Dissertations / Theses: 'Community child health'

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Waters, Elizabeth. "Measuring child health and wellbeing." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270153.

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Kearney, Lauren Naomi. "Open Access community child health services: A three-phase evaluation." Thesis, Australian Catholic University, 2010. https://acuresearchbank.acu.edu.au/download/72ba800703df2602e5bbb1296d3eed793f534b7d7413d033db2d02bd6fd46c07/4262683/64944_downloaded_stream_169.pdf.

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Despite significant evidence of the importance of the early years of life, to date limited research has evaluated how health services best support and assist families during this crucial time. One important service through which infant and children's health are promoted and monitored in Australia are the government-based community child health nursing services (CCHNS). Traditionally, child health surveillance and health promotion are provided through CCHNS via individual appointment-based clinics. In recent years, resource allocation and workload within CCHNS has changed, requiring the development of contemporary approaches to service delivery. One novel approach, which was examined in this study, was an Open Access Clinic (OAC), which provided a group-based, appointment-free clinic where parents could attend with their infant for child health nurse support and health care, based on parental needs and convenience. The objective of this research study was to investigate the efficacy, quality and perceived value of the OAC approach to universal child health surveillance in one urban community child health service. A three-phase study, using method triangulation was conducted. It comprised a retrospective documentary analysis of pre- and post-OAC healthcare outcomes; a phenomenological inquiry into the lived experience of those directly involved with the OAC; and an 18-month prospective cohort study, tracking health care-seeking behaviours and child care practices of families who accessed the OAC.;There was also a statistically significant increase in families receiving unemployment benefits (thus were from a relatively low socio-economic demographic) in the OAC cohort, when compared with the individual appointment approach. However, a statistically significant decrease was noted in the developmental assessment documentation in the OAC cohort when compared with the individual appointment cohort, which was further investigated in the prospective cohort study (phase three). The second phase of the overall study was a phenomenological inquiry into the everyday experience of the OAC. The purpose of phase two was to understand what the OAC meant to those involved with it, and to gain insight into the everyday experience of the OAC. The methodology used for this phase was a North American phenomenological inquiry approach, which sought to describe and interpret the everyday experience of multiple participants' lived experiences of the phenomenon - the OAC. New knowledge and understanding has been generated through this inquiry. According to the participants the OAC represented a place where support and reassurance could be accessed flexibly and provided in a non-judgemental manner. The emerging themes described a busy and bustling clinic. It was a place where parents felt safe and supported. They enjoyed the flexibility, the appointment-free structure and valued the accessible location of the both the urban clinics, where shops were close by and public transport available. However, for working parents, services offered in extended hours would be of benefit. The service had a clear role definition and according to the participants achieved this purpose through the working of the OAC, in conjunction with other support services (such as the breastfeeding clinic and the early intervention specialists). Furthermore, parents often shared experiences of feeling lonely and socially isolated.;They valued the consistency of seeing the same child health nurse within the OAC, and the child health nurses valued this for reasons of continuity. The parents reported the benefits of the group approach, and overall preferred it to individual appointments. The mothers identified their use of other service providers, for example their general practitioner if sensitive or confidential issues required attention. The information discussed during the clinics was offered in a non-judgemental way, however the findings indicate that it is essential that the child health nurse's advice and practice is consistent with the latest evidence-based guidelines. The child health nurses sometimes found the clinic stressful and busy, without enough time to perform thorough family assessments.;More specifically, clear trends of usage, such as increased visit frequency and use of breastfeeding clinics in the early weeks, provided helpful evidence to assist in service planning. Through understanding where parents access information, such as family and friends, health services may target these sources with health promotion activities. 'The real challenge lies in ensuring sustained policy effort to achieve long-term measurable change in outcomes for children - to improve their health and well being, to modify the effects of social determinants, and to minimise the inequalities already apparent in early childhood' (Goldfeld & Oberklaid, 2005, p. 209). This final phase affirmed that parents have varied patterns of attendance within the OAC, based on their immediate needs, and that these change with the age of the infant. Important data was also found detailing patterns of usage for other child health service providers, such as access of general practitioners and child health nurses for routine well-baby assessments. Potentially, parents could be provided with clearer service pathways prior to discharge from maternity units, informing them regarding which services are helpful for specific infant health issues. There is also potential for increased collaboration between Queensland Health and general practitioners and practice nurses, to ensure that services are streamlined and thus reduce unnecessary burden on the health care system. This may also be helpful in ensuring consistency of health care information provided to parents between different providers. Whilst this phase was limited by the small sample size, and a context specific group of families, it does provide new information in key areas, such as why parents introduce solids early, when they consider prevention for childhood obesity, where they are attending for their infants' developmental assessments, and health care needs at different stages between 0-eighteen months.;These findings will provide Child Health Services, with valuable information to more efficiently and effectively plan services to meet parental and infant health needs. Overall, the key findings from the combined phases found the OAC compared favourably to the traditional individual-appointment method of child health surveillance in the areas of parent and health care professional satisfaction, infant growth and nutrition, immunisation status and key health promotion areas such as Sudden Infant Death Syndrome prevention. However, areas for quality improvement were also found, specifically in the areas of consistent evidence-based information, documentation in areas such as developmental assessment attendance, health care provider duplication and collaboration and timely discussion of parent-infant attachment. This study has generated new knowledge and understanding regarding the effectiveness and quality of an OAC approach to community child health nursing services, specifically in the delivery of group-based, appointment-free universal child health surveillance services.

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Day, Crispin Stuart Mark. "An evaluation of a needs-based community child mental health service." Thesis, King's College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406747.

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Hall-Sterling, S. "Parenting and social capital : promoting child mental health as a community." Thesis, Canterbury Christ Church University, 2018. http://create.canterbury.ac.uk/17764/.

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There is a growing body of evidence to suggest that parental social capital may be beneficial for the mental wellbeing of children. While the mechanisms underlying this association may not yet be clearly established, the strong association alone presents an argument for building parental social capital as a way of preventing and/or overcoming difficulties with their children’s mental health. However, in order to encourage the building of parental social capital, an understanding of the building process and what might contribute to its formation is required. This study explores the processes involved in building social capital amongst parents attending a peer-led parenting intervention group. Participants were 14 mothers who each attended the inner city-based group for parents of children aged 2-11 years. The mothers were interviewed about their experiences of attending the parenting group, and a critical realist grounded theory approach was used to develop a framework for understanding the process of building social capital within this context. Findings suggested that the following key processes were associated with building social capital: Personal Development, Making Connections, Feeling Safe, and Overcoming Differences. Each of these processes was facilitated by aspects of the intervention, as well as participant and facilitator attributes. These findings are described in detail, followed by suggestions for future research and implications for clinical intervention.

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Singh, Debra. "Empowering Community Health Volunteers to improve maternal and child health intervention coverage in rural Uganda." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/16341.

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Community Health Workers (CHWs) and Community Health Volunteers (CHVs), lay persons who have received some training to deliver health care services but are not professionals, have been found to contribute in a variety of capacities to bridge gaps in health systems in some countries specifically by undertaking interventions that improve maternal and under-5 outcomes. Supervision has been acknowledged as an important, but often neglected, component of effective CHW and CHV programs. To explore supervision of part-time CHVs by full-time CHWs a mixed-methods study was conducted in eight villages in Budondo, Uganda from March 2014 to February 2015. The quantitative component involved a pair-matched cluster randomised trial. After conducting a baseline household survey (n=216) and focus groups with community members, 82 volunteer CHVs were selected from the eight study villages. The CHVs from all villages received monthly in-village training from four full-time CHWs. Each CHV made home-visits about pregnancy, new-born care and hygiene. The CHVs from the four intervention villages received additional monthly supervision and accompaniment from the full-time CHWs. CHVs were interviewed at the beginning and end of the study. A post-intervention household survey (n=201) was conducted one year after the baseline survey. There was 100% retention of full-time CHWs at the end of one year and a 95% retention rate of CHVs in both the intervention and the control groups during the same period. Trust, working in pairs, accompaniment, relationship building in the community and knowledge gained were found to be important in both CHW and CHV motivation and community engagement. The final household survey showed a significantly higher percentage of households with tippy taps built in intervention villages (47%) than the control villages (35%) (p<0.002), from a baseline of 5% in all villages, which was indicative of increased community engagement. Though not statistically significant, a higher percentage of CHVs were known in the community in intervention villages and the frequency of home visits was also higher. The research showed that CHVs can be retained in the community when trained once a month by full-time CHWs. Appreciation, forming relationships, gaining knowledge and seeing action were key motivators for all the CHVs.

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Bula, Agatha Kapatuka. "Influences of HIV on exclusive breastfeeding : an exploration of community-based peer support in rural Malawi." Thesis, City University London, 2015. http://openaccess.city.ac.uk/14679/.

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Exclusive breastfeeding (EBF) for 6 months is recommended as the most cost-effective public health intervention to improve child survival particularly in Sub-Saharan Africa and is central to achieving Millennium Development Goal number 4 for child health. However, despite the benefits of EBF to infants and mothers, the rates continue to decrease as the age of the infant increases in an African cultural context including Malawi. There is increasing literature on the effectiveness of community-based peer counselling on EBF promotion in resource-poor settings but its effectiveness in the context of HIV and experiences of HIV positive women with the intervention remains a gap. The purpose of this thesis was to explore determinants of EBF using MaiMwana infant feeding peer-counselling intervention conducted in Mchinji, Malawi as a case study. Specifically, in this study I explored the effectiveness of the intervention to help HIV positive women to overcome the barriers and examine people’s experiences and perceptions towards the intervention with respect to HIV and poverty. I adopted qualitative in-depth interviews with 39 informants, including breastfeeding mothers, peer counsellors and key informants who were purposely selected. The data was analysed using a framework approach. I found that despite having good knowledge, women from rural communities face considerable challenges while practicing EBF. Cultural beliefs, economic constraints, lack of power and support, and fear of transmitting the virus to their infants were cited as major barriers that prevented them from practicing EBF. Overall, the findings from this study suggest that peer counsellors are well accepted by service-users and other community members as they positively viewed their frequent visits as providing additional support, reinforcing infant feeding messages and provide psychological support to women resulting in improved EBF rates. Furthermore, the presence of peer counsellors was viewed as “bringing services at their door step” which reduced time and cost to travel to the health facility. Nevertheless, the findings suggest that voluntary work in resource-poor settings presents considerable challenges such as: poor motivation due to lack of incentives, overworking, lack of knowledge and time to handle HIV positive cases and poor supervision. In order to effectively promote EBF in resource-poor settings, public health programme designers and implementers need to consider these barriers so as to design community-based interventions that suit the local context and create an enabling environment.

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Finn, Natalie K. "Identifying Targets for Quality Improvement in a Community Child Mental Health Agency." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6107.

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The implementation of evidence-based practices has great potential to improve the quality of children’s services; however, with a large variety of available practices, it can be challenging to select targets for quality improvement in community-based treatment. This study used a method called relevance mapping to identify how thoroughly evidence-based programs could cover a specific population of children seeking services at a large public agency and identify practice elements relevant to these clients. A therapist survey was used to examine current practice at the agency. Eight therapists at the agency reported on their practice delivery for 141 clients. Results from relevance mapping and therapist surveys were combined to create practice profiles for two predominant diagnostic categories seen at the agency: substance use and depression. These practice profiles were used to identify three areas of interest for agency quality improvement with regard to practice element delivery: Agency Strengths, Opportunities, and Weaknesses. Results demonstrate a potential blueprint for tailoring specific feedback to an agency for use in quality improvement efforts.

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Gavirneni, Madhavi, Karen E. Schetzina, Nilesh Dankhara, Jeremy Bradley, Laura Maphis, Jason Tyler Williams, Gayatri Bala Jaishankar, Michelle Tanner, Laurie Bennie, and William T. Dalton. "Community Partnerships to Promote Healthy Active Living." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/5043.

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Purpose To describe outcomes of community partnerships for promoting healthy active living among families with young children in the ReadNPlay for a Bright Future Project. Methods ReadNPlay for a Bright Future was developed through grant support from the American Academy of Pediatrics (AAP) and Metlife Foundation awarded to the East Tennessee State University Department of Pediatrics and Tennessee AAP Chapter. ReadNPlay is a coordinated, multi-level, multi-component initiative promoting healthy active living among families with young children during infant-toddler health supervision visits and in childcare and other community settings. The project site is located in rural southern Appalachia, an area of the country with a high prevalence of obesity. Materials and messages developed by the project team were finalized during a community forum with stakeholders held in Northeast Tennessee in fall 2012. Four themes emerged as a focus for the initiative: Play More: Shut off the Screen, Play Together: Be Active as a Family, Fuel to Play: Eat Healthy, and Play Safely. Partnerships with the regional children's hospital, childcare providers, health department, public libraries, and farmers' markets were supported through on-going communication via email, social media, and individual meetings. Availability of two $750 pediatric resident mini-grants and structure afforded by the residency program's existing community pediatrics rotation facilitated development and implementation of community initiatives for this project. Results Project posters displayed in community settings, use of social media, and periodic community events are reinforcing efforts to promote healthy active living in the clinical setting. A new event for families with infants/toddlers was added to the children's hospital annual Kids Run, involving over 120 families during the first year. Walk N' Rollers received free Reach Out and Read books and were surprised at the sugar content of juice and other beverages displayed in sippy cups as part of a “Sugar Quiz.” Information disseminated through regional child care centers will promote participation in a summer Walk N' Roll program in addition to this annual event. At a regional childcare provider conference, ReadNPlay workshops with over 100 infant-toddler teachers and 40 families were conducted and information on Tennessee's “Gold Sneaker” designation for compliance with state nutrition and physical activity policies was shared (only 6% of local centers are designated). During summer 2013, 75 families are being provided with $10 farmers' market vouchers at their 12-15 month well child visit to encourage consumption of fruits and vegetables. 18-month statistics on social media reach, walking program participation, new Gold Sneaker designations, and farmers' market program participation will be presented. Conclusion This presentation will illustrate how pediatric residency programs and practitioners may partner with existing community organizations and initiatives to promote healthy active living in families with young children.

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Vaughan-Thomas, Non. "The child, first and always? Aspects of children's health care interests." Thesis, University of Cambridge, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240053.

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Cesar, Juraci A. "Community health workers in Sergipe, Brazil : implications for their future role in maternal and child health." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2005. http://researchonline.lshtm.ac.uk/1366862/.

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Every year six million children die worldwide due to diseases that are easily preventable or curable. Interventions to reduce the number of deaths are offered by health facilities, yet many children continue to die at home without receiving any type of health care. Expansion of the strategy for the Integrated Management of Childhood Illness (IMCI), promoted by WHO and UNICEF, provides a unique opportunity to improve health care for young children at the household level. This thesis examines the potential role for community health workers (CHWs) in extending the IMCI strategy from health facilities to the community. A review of the literature on CHWs and IMCI is followed by a description of two state-wide questionnaire surveys and a qualitative study carried out in Sergipe, Northeastern Brazil, aimed at evaluating child health care with particular emphasis on the role ofCHWs. In the first survey, children less than five years of age were investigated regarding morbidity patterns, utilization of health services, socioeconomic and household conditions. A two-stage process led to a representative sample of caretakers of 1,785 children (response rate of 98%). About one third of the families with children were living below the poverty line and under unfavourable environmental conditions. Of all the children studied, 39% had been ill in the two weeks preceding the survey, mostly with acute lower respiratory infections which is the main reason for medical consultations and hospital admissions in the State. Co-morbidity was frequent and 85% of all reported illness episodes were covered by the IMCI strategy. Nine out of 10 children were fully immunized, and 69% had had their growth monitored in the last month. Almost all children who sought care were seen by a health worker. Despite high access to health care, essential drugs were often unavailable in health facilities. Overprescribing was also common with two thirds of children, seen by a doctor, having received an antibiotic. The median duration of total and exclusive breastfeeding were very short at 5.4 months and 2.1 months, respectively. Complementary feeding was also inappropriate with a median number of three meals in the previous 24 hours when, at least, five meals are recommended. There is therefore a potentially significant role for IMCI in improving the quality of care and nutritional management of children under five years of age. CHWs were regularly visiting 81% of all children under five years of age in the State. There was a clear trend towards higher coverage among the poor. Coverage was highest among children living in municipalities in the interior of the State (86.9% against 58.1% in the capital) and in rural areas (88.5% against 76.3% in urban areas). CHWs were also more 8 likely to visit children whose mothers did not attend school (86.3% against 69.3% with nine years or more of schooling) and those belonging to families earning less than one minimum wage (89.2% against 69.4% of families receiving four minimum wages or more). This suggests that CHWs are contributing to reducing inequities in access to basic health care and may explain the high coverage of immunization and growth monitoring activities as CHWs playa major role in delivering these activities. In the second representative survey, 311 CHWs were asked about their knowledge on child survival issues as well as about the support and supervision they received from their local health teams. Again, a two-stage sampling process (municipalities and CHWs) was used with a response rate of 96%. CHWs from Sergipe state were usually female, young and married. Their educational level was substantially higher than that of mothers of young children. Yet, CHWs were inadequately trained, supervised and supported. They were overloaded having to deliver 26 different tasks and usually worked alone in the community. In addition, their professional standing was negatively affected by low salaries, a lack of job security and few fringe benefits. A comparison of families who were regularly visited by CHWs and those that were not, showed a positive effect on maternal knowledge about oral rehydration therapy, breastfeeding and kind of delivery. Children who were visited were also more likely to receive vitamin A and be weighed regularly. The positive impact of CHW visits remained after adjustment for confounding variables. These findings suggest that CHWs are already effective in improving maternal knowledge as well as in providing several interventions that are part of the IMCI strategy. In order to investigate perceptions and beliefs regarding health care, the qualitative study included expert interviews with doctors, nurses and heads of municipal departments of health as well as in-depth interviews with a sample of CHWs. Mothers of children under five years old were enrolled in the qualitative study through focus groups discussions. A total of 90 qualitative interviews and six focus groups were carried out by the author of this thesis and an anthropologist. These data showed that the relationships between facility workers, CHWs and community mothers were often conflicting. Facility workers did not take part in community activities and, in tum, mothers did not participate in group activities in the health facilities. As a result, integration was poor or non-existent. Mothers, especially those from rural areas, wanted a greater availability of doctors and nurses. Most facility workers, in contrast, judged mothers to be highly demanding, making excessive use of health services by seeking health care for mild illnesses, and making inappropriate demands because they 9 lacked knowledge about the roles of the different cadres of health workers. The role of CHWs in the health team was unclear and their tasks were not properly defined. Their relationship with facility workers, especially doctors, was often conflicting. They also did not relate well to urban mothers, who wanted direct access to doctors and who did not feel that CHWs had greater knowledge than themselves. Rural mothers had a generally positive view of CHWs. Currently the main task of CHWs is to act as messengers between the community and the health facility. While this is a positive role per se, CHWs could have a greater impact if their roles in urban and rural areas were more specialized. In urban areas, they should be better trained to deliver educational messages, whereas in rural areas they should also be allowed to perform simple curative tasks to improve their professional standing as well as to deliver key interventions in areas with poor access to health facilities. Almost all respondents stated that extending the activities related to IMCI - such as identifying pneumonia and dysentery at household level through CHWs - would be highly appropriate and desirable. However, to effectively extend IMCI to the community through CHWs, substantial changes would have to occur in their selection, training, supervision, support and professional standing. Several policy recommendations for improving child health in Sergipe are presented. These include improving the performance and professional standing of CHWs and redefining their tasks in the light of the IMCI strategy. Recommendations are also given for improving the integration between communities, facility-based health workers and CHWs, and on how to extend IMCI more effectively to the community through an enhanced role for CHWs.

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Kachimanga, Chiyembekezo. "Improving utilization of maternal health related services: the impact of a community health worker pilot programme in Neno Malawi." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29240.

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Introduction: Malawi has one of the highest maternal mortality ratio (MMR) in sub-Saharan Africa (SSA). Despite investments in family planning and emergency obstetric care (EmOC), Malawi’s Millennium Development Goal (MDG) target of reducing maternal deaths to 155 deaths per 100,000 live births was not met by the end of 2015. Between 2010 and 2015, Malawi was only able to reduce the MMR from 675 to 439 per 100,000 live births. Inadequate utilisation of perinatal services is the contributing factor to the MMR target not being achieved. One approach for improving the utilisation of perinatal services is to invest in community health workers (CHWs). CHWs can be trained to: identify women of child bearing age (WCBA) who need perinatal services; provide community education; encourage timely referral of clients to the nearest health facility; and undertake community follow up for WCBA who are pregnant and/or have recently given birth. We evaluated changes in utilisation of antenatal care (ANC), facility based births, and postnatal care (PNC) after CHW deployment to conduct monthly home visits to WCBA for pregnancy identification and escorting women to ANC, labour and facility birth and PNC clinics in Neno district, Malawi. The CHW programme was implemented in two catchment areas from March 2015 to June 2016. Methodology: We employed a retrospective quasi-experimental study design to evaluate the impact of CHWs on changes in the utilisation of ANC, facility based births, and PNC in Neno district, Malawi between March 2014 and June 2016 (pre-intervention period: March 2014 to February 2015, and post- intervention period: March 2015 to June 2016). Monthly outcomes were compared between a combined CHW intervention area and its synthetic control area using the synthetic control method. The synthetic control area (or synthetic counterfactual of the CHW) was the control area that was created from multiple available control sites where the CHW programme was not implemented to allow the comparison of outcomes between the sites where CHWs were implemented and the sites where CHWs was not implemented. Two hundred and eleven CHWs (128 existing CHWs plus 83 new CHWs from the community) were trained in maternal health and deployed to cover an estimated 5,132 WCBA living in a catchment area of about 20,530 people. The primary focus of the CHWs was to conduct monthly household visits to identify pregnant women, and then escort pregnant women to their initial and subsequent ANC appointments, facility births, and to PNC check-ups. As part of package of care, community mobilisation and improvements in services to achieve a minimum package of services at the local health centres were also added. Using the synthetic control method, as developed by Abadie and Gardeazabal (2003) and Abadie, Diamond and Hainmueller (2010) and a Bayesian approach of synthetic control developed by Brodersen (2015), a synthetic counterfactual of the CHW intervention was created based on six available public control facilities. The synthetic counterfactual trend was created to have similar preintervention characteristics as the CHW intervention trend. The impact of the CHW intervention was the difference between the CHW intervention site and its synthetic counterfactual Results: CHWs in the intervention areas visited an average of 3,147 (range 3,036 – 3,218) of WCBA monthly, covering 61.0% of WCBA. During these visit 3.6% (97 women per month) of WCBA were suspected to be pregnant every month. Of those women suspected to be pregnant, 67.8% (66 women per month) were escorted to health facilities immediately every month. CHWs visited an average of 254 pregnant women enrolled in ANC and 64 women in postpartum period monthly. ANC and facility births utilisation in the CHW intervention site increased in comparison to the control site. Firstly, the number of new pregnant women enrolled in ANC per month increased by 18.0 % (95% Credible Interval (CrI) 8.0%, 28.0%), from 83 to 98 per pregnant women. Secondly, the proportion of women starting ANC in first trimester increased by 200.0% (95% CrI 162.0%, 234.0%), from 9.5% to 29.0% per month. Thirdly, the number of women attending four or more ANC visits increased by 37.0% (95% CrI 31.0%, 43.0%), from to 28.0% to 39.0%. Lastly, the number of facility births increases by 20% (CrI 13.0%, 28.0%), from 85 women to 102 per month. However, there was no net difference on PNC visits between the CHW intervention site and its counterfactual unit (-37.0%, 95% CrI -224.0%, 170.0%). Conclusions: CHW intervention significantly increased the utilisation of ANC and facility based births in Neno, Malawi. However, CHWs had no net difference on PNC utilisation.

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Al-Ali, Ibrahim Jassim. "Child care policy and fostering in Kuwait." Thesis, Cardiff University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.238135.

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Ranson, Sonya L. "A study of the dental health status of children participating in the Child Health Investment Partnership." Thesis, This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-07292009-090354/.

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Rowland, Gemma. "How do parents within the Orthodox Jewish community experience accessing a community Child and Adolescent mental health service?" Thesis, University of East London, 2016. http://roar.uel.ac.uk/5387/.

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Previous research suggests that children of minority groups may be underserved by mainstream services (Elster, Jarosik, VanGeest & Fleming, 2003). There has been an identified need for research that focuses on barriers to accessing services faced by minority groups, such as the Orthodox Jewish community (Dogra, Singh, Svirdzenka & Vostansis, 2012). Given that parents are often the gate-keepers to care (Stiffman, Pescosolido & Cabassa, 2004), understanding their help-seeking behaviour is crucial to ensure that Orthodox children and families are given the same opportunities to access services as their majority group peers. To date there is extremely limited research on the help-seeking behaviours of Orthodox Jewish parents. The current study sought to consider the experiences of Orthodox Jewish parents who have accessed Child and Adolescent Mental Health Services (CAMHS) in order to seek help for their families. Semi-structured interviews were completed with nine Orthodox Jewish parents with regards to their experiences of accessing tier 2 CAMHS for their child. A thematic analysis was conducted. Four themes were found: ‘The Orthodox community as unique’, ‘Pathways to help’, ‘Attitudes towards mental health’ and ‘The parental journey’. Participants described a number of significant cultural barriers to seeking help. Stigma was identified as occurring in relation to mental health and also in relation to the process of help-seeking, as suggested by previous research within adult Orthodox populations (Feinberg & Feinberg, 1985). These stigmas relate to concerns regarding labelling and future matchmaking for the child and their siblings. Parents experience emotional and practical strains in parenting a child with mental health difficulties and in accessing psychological support for their children. The implications for service level change and clinical practice are considered.

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Lopez, Quetzalsol F., Karen E. Schetzina, Amanda Haiman, and Fernando Mendoza. "Barriers to Obtaining Health Insurance among Patients Served By a Mobile Community Health Van." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/5064.

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Li, Jun. "The use of child health computing systems in primary preventive care : an evaluation." Thesis, University College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274686.

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Arora, Amit. "Child Oral Health And Community Support For Water Fluoridation In Lithgow New South Wales." Thesis, Faculty of Dentistry, 2007. http://hdl.handle.net/2123/4161.

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Jonker, Linda. "The experiences and perceptions of mothers utilizing child health services." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20294.

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Thesis (MCur)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Member states of the United Nations accepted eight Millennium Development Goals in 2000. Millennium Development Goal number four addresses the improvement of child health. The purpose of goal number four is to decrease the child mortality rate by 60% for the period 1990 to 2015. South Africa is one of twelve countries where the incidence of child mortality increased during this period. Guided by the research question “What are the experiences and perceptions of mothers utilizing child health services”, a study was done. A qualitative, descriptive phenomenological methodology was applied to explore the experiences and perceptions of mothers utilizing child health services for children younger than two years. The goal of this study was to determine the experiences and perceptions of mothers utilizing child health services. The objectives were to explore their experiences and perceptions, with specific reference to the service they receive regarding: - immunization - nutrition assessment - the growth of the child - the growth chart - other underlying illnesses Ethical approval was obtained from Stellenbosch University and various health authorities. Validity was assured by adhering to the principles of trustworthiness, namely credibility, transferability, dependability, and conformability. The population for this study was mothers who utilized ten clinics in a demarcated area of Cape Town for child health services. Purposive sampling was utilized to consciously select three clinics (N =10), and at each of the clinics four mothers were purposively selected to participate. A total of seventeen mothers participated in the study. An interview guide was used to conduct interviews with participants. The researcher conducted and recorded the interviews after obtaining written informed consent from each participant. A field diary was kept for notation of observations. Data analysis involved the transcribing of digitally recorded interviews, the coding of the data, the generating of themes and sub-themes, interpretation and organization of data and the drawing of conclusions. The Modeling Role-Modeling Nursing theory of Erickson, Tomlin and Swain were utilized as conceptual theoretical framework to facilitate application to the broad population. Findings of the study indicated varied experiences. All mothers did not receive information about the RtHB or RTHC. Not all mothers developed a relationship of trust with caregivers or were afforded the respect of becoming part of the child’s health care team. According to the mothers integrated child health care services were not practised. The consequences were missed opportunities in immunization, provision of Vitamin A, absence of growth monitoring, feeding assessment and provision of nutritional advice. Hospitals and private practitioners equally did not provide immunization services or offered holistic care. Simple interventions such as oral rehydration, early recognition and treatment of diseases, immunization, growth monitoring and appropriate nutrition are not diligently offered; that could reduce the incidence of child morbidity and mortality. The following recommendations are made: determine why hospitals do not immunize children. The root causes must be addressed to change practice. Rendering of child services must happen in an integrated approach. Staff must be empowered with skills regarding procurement, in particular regarding vaccines.
AFRIKAANSE OPSOMMING: In 2000 het die lidlande van die Verenigde Volke Organisasie die Millenium Ontwikkelingsdoelwitte aanvaar. Die Millenium Ontwikkelingsdoelwit nommer vier roer die kwessie van kindergesondheid aan. Die strategie om die voorkoms van kindersterftes met 60% te verminder vanaf 1990 tot 2015 is die vierde millenium doelwit. Suid Afrika is een van twaalf lande in die wêreld waar die kindersterftes vir hierdie tydperk toegeneem het. ‘n Studie is gedoen om te bepaal “Wat die ervaring en persepsies van moeders is wat van kindergesondheidsdienste gebruik maak. ‘n Kwalitatiewe, beskrywende, fenomenologiese studie is gedoen,om die ervaring en persepsies van moeders wat kinders jonger as twee jaar na klinieke geneem het, te bepaal. Die doel van die studie was om die ervaring en persepsies van moeders ten opsigte van kindergesondheidsdienste vas te stel. Spesifieke doelwitte was die bepaling van die ervaring en persepsies rondom: - immunisasiedienste - groeimonitering - voedingsvoorligting - die groeikaart - behandeling van siektes Etiese goedkeuring was verkry vanaf die Universiteit van Stellenbosch en die verskeie gesondheidsowerhede. Geldigheid van die studie is verseker deur die beginsels van geloofwaardigheid na te kom naamlik, aaneemlikheid, betroubaarheid, oordraagbaarheid en inskiklikheid. Die bevolking betreffende die studie was moeders wat kliniekdienste gebruik het vir hulle kinders in ‘n spesieke area van Kaapstad, bestaande uit tien klinieke. Drie klinieke (N=10) is doelgerig geselekter vir deelname. Vier moeders is doelgerig by elk van die drie klinieke geselekteer vir deelname. Onderhoude is met sewentien deelnemers gevoer. ‘n Onderhoudsgids is gebruik en die navorser het rekord gehou van waarnemings. Die navorser het onderhoude gevoer en opgeneem na skriftelike toestemming daarvoor van elke deelnemer verkry is. ’n Veldwerkdagboek is gehou van alle waarnemings. Data-analise het behels: digitale opnames wat woordeliks beskryf , tematies ontleed en geïnterpreteer is en volgens temas georganiseer is. Toepassing na die breër populasie is bevorder deur die gebruik van die verpleegteorie van Erickson, Tomlin en Swain. Bevindinge van die studie het getoon dat moeders verskillende ervaringe gehad het. Nie alle moeders het inligting ontvang omtrent die RtHB of RTHC nie. Nie alle moeders het vertroue in die kliniek nie en moeders word nie erken as bepalende faktore in die sorgspan nie. . Volgens die moeders is geïntegreerde gesondheidssorg nie beoefen nie. Die gevolge is dat geleenthede nie benut word om te immuniseer nie, vitamien A te verskaf, groei te kontroleer, voeding te bepaal en voedingsadvies te verskaf. Die voorraadvlakke van entstof word nie oral doeltreffend beheer nie. Hospitale en dokters beoefen nie altyd immunisering en holistiese kindergesondheidsdienste nie. Eenvoudige intervensies, wat die voorkoms van kindermorbiditeit en kindermortaliteit kan bestry, word nie verskaf nie. Voorbeelde van sulke intervensies is mondelinge rehidrasie, vroeë diagnose en behandeling van siektes, immunisering, groeimonitering en geskikte voedingsinligting. Daar word aanbeveel dat daar indringend bepaal word hoekom hospitale nie kinders immuniseer nie en dat die oorsake aangespreek word. Integrasie van dienste by klinieke moet as prioriteit gesien en geïmplimenteer word. Personeel se vaardighede betreffende beheer van voorraad moet verbeter word, veral t.o.v. entstof voorraad.

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Grow, Mollie, Allison LaRoche, Elizabeth Baca, Janine S. Bruce, Emily Borman-Shoap, Emily Hall, Katherine M. Satrom, et al. "Collaborating with Community Partners, Residents." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5041.

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20

Hiiri, A. (Anne). "Community-wide oral health promotion in the Pitkäranta district of Russian Karelia:a case study." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514288579.

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Abstract The aim of this study was to describe the planning, implementation and evaluation of a community-wide programme of oral health promotion that begun in 1993 in the Pitkäranta district of Russian Karelia. Baseline analysis of the community included clinical dental examinations and questionnaire surveys which were carried out in the same way as in the Finnish reference areas, Kuopio and Jyväskylä, in 1992. In addition, interviews of stomatologists and dentists, observations at local shops, kiosks, schools and dental clinics, and determinations of fluoride levels in drinking water were carried out in the Pitkäranta district. Previous information on oral health and its determinants among children in the Republic of Karelia was sought in the literature, from local statistics and from patient documents in the Pitkäranta district. Community analysis at baseline revealed that in the Pitkäranta district the occurrence of dental diseases was high. Behaviours related to oral health were generally unfavourable, and professional prevention at dental offices was practically non-existent. Therefore, the results of the baseline analysis of the community in 1993 called for an intervention with emphasis on enhancing healthy lifestyles, reorienting the methods of action of the system of oral health care towards health promotion and prevention of diseases, creating a supportive environment and empowering community actions as suggested in the Ottawa Charter. The goal was to achieve at least the same level of oral health as that found among children in the Finnish reference areas. In the 2001 follow-up, community oral health was analysed with the methods used in 1993. The results of the follow-up community analysis were used to monitor the changes in 1993–2001 and to assess the strengths and weaknesses of the programme. The improvements in oral health and in oral health-related behaviours among children as well as other developments in the community were impressive. Some oral health-related behaviours, such as frequent use of sugary snacks, non-daily use of fluoridated toothpaste and increasing smoking among adolescents, called for further actions.

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Aujla, Mark Amrinder, and Demetrio Macariola. "Inpatient versus Outpatient Pediatric Antibiograms: An Analysis Looking for Significant Difference." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/46.

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Antibiograms are aggregates of susceptibility testing data of pathogens over a period of time. Bacteria are cultured from infected patients. Once identified, a pathogen undergoes testing against common antibiotics, indicating the effectiveness of specific antibiotics to the pathogen identified. This data gives clinicians an understanding of which antibiotics face increasing resistance in their communities. This project involved the development of a pediatric outpatient antibiogram which was compared against a regional inpatient pediatric antibiogram. The goal was to identify a significant difference in susceptibility between inpatient and outpatient pediatric infections. All urine cultures ordered within the ETSU Health pediatrics department over the course of 1 year between September 2018 and September 2019 were examined. There were 251 such cultures, of these 52 were abnormal, and required antibiotic treatment. All abnormal urine cultures were examined for pathogen identity, and susceptibility data. Pathogens were stratified by species and their susceptibility to commonly utilized antibiotics was aggregated and expressed as a percentage. This analysis did not distinguish between intermediate and resistant strains of bacteria, both results were marked resistant. There were 3 patients that presented with repeat cultures. Two of these patients presented with a single species of bacteria on follow-up cultures, and subsequent samples were excluded. One patient presented with two different urine cultures at different points in the year, and both samples were included. When stratified based on species, only E. Coli, with 30 unique samples, presented enough statistical power for analysis. We compared community and hospital pediatric antibiograms and found no statistical difference in susceptibility in E. Coli. However, analysis showed significant difference between both pediatric antibiograms and the inpatient adult antibiogram. We found significant difference in susceptibility between samples for ampicillin 11%, ampicillin-sulbactam 34%, tetracycline 21%, levofloxacin 21%, and Trimethoprim-sulfamethoxazole 12%. The adult antibiogram demonstrated lower susceptibility against all of these antibiotics. Additional research is necessary in this area. Based on this analysis, we cannot recommend pediatric community antibiogram creation. However, the differences observed between adult and pediatric antibiograms indicate a utility for continued stratification of antibiograms by age.

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Swanepoel, Daniël Christiaan De Wet. "Infant hearing screening at maternal and child health clinics in a developing South African community." Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-08242005-093303.

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Holt, Nicole, Arsham Alamian, Deborah L. Slawson, and Shimin Zheng. "Child, Family, and Community Factors and the Utilization of Oral Health Services in Early Childhood." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/119.

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Access to dental care is the leading unmet health need among American children. Early access to oral health care is critical in the prevention and treatment of early childhood caries, and any barriers perceived by parents can cause delay in seeking treatment. The purpose of this study was to examine child, family, and community factors associated with the utilization of oral health services among U.S. and HRSA region IV children aged 1-5 years. The data were obtained from the 2011/2012 National Survey of Children’s Health. Descriptive statistical summaries were calculated for all independent variables grouped by child, family, and community. A caregiver was asked whether the child received dental care in the past 12 months. Multiple logistic regression analysis using an investigator driven stepwise selection methodology was conducted. Nearly half (46.7%) of caregivers in the national sample reported that their child had visited a dentist in the past 12 months, slightly fewer (46.0%; p

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Gurganus, Jill Renee. "An evaluation of educational literature distributed by the Child Health Investment Partnership." Thesis, Virginia Tech, 1993. http://hdl.handle.net/10919/46306.

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Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index. A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail.
Master of Science

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Wood, David L. "Transforming Early Childhood Community Systems in NE TN." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5169.

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Bambrick, Hilary Jane, and Hilary Bambrick@anu edu au. "Child growth and Type 2 Diabetes Mellitus in a Queensland Aboriginal Community." The Australian National University. Faculty of Arts, 2003. http://thesis.anu.edu.au./public/adt-ANU20050905.121211.

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Globally, the prevalence of Type 2 diabetes is rising. The most affected populations are those that have undergone recent and rapid transition towards a Western lifestyle, characterised by energy-dense diets and physical inactivity.¶ Two major hypotheses have attempted to explain the variation in diabetes prevalence, both between and within populations, beyond the contributions made by adult lifestyle. The thrifty genotype hypothesis proposes that some populations are genetically well adapted to surviving in a subsistence environment, and are predisposed to develop diabetes when the dietary environment changes to one that is fat and carbohydrate rich. The programming hypothesis focuses on the developmental environment, particularly on prenatal and early postnatal conditions: nutritional deprivation in utero and early postnatal life, measured by low birthweight and disrupted child growth, is proposed to alter metabolism permanently so that risk of diabetes is increased with subsequent exposure to an energy-dense diet. Both hypotheses emphasise discord between adaptation (genetic or developmental) and current environment, and both now put forward insulin resistance as a likely mechanism for predisposition.¶ Diabetes contributes significantly to morbidity and mortality among Australia’s Indigenous population. Indigenous babies are more likely to be low birthweight, and typical patterns of child growth include periods of faltering and rapid catch-up. Although there have been numerous studies in other populations, the programming hypothesis has not previously been tested in an Australian Indigenous community. The framework of the programming hypothesis is thus expanded to consider exposure of whole populations to adverse prenatal and postnatal environments, and the influence this may have on diabetes prevalence.¶ The present study took place in Cherbourg, a large Aboriginal community in southeast Queensland with a high prevalence of diabetes. Study participants were adults with diagnosed diabetes and a random sample of adults who had never been diagnosed with diabetes. Data were collected on five current risk factors for diabetes (general and central obesity, blood pressure, age and family history), in addition to fasting blood glucose levels. A lifestyle survey was also conducted. Participants’ medical records detailing weight growth from birth to five years were analysed with regard to adult diabetes risk to determine whether childhood weight and rate of weight gain were associated with subsequent diabetes. Adult lifestyle factors were xiialso explored to determine whether variation in nutrition and physical activity was related to level of diabetes risk.¶ Approximately 20% of adults in Cherbourg have diagnosed diabetes. Prevalence may be as high as 38.5% in females and 42% in males if those who are high-risk (abnormal fasting glucose and three additional factors) are included. Among those over 40 years, total prevalence is estimated to be 51% for females and 59% for males.¶ Patterns of early childhood growth may contribute to risk of diabetes among adults. In particular, relatively rapid weight growth to five years is associated with both general and central obesity among adult women. This lends some qualified support to the programming hypothesis as catch-up growth has previously been incorporated into the model; however, although the most consistent association was found among those who gained weight more rapidly, it was also found that risk is increased among children who are heavier at any age.¶ No consistent associations were found between intrauterine growth retardation (as determined by lower than median birthweight and higher than median weight growth velocity to one and three months) and diabetes risk among women or men. A larger study sample with greater statistical power may have yielded less ambiguous results.¶ Among adults, levels of physical activity may be more important than nutritional intake in moderating diabetes risk, although features of diet, such as high intake of simple carbohydrates, may contribute to risk in the community overall, especially in the context of physical inactivity. A genetic component is not ruled out. Two additional areas which require further investigation include stress and high rates of infection, both of which are highly relevant to the study community, and may contribute to the insulin resistance syndrome.¶ Some accepted thresholds indicating increased diabetes risk may not be appropriate in this population. Given the relationship between waist circumference and other diabetes risk factors and the propensity for central fat deposition among women even with low body mass index (BMI), it is recommended that the threshold where BMI is considered a risk be lowered by 5kg/m2 for women, while no such recommendation is made for men.¶ There are a number of social barriers to better community health, including attitudes to exercise and obesity, patterns of alcohol and tobacco use and consumption of fresh foods. Some of these barriers are exacerbated by gender roles and expectations.¶

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Nsibande, Duduzile. "Assessment of the uptake of referrals by community health workers to public health facilities in Umlazi, Kwazulu-Natal." Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2920_1367481376.

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Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens &
Zupan, 2005). Early
detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing
countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking
behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home
visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit,
community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing
community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured
questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers&rsquo
home or at the study
offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis.
Descriptive analysis was
conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant
associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were
enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the
highest number of which occurred within
the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking
their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW.
Conclusion: This study found
high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South
African National Department of Health (SANDOH) which will involve the establishment of family health worker teams
including community health workers. A key function of these workers will
be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with
non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by
community health workers. Most of the referrals in this study were
neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal
and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater
realization of a team approach to PHC.

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28

Gharaibeh, Muntaha Khaleel. "Maternal knowledge, beliefs, attitudes and practices relating to child immunization among Jordanian mothers." Thesis, University of Ulster, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390060.

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Skuse, David Henry. "Failure to thrive in the first postnatal year : an inner city community survey." Thesis, Institute of Cancer Research (University Of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243411.

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30

Yohannes, Aynalem G. "Differentials in child morbidity and utilization of health facilties [i.e. facilities] in rural Ethiopia." Thesis, Canberra, ACT : The Australian National University, 1988. http://hdl.handle.net/1885/142298.

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31

Fraser, Jennifer Anne, and n/a. "The Role of Home Visiting as an Early Intervention Strategy for Prevention of Child Abuse and Neglect." Griffith University. School of Applied Psychology, 2000. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20050915.140055.

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Burgeoning numbers of child abuse and neglect reports throughout the developed world has prompted calls for preventive and early intervention measures to support and prepare families for parenting. Nurse home visiting is one form of service delivery gaining acceptance as an appropriate strategy. Although home visiting is not a new concept in service delivery, enthusiasm for home-visitation programmes has re-emerged not only in Australia in recent years, but in many other developed countries with initiatives being launched or recommended at state, national and international levels. This thesis presents a review of the tenets of home visiting and examines a home visiting intervention programme targeting children born into families with child abuse or neglect risk factors. A randomised controlled trial using a cohort of 181 families was undertaken to evaluate the impact of this home visiting programme. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting programme or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. This procedure was shown to have utility in the context of recruitment to a research trial, in that respondents were willing to disclose sensitive personal issues using this form of screening as the basis for targeted intervention. The home visiting programme examined by this study was also shown to have social validity, with mothers willing to accept this form of intervention from the immediate postnatal period. High retention and satisfaction rates strengthened this conclusion. The ability of this study to evaluate the effectiveness of the home visiting intervention programme may have been compromised by a range of contextual factors influencing programme outcomes detailed in this thesis. Nonetheless, the study found that, for a group of families reporting risk factors for child abuse and neglect potential, provision of an intensive home visiting intervention using nurses, social workers, and parent aides was not effective in producing more favourable adjustment to the parenting role over time compared with nonintervention or clinic based service provision. The intervention programme group participants gained knowledge of child development and child management skills during the early postnatal weeks while the comparison group participants developed knowledge and skills later in the first year of their infant's lift. Early adaptation to the parenting role, parenting knowledge, and skill acquisition bodes well for parent-infant attachment and the children's long-term health and developmental outcomes. However, a 12-month assessment of maternal, family, and child development variables did not demonstrate maintenance of a positive intervention impact on parenting stress, parenting competence, or quality of the home environment. Finally, predictive analysis of fictors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. These results not only demonstrate that there is a relationship between maternal, family and enviromnental factors identified in the immediate postnatal period, and adjustment to the parenting role, but also challenge demographic targeting for child abuse and neglect risk. Findings are discussed and placed within the context of previous research and reference is made to implications for future child health practice, development, and research. Recommendations arising from this discussion relate to both future research and community child health practice.

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32

Fraser, Jennifer Anne. "The Role of Home Visiting as an Early Intervention Strategy for Prevention of Child Abuse and Neglect." Thesis, Griffith University, 2000. http://hdl.handle.net/10072/365313.

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Burgeoning numbers of child abuse and neglect reports throughout the developed world has prompted calls for preventive and early intervention measures to support and prepare families for parenting. Nurse home visiting is one form of service delivery gaining acceptance as an appropriate strategy. Although home visiting is not a new concept in service delivery, enthusiasm for home-visitation programmes has re-emerged not only in Australia in recent years, but in many other developed countries with initiatives being launched or recommended at state, national and international levels. This thesis presents a review of the tenets of home visiting and examines a home visiting intervention programme targeting children born into families with child abuse or neglect risk factors. A randomised controlled trial using a cohort of 181 families was undertaken to evaluate the impact of this home visiting programme. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting programme or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. This procedure was shown to have utility in the context of recruitment to a research trial, in that respondents were willing to disclose sensitive personal issues using this form of screening as the basis for targeted intervention. The home visiting programme examined by this study was also shown to have social validity, with mothers willing to accept this form of intervention from the immediate postnatal period. High retention and satisfaction rates strengthened this conclusion. The ability of this study to evaluate the effectiveness of the home visiting intervention programme may have been compromised by a range of contextual factors influencing programme outcomes detailed in this thesis. Nonetheless, the study found that, for a group of families reporting risk factors for child abuse and neglect potential, provision of an intensive home visiting intervention using nurses, social workers, and parent aides was not effective in producing more favourable adjustment to the parenting role over time compared with nonintervention or clinic based service provision. The intervention programme group participants gained knowledge of child development and child management skills during the early postnatal weeks while the comparison group participants developed knowledge and skills later in the first year of their infant's lift. Early adaptation to the parenting role, parenting knowledge, and skill acquisition bodes well for parent-infant attachment and the children's long-term health and developmental outcomes. However, a 12-month assessment of maternal, family, and child development variables did not demonstrate maintenance of a positive intervention impact on parenting stress, parenting competence, or quality of the home environment. Finally, predictive analysis of fictors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. These results not only demonstrate that there is a relationship between maternal, family and enviromnental factors identified in the immediate postnatal period, and adjustment to the parenting role, but also challenge demographic targeting for child abuse and neglect risk. Findings are discussed and placed within the context of previous research and reference is made to implications for future child health practice, development, and research. Recommendations arising from this discussion relate to both future research and community child health practice.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology
Griffith Health
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33

Al-Naimi, Fouzia Z. M. "Mother and child health care compliance and the immunization up-take study in the State of Qatar." Thesis, University of Dundee, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264320.

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Williams, Bryan L. "Physician utilization patterns and family characteristics of participants in the Comprehensive Health Investment Project." Master's thesis, This resource online, 1990. http://scholar.lib.vt.edu/theses/available/etd-01122010-020028/.

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Project (M.S.)--Virginia Polytechnic Institute and State University, 1990.
Questionnaires ([6] leaves) in pocket. Includes bibliographical references (leaves 70-72). Also available via the Internet.

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Rukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.

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Shrestha, Ranjan. "Family planning, community health interventions and the mortality risk of children in Indonesia." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1187119287.

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Ruth, Corinne Elizabeth. "Parenting Skills as a Predictor of Youth Externalizing Outcomes in Routine Community Mental Health Services." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6760.

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This study examined the relationship between perceived parenting skills and youth externalizing symptoms throughout the course of routine treatment of youth receiving services in a community mental health setting. Specifically, this study investigated whether changes in parenting skills were associated with changes in three dimensions of youth externalizing behaviors (behavioral dysfunction, interpersonal relations, social problems). Participants were 401 youth (aged 4-17, mean aged 10.7, 48% female) and their parents/guardians. At regular intervals throughout treatment, parents completed the Treatment Support Measure (TSM) to assess perceived parenting skills along with the Youth Outcome Questionnaire (Y-OQ) to assess youth externalizing symptoms. Hierarchical linear modeling analyses revealed that changes in perceived parenting skills were not significantly related to changes youth behavioral dysfunction, interpersonal relations, or social problems. However, parenting skills and all facets of externalizing significantly changed throughout the course of therapy and higher parenting skills were associated with lower levels of youth externalizing throughout therapy. Parenting skill appears to require further study as a key factor involved in youth psychotherapy outcomes in real world settings, especially in relation to youth externalizing symptoms.

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Shemanchuk, Carol. "Dimensions of quality in Well Child Clinic services, a comparison of community health nurses' and mothers' perceptions." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0010/MQ60175.pdf.

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Roche, Marion. "A community-based positive deviance/hearth intervention to improve infant and young child nutrition in the Ecuadorian Andes." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104543.

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Most growth faltering in developing countries occurs in the first two years of life; therefore, there is a need to identify interventions for vulnerable communities which improve child growth during this critical period. The purpose of this research was to evaluate the effectiveness of a community-based Positive Deviance (PD)/hearth infant and young child feeding intervention to improve growth and nutrition in infants and young children in the Ecuadorian highlands. The first study was with experiences of mothers in rural communities in the Ecuadorian Andes who had previously (2008) participated in a PD/hearth intervention (n=168). Infant and young child feeding practices and predictors of stunting in the Ecuadorian highlands communities were assessed to guide the development of the 2009 intervention. In this cold environment with limited health infrastructure, it was necessary to develop a procedure for adjusting anthropometric measures for clothing weight of infants and young children (n=293). This study used a quasi-experimental non-randomized study design to compare growth and diet of infants and young children in six intervention communities (n=80) to those in nine non-intervention communities (n=184). Intervention mothers and their children participated in a 12-day PD/hearth nutrition intervention. Demographic, nutritional, and anthropometric data were collected at baseline and at six months follow-up. The results were as follows. 1) Mothers credited the 2008 intervention with increasing self-esteem and social support, yet greater importance was placed on social changes than on growth. 2) Stunting was found in 56.2% of the study population at baseline. Older age, respiratory infections, and being male were predictors of lower height-for-age z-score (HAZ), whereas early initiation of breastfeeding, higher socioeconomic status, consumption of iron-rich foods, and higher dietary protein density were protective. 3) Modeling showed that without adjusting for clothing weight 24% of children were misclassified for weight-for-age z-score (WAZ), and 13% for weight-for-height z-score (WHZ). 4) Six months after the 2009 intervention, participants were 1.6 to 5.7 times more likely than comparison children to consume the foods promoted in the intervention. Intervention children consumed more iron, zinc, vitamin A, protein, and energy (p < 0.05). Compared to non-intervention children, intervention children had greater improvement in WAZ (β=0.16; 95% CI: 0.01, 0.32), but not HAZ (β= 0.00; 95% CI: -0.21, 0.17). The intervention was beneficial in eliminating the risk of severe underweight (OR=0.00; 95% CI: 0.00, 0.08). In rural Ecuador, mothers improved their children's diet and weight with peer support, indigenous knowledge, and local foods. Supporting mothers' groups through community PD/hearth nutrition interventions is an effective way to reduce the global burden of underweight in infants and young children.
La majorité des problèmes de croissance dans les pays en développement ont lieu au cours des deux premières années de la vie, c'est pourquoi il existe un besoin d'identifier les interventions améliorant la croissance infantile et qui ciblent les communautés vulnérables durant cette période critique. L'objectif principal de cette recherche était d'évaluer l'efficacité d'une intervention communautaire de Deviance Positive (DP)/ foyer du nourrison et du jeune enfant afin d'améliorer la croissance et la nutrition des nourrissons et des enfants en bas-âge dans les hautes terres équatoriennes. La premiere etude a été Afin avec des mères des communautés rurales des Andes équatoriales qui en 2008 avaient participé à l'intervention DP/foyer avec leurs enfants de 2-5 ans (n=168). Les pratiques d'alimentation du nourrisson et du jeune enfant et les prédicteurs du retard de croissance des communautés des hautes terres équatoriennes ont été évaluées pour guider le développement de la nouvelle intervention de 2009. Il a été nécessaire de développer une procédure pour ajuster les mesures anthropométriques pour le poids des nourrissons et des jeunes enfants (n=293) étant donné les températures faibles et les infrastructures limitées. Une étude avec conception non randomisée quasi-expérimentale a été utilisée pour comparer la croissance et la nutrition des nourrissons et des jeunes enfants au sein de 6 communautés d'intervention (n=80) à ceux des 9 communautés sans intervention (n=184). Dans le groupe d'intervention, les mères et leurs enfants agés de moins de 2 ans ont participé à l'intervention communautaire participative DP/Foyer de 12 jours. Les données démographiques, nutritionnelles et anthropométriques ont été récoltées au début et après 6 mois de suivi. Les résultats étaient les suivants: 1) selon les mères, leur estime de soi et le soutien social se sont améliorés grâce à l'intervention de 2008, mais elles ont donné plus d'importance aux changements sociaux qu'une amélioration de la croissance. 2). Au début de l'étude 56.2% de la populatin avaient un retard de croissance. Un âge plus élevé, des infections respiratoires et le sexe masculin étaient des prédicteurs d'un score Z du rapport 'Taille pour Age' plus faible alors que le début précoce de l'allaitement maternel, un statut socio-économique plus élevé, la consommation d'aliments riches en fer et une densité élevée en protéines étaient des éléments protecteurs. 3) Le modèle a montré que jusqu'à 24% des enfants avaient été classés en score Z du rapport 'Poids pour l'Age' et 13% pour le score Z du rapport 'Poids pour Taille' lorsque le poids des vêtements avait été ajusté. 4) Six mois après l'intervention de 2009, les mères avaient 1.6 à 5.7 fois plus de chances de nourrir leurs enfants avec des aliments promus par l'intervention que les mères du groupe de comparaison (p < 0.05). Au cours du suivi, les enfants du groupe d'intervention consommaient plus de fer, de zinc, de vitamine A, de protéines et d'énergie, lorsque les covariantes ont été controlées (p < 0.05). Les enfants du groupe d'intervention avaient une plus grande amélioration du score Z du rapport 'Poids pour Age ' (aβ=0.16; 95% CI: 0.01, 0.32), mais pas du score Z du rapport 'Taille pour Age' (aβ= 0.00; 95% CI: -0.21, 0.17). L'intervention a été bénéfique en éliminant le risque d'insuffisance pondérale sévère (aOR=0.00; 95% CI: 0.00, 0.08). Les mères de l'Equateur rural ont amélioré le régime alimentaire et le poids de leurs enfants grâce au soutien par les pairs, aux connaissances autochtones et à leurs aliments locaux, mais ne pouvaient pas améliorer la croissance linéaire. Le soutien des groupes de mères à travers des interventions communautaires de Deviance Positive/Foyer est un moyen efficace pour réduire la charge globale de l'insuffisance pondérale des nourrissons et des jeunes enfants.

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Ebdon, Rosamund. "Community based health care the NGO way : an anthropological study of a maternal-child health and family planning programme in rural Bangladesh." Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/20492.

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This is an anthropological study of a rural Maternal-Child Health and Family Planning (MCH-FP) project and the community in which it worked, in Bangladesh. It analyses the Non-Government Organisation's (NGO's) approach to rural community-based health care and integrated development, using the health programme as a framework. Beginning with an examination of the NGO's relationships with its donor-funding and technical support organisations, it moves on to a critique of population policy from a socio-cultural perspective, focusing on issues of gender and poverty. The main conclusions call for an expansion of the MCH agenda to adopt a more holistic perspective on the social context of women's health. This involves recognising the role of men in women's health care and actively including them in programmes. It also necessitates recognising the heterogeneity of female needs, beyond those of the conventional MCH reproductory focus, and the recognition of domestic violence as a significant cause of female morbidity and mortality. The principal conclusion is, therefore, the need for a gender perspective in the formulation of health policy and the design and implementation of health programmes, and more active participation in these processes, not only of women, but all members of the community, particularly men and influential leaders. Finally, a comparison is made between the ethnography of this and other anthropological works on Bangladesh, placing the study in the context of existing literature.

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Schetzina, Karen E. "Community-Based Participatory Research Approaches to Obesity Prevention in Appalachia." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/5012.

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Sharland, Elaine Ruth. "Protection, partnership and the promotion of welfare : the experience of professional intervention in child sexual abuse referrals." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310561.

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Saitowitz, Romy. "An evaluation of the nutritional status of preschool chldren living in a rural health district : implications for a community based nutrition programme in the Northern Province." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/26766.

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The study aimed to evaluate the nutritional status of pre-school children (0-6 years), and the activities of a local CBNP serving these children, in the Ngwaritsi health district of the Northern Province. The following objectives were identified: o To determine the anthropometric status of children 0-6 years o To determine the dietary intake of children 0-6 years o To evaluate the nutrition services offered to these children by a local CBNP o To make recommendations, based on these findings, for improving existing strategies to address malnutrition in the area.

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Chang, Catherina. "Prevalence and Determinants of Overweight and Obesity in Preschoolers in Miami-Dade County." FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3171.

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Background: The prevalence of childhood overweight in the United States continues to be a national public health problem. The child care and household environments play an important role in the nutrition, physical activity, and screen-time behaviors of preschoolers. Aims: This dissertation aimed to (1) estimate the prevalence of overweight and obesity in 3-5 year old children enrolled in child care centers in Miami-Dade County; (2) identify early life, dietary, and screen-time risk factors of overweight, and (3) assess child care centers' level of adherence to nutrition, physical activity, and screen-time regulations by center socioeconomic location (SEP). Methods: A total of 366 children ages 3-5 years old from 34 child care centers participated in the study. Caregivers completed a questionnaire on socioeconomic, early life, dietary, and screen-time factors. We measured children's heights and weights. Chi-square and logistic regression analyses were used to examine the association between child overweight and determinants. Results: the prevalence of overweight was 29.8% in this sample. The middle-SEP group had the highest prevalence of overweight (35.3%) when compared to low and high-SEP groups. Being Hispanic was associated with a three-fold risk of overweight/ obesity (AOR: 2.91, 95% CI 1.36, 6.21). Lack of daily fruit consumption increased the risk of overweight in Hispanic children. Middle-SEP children reported lowest consumption of fruits and vegetables. There were significant differences in breastfeeding practices by ethnicity and SEP. Assessment of child care practices resulted in all child care centers adhering to two-hour screen-time regulation for children older than 2-years old. Low and middle SEP centers fared better in serving of fruits , vegetables, and low fat/ fat free milk. The centers had incorporated quite and active play in their routines. Conclusions: This is the first study to examine prevalence by SEP in Miami-Dade County. Findings highlight opportunities for improvement in early life nutrition, as well as dietary and screen-time practices in the household and child care environments.

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Govender, Nicole. "Knowledge, perceptions and attitude of community members and healthcare workers regarding the donation of breast milk and use of donated human milk (DHM) in Empangeni, KwaZulu-Natal." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32699.

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Background: Breast milk provides optimal nutrition for infants. Human milk banks allow breast milk feeding for infants who do not have access to their own mother's milk. However, there are variable perceptions and attitudes towards human milk banking. Aim: This study aimed to evaluate community members' and healthcare workers' knowledge, perceptions and attitudes towards breast milk donation and use in Empangeni, KZN. Methodology: The research was conducted at a large regional hospital and an affiliated primary health care centre in the area. There were five focus group discussions held with healthcare workers employed at the two sites which explored the attitudes regarding donating and receiving breast milk. In addition, there were sixteen individual semi-structured interviews held with community members. Content analysis was used to analyse the data. Results and Discussion: Five main themes were found which includes: “Breastfeeding is an optimal feeding choice”, “Infant feeding choice”, “Misperceptions of HIV”, “Knowledge of DHM” and “Acceptance of DHM”. Though most participants were aware of breastfeeding benefits, there are poor breastfeeding rates within the area. Many mothers choose to formula feed their infants due to the fear of HIV transmission. There is also a fear of HIV transmission when using DHM. Acceptance of DHM was largely related to knowledge of DHM and exposure to its use. Conclusion: Healthcare workers need to be given updated, evidence-based information (in accordance with national guidelines and policies) to ensure appropriate counselling of caregivers. Furthermore, community awareness and engagement is required to improve breastfeeding rates and acceptability of DHM.

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Holt, Nicole. "An Investigation of the Relationship Between Child, Family, and Community Factors and Early Childhood Oral Health and the Utilization of Dental Health Services." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3242.

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Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community levels. Binary logistic methods were applied to each outcome and predictor variable. Stepwise logistic regression models were constructed for child, family, and community variables. Additionally the mediating effect of oral health services utilization in the association between child, family and community factors and parental perception of child’s oral health was evaluated. National results and Health Resource Service Area (HRSA) region IV results were compared. Results: In the national (n=24,875) and HRSA region IV sample (n=4,017) 9.7% and 10.2% of caregivers, reported that the child had an oral health problem in the past 12 months. Fewer than half (46.7%) of caregivers reported that their child had visited a dentist in the past 12 months. Absence of neighborhood cohesion, neighborhood amenities, and residence in metropolitan statistical area all had positive significant effects on children seeing a dentist. There was a mediating effect by utilization of oral health services between child with special health care needs (p=0.005), number of children (p=0.045) and adults (p=0.046) in the household, and tobacco use (p=0.018) and parents perception of oral health in the HRSA region IV population. Conclusion: This study identified several factors as correlates of poor oral health outcomes. Our results expand our knowledge of early childhood oral health by studying how oral health is impacted not only by child factors but also the family and community at large. Our results begin identifying the unique constellation of risk factors that contribute to early childhood oral health.

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Kaane, Sophia Inziani. "A study of the effectiveness of visual media in the promotion of child immunisation in Kakamega District, Kenya." Thesis, Loughborough University, 1995. https://dspace.lboro.ac.uk/2134/31904.

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The health of children is very important in Kenya, given that more than half of its population is under twenty years of age. Despite continued efforts, Kenya has not achieved the Universal Child Immunisation (UCI) target of full immunisation for 75 per cent of all children. It is argued here that two of the factors contributing to this situation are the lack of information and of effective media of communication.

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Ach, Elizabeth. "Analyzing Option B+ Model For Preventing Mother To Child Transmission of HIV in Resource Limited Countries in Sub-Saharan Africa." Scholarship @ Claremont, 2016. http://scholarship.claremont.edu/scripps_theses/729.

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In 2013, 2 million people were newly infected with HIV, and 11% of those new infections were infants that obtained the disease from their mother. In resource poor settings, like Sub-Saharan Africa, infection rates from mother to child can range from 15-45%. With proper prevention of mother to child transmission (MTCT), these rates can drop to 5%. Proper prevention includes the use of antiretroviral treatment (ART) during pregnancy, delivery, and post-partum and breastfeeding. In 2010, WHO proposed a model that required all HIV positive mothers to receive ART. The model successfully increased the amount of women on treatment, and many countries also saw a decrease in the rate of MTCT, however barriers still exist. In my thesis, I explain how HIV attacks an individual’s immune system, and why it has been such a difficult epidemic to control in regards to mother to child transmission. I also examine how different models of prevention are successful, and why Option B+, proposed by WHO in 2010, has been the most successful. Lastly, I propose new additions to the model in an attempt to circumvent the barriers.

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Brindle, Jillian. "A study of family perceived needs and interventions provided by the Comprehensive Health Investment Project." Thesis, Virginia Tech, 1992. http://hdl.handle.net/10919/45000.

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The demographics and perceived needs of the Comprehensive Health Investment Project participants were studied along with the interventions provided by the CHIP staff. Demographic information and perceived needs were calculated on 397 household heads. These families were followed for a year and the interventions provided to them during that year were recorded. Intervention records were collected quarterly and analyzed for comparisons with the family profile grid.Results show a unique demographic makeup of CHIP participants. Sixty percent of household heads had one or more years of college; 66 percent were employed at the time of the study; 73 percent were receiving federal financial assistance of some kind. Health and nutrition of the family were the main concerns of the clients. Other needs included financial assistance, employment, and housing. Eleven percent of interventions provided by CHIP throughout the study year were directed towards financial assistance. Ten percent of services were employment oriented. CHIP participants were also shown to use physicians during well times - not just during emergencies. Results and conclusions are discussed in detail.
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Sims, Donna. "Impact on Material and Child Health Knowledge as a Result of Participation in a Family Resource\Youth Services Center New and Expectant Parenting Series." TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/320.

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The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the pre-test and posttest questionnaires. The questionnaire was a 20 item multiple choice instrument (Learning About Parenting Survey or LAPS) which measured maternal and child health knowledge in such areas as family planning; informed parenting; maternal health; basic baby care; breast-feeding; bottle-feeding; first aid; child's health including immunizations, child safety; nutrition; child development and discipline. Analysis of covariance was performed using the LAPS raw scores from the posttests as the dependent variable, the pretest scores as the covariate and the treatment as the independent variable. The results showed no significant difference in parenting knowledge between the individuals enrolled in the Family Resource\Youth Services Center's New and Expectant Parenting Series and the comparison group who did not take the course.

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Dissertations / Theses on the topic 'Community child health'

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