting. Each individual session lasts approximately 2 hours, allowing more time for education and support than can occur in an individual visit. Compared with individual care, research suggests that group care is associated with similar or better short-term outcomes, but no studies have yet examined potential long-term benefits beyond one year postpartum. The purpose of this qualitative descriptive study was to elicit women's recall about content covered in group prenatal and well-baby care and whether they were or were not continuing to use skills discussed during group prenatal and well-baby care 2 or more years after their group ended. METHODS: Eligible women participated in group prenatal and/or well-baby care between 2008 and 2012, were aged at least 18 years, and were English-speaking. Of the 127 eligible women, 32 were reached and 17 agreed to participate. Women were interviewed on average 3 years after group prenatal or well-baby care ended using a semistructured interview guide. Transcripts were reviewed and coded by each team member. Final codes and themes were identified using an iterative review process among the research team. RESULTS: Three themes were identified: sustained change, transferable skills, and group as a safe haven. All women were still using strategies discussed during group and had made sustained improvements in nutrition, stress management, and/or in the quality of their interactions with their children, partner, or families. The group environment was described as a safe haven: a respectful, nonjudgmental space that allowed women to share and support each other while learning new skills. DISCUSSION: This is the first study to document that group prenatal and well-baby care is associated with long-term benefits in areas not yet reported in the literature: nutrition, family communication, and parenting.

Breast cancer screening behaviors among Korean American immigrant women: findings from the Health Belief Model.

This study examined the utilization of clinical breast examinations (CBEs) and mammograms among Korean American immigrant women and investigated how the six constructs of Health Belief Model (HBM) are associated with the receipt of breast cancer screening. Using a quota sampling strategy, 202 Korean American immigrant women were recruited in metropolitan areas in the northeastern United States. Approximately 64% of the participants reported having had at least one CBE in their lifetime, and about 81% of the sample had undergone at least one mammogram in their lifetime. Women who perceived themselves to be susceptible to breast cancer were more likely to have undergone a CBE, and women who had lower barriers to screening or demonstrated a higher level of confidence were more likely than their counterparts to undergo a mammogram. Findings suggest that HBM constructs such as susceptibility, barriers, and confidence should be considered when designing interventions aimed at promoting breast cancer screening.