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Goodman ML, Temple JR, Elliott AJ, Seidel SE, Gitari S, Raimer-Goodman LA. Child maltreatment, social capital, maternal mental health and duration of program involvement: Assessment from a community-based empowerment program in Kenya. JOURNAL OF FAMILY VIOLENCE 2023; 38:407-417. [PMID: 37197413 PMCID: PMC10187605 DOI: 10.1007/s10896-022-00391-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 05/19/2023]
Abstract
Multisystem, multi-level interventions are required to enable resilient, nurturing environments for children facing adversity. This study assesses parenting behavior associated with participation in a community-based, adapted microfinance program, and mediated by program-affiliated social capital, maternal depression and self-esteem among Kenyan women. Participants in the intervention, Kuja Pamoja kwa Jamii (KPJ, Swahili for "Come Together to Belong"), gather weekly to engage in trainings and group-based microfinance. Groups selected for the study had participated in the program for 0-15 months at the time of the first interview. Women (n = 400) completed surveys in June 2018 and June 2019. Measures included duration of program exposure, group-affiliated social capital (i.e. trust, belonging, cohesion, and expectation of mutual benefit), depression, self-esteem, and conflict tactics. We used regression analyses and generalized structural equation models to explore associations between program exposure, social capital, psychosocial variables and child maltreatment. Each standard deviation increase in duration of program exposure decreased odds of child physical abuse by 40% and child neglect by 35%. Each standard deviation in the social capital index predicted a significant reduction in odds of child physical abuse (aOR: 0.67), and child neglect (aOR: 0.71). Self-esteem and depression fully mediated observed associations between social capital and child maltreatment. Findings recommend further investigation of the potential for adapted microfinance programs to deliver parenting interventions, improve mental health and foster resilience-enabling social capital. A randomized control trial is required to validate the potential of the assessed intervention to improve parenting behaviors and supportive social conditions.
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Affiliation(s)
- Michael L. Goodman
- University of Texas Medical Branch, Galveston, TX, USA
- Sodzo International, Houston, TX, USA
| | | | - Aleisha J. Elliott
- University of Texas Medical Branch, Galveston, TX, USA
- Sodzo International, Houston, TX, USA
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Moore N, Abouhala S, Maleki P, Kheyfets A, Carvalho K, Amutah-Onukagha N. The Efficacy of Provider-Based Prenatal Interventions to Reduce Maternal Stress: A Systematic Review. Womens Health Issues 2023; 33:300-311. [PMID: 37019762 DOI: 10.1016/j.whi.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/08/2023] [Accepted: 02/24/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Exposure to stress during the prenatal period is often associated with adverse maternal and neonatal health outcomes and is increasing in prevalence in the United States. Health care providers play a crucial role in addressing and mitigating this stress, but there is a lack of consensus in effective interventions. This review evaluates the effectiveness of prenatal provider-based interventions that reduce stress for pregnant people, especially those who are disproportionately affected by stress. METHODS A search of relevant English-language literature was conducted using PubMed, CINAHL, Web of Science, Embase, and PyscInfo. Inclusion criteria were 1) the target population was pregnant people, 2) the intervention was delivered within the U.S. health care system, and 3) the study intervention had the goal of reducing stress (stress-reducing intervention). RESULTS A total of 3,562 records were identified in the search and 23 were included in analysis. The four identified categories for provider-led stress-reducing prenatal interventions included in the review are 1) skills-building, 2) mindfulness, 3) behavioral therapy, and 4) group support. Findings suggest an increased overall likelihood of mood and maternal stress improvement among pregnant people who complete provider-based stress-reducing interventions, especially group-based therapies that integrated resource allocation, skills-building, mindfulness, and/or behavioral therapy into an intersectional program. However, the efficacy of each type of intervention varies by category and type of maternal stress targeted. CONCLUSIONS Although few studies demonstrated a significant reduction in stress for pregnant people, this review highlights the critical need for increased research and attention to stress-reducing interventions in the prenatal period, especially as it pertains to minoritized populations.
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Affiliation(s)
- Nichole Moore
- Tufts University School of Medicine, Boston, Massachusetts.
| | | | - Pegah Maleki
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anna Kheyfets
- Tufts University School of Medicine, Boston, Massachusetts
| | - Keri Carvalho
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences. Dev Psychopathol 2023; 35:447-458. [PMID: 35249575 PMCID: PMC9448830 DOI: 10.1017/s0954579421001486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.
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Smith H, Ashby B. Looking Into the Future for Children of Young Mothers. Pediatrics 2022; 150:189766. [PMID: 36281713 DOI: 10.1542/peds.2022-058142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 02/25/2023] Open
Affiliation(s)
| | - Bethany Ashby
- Obstetrics and Gynecology.,Psychiatry, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Namutebi M, Kabahinda D, Mbalinda SN, Nabunya R, Nanfuka DG, Kabiri L, Ngabirano TD, Muwanguzi PA. Teenage first-time mothers' perceptions about their health care needs in the immediate and early postpartum period in Uganda. BMC Pregnancy Childbirth 2022; 22:743. [PMID: 36192734 PMCID: PMC9528157 DOI: 10.1186/s12884-022-05062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background Teenagers have higher risks for complications during the intrapartum and postpartum periods. Although facility-based postpartum care focusses on preventing complications in mothers and babies, it is not understood what teenage-mothers’ perceptions are about their health care needs in the early postpartum period. Methods An exploratory descriptive qualitative study was conducted in four health facilities in Uganda. In-depth interviews with 42 first-time teenage mothers aged 14 to 19 years were conducted between March and April 2020. Thematic analysis was done. Results Two themes emerged, Health promotion and Rehabilitation and counseling. Teenage first time mothers desired to receive information about key issues like self and newborn care, breast feeding, immunization and family planning. They noted that health workers need to monitor their vital signs which aids in early diagnosis of complications, disease prevention/treatment of current conditions. Others felt that health workers are key in arbitrating between them and their estranged parents and also help to link them to community based organizations that can provide them with counseling and life skills. Conclusions Teenage first-time mothers have many health care needs during the immediate and early postpartum period. This is a missed opportunity to provide health education and link them to sexual reproductive health services including family planning, breastfeeding clinics and other community based programs which provide life skills or continuing education for girls. Focusing on these needs and integration of services is key in providing holistic care to the teenagers. We propose that further research be done to explore how their health care needs change at 6 months post-delivery.
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Affiliation(s)
- Mariam Namutebi
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda.
| | - Dorcus Kabahinda
- Department of Social Work and Social Administration, College of Humanities and Social Sciences, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Scovia Nalugo Mbalinda
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Racheal Nabunya
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Dorothy Gingo Nanfuka
- Department of Paediatrics and Child Health, College of Health Sciences, School of Medicine, Makerere University, Kampala, Uganda
| | - Lydia Kabiri
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Tom Denis Ngabirano
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Patience A Muwanguzi
- Department of Nursing, College of Health Sciences, School of Health Sciences, Makerere University, Kampala, Uganda
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Tebb KP, Brindis CD. Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach. Semin Reprod Med 2022; 40:107-115. [PMID: 34991169 DOI: 10.1055/s-0041-1741518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The relationship between mental health and teenage pregnancy is complex. Mental health can be both an antecedent and contributing factor to teenage pregnancy and a concurrent factor wherein pregnancy itself can contribute to depression. Expectant and parenting teens (EPT) are faced with the simultaneous challenges of pregnancy and parenting while navigating the developmental tasks of adolescence which increases their risk for mental health problems. In addition, adolescents growing up in stressful community or home situations where their parents experienced depression, further places them and their children at greater risk of repeated patterns over time. However, adverse mental health outcomes are not inevitable. The socio-ecological model combined with a life course perspective provides a framework for understanding the complexity of risk and protective factors at multiple levels that influence knowledge, attitudes, behaviors, and other health outcomes later in life and across generations. This approach has important implications for reducing adolescents' risk of an unintended/mistimed pregnancy and improving mental health and other outcomes for EPT. This paper describes the prevalence of mental health problems in EPT and using a socio-ecological framework and life course perspective explains variations in mental health outcome among EPT. Implications for interventions and innovative approaches are also discussed.
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Affiliation(s)
- Kathleen P Tebb
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, California, San Francisco
| | - Claire D Brindis
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Adolescent and Young Adult Health National Resource Center, University of California, California, San Francisco.,The Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, University of California, California, San Francisco
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Bang KS, Kim S, Lee G, Jeong Y, Shin DA, Kim M. Intervention Studies on the Enhancement of Self-Concept Among Adolescent Mothers: A Systematic Review. J Psychosoc Nurs Ment Health Serv 2021; 60:31-39. [PMID: 34432589 DOI: 10.3928/02793695-20210819-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Self-concept affects the overall process of pregnancy, childbirth, and parenting among adolescent mothers. The current systematic review explores intervention studies on the enhancement of self-concept among adolescent mothers, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English and Korean literature published within the past 10 years was searched and five articles met the inclusion criteria. To improve self-concept among adolescent mothers, especially self-esteem, it was deemed necessary to strengthen a balanced capacity of physiological, psychological, sociocultural, and developmental aspects, based on a comprehensive assessment. To provide effective intervention, it was essential to reflect the cultural characteristics of adolescent mothers' native countries. Lectures were confirmed as a representative method of enhancing self-concept and participatory learning methods, such as group discussions, group activities, practical skills training, and supervision, were considered effective for enhancing self-esteem by strengthening not only knowledge but also the motivation of adolescent mothers. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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YILMAZ B, OSKAY Ü. Karitane Ebeveyn Kendine Güven Ölçeği: Türkçe geçerlik ve güvenirlik çalışması. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.902521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
Teen pregnancy and parenting remain important public health issues in the United States and around the world. A significant proportion of teen parents reside with their families of origin, which may positively or negatively affect the family structure. Teen parents, defined as those 15 to 19 years of age, are at high risk for repeat births. Pediatricians can play an important role in the care of adolescent parents and their children. This clinical report updates a previous report on the care of adolescent parents and their children and addresses clinical management specific to this population, including updates on breastfeeding, prenatal management, and adjustments to parenthood. Challenges unique to teen parents and their children are reviewed, along with suggestions for the pediatrician on models for intervention and care.
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Affiliation(s)
- Makia E Powers
- Children's Healthcare of Atlanta and Morehouse School of Medicine, Atlanta, Georgia; and
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Maslowsky J, Hendrick CE, Stritzel H. Mechanisms linking teenage mothers' educational attainment with self-reported health at age 50. BMC WOMENS HEALTH 2021; 21:15. [PMID: 33407362 PMCID: PMC7789595 DOI: 10.1186/s12905-020-01150-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/13/2020] [Indexed: 11/10/2022]
Abstract
Background Early childbearing is associated with adverse health and well-being throughout the life course for women in the United States. As education continues to be a modifiable social determinant of health after a young woman gives birth, the association of increased educational attainment with long-term health for women who begin childbearing as teenagers is worthy of investigation. Methods Data are from 301 mothers in the National Longitudinal Survey of Youth 1979 who gave birth prior to age 19. We estimated path models to assess women’s incomes, partner characteristics, and health behaviors at age 40 as mediators of the relationship between their educational attainment and self-rated general health at age 50. Results After accounting for observed background factors that select women into early childbearing and lower educational attainment, higher levels of education (high school diploma and GED attainment vs. no degree) were indirectly associated with higher self-rated health at age 50 via higher participant income at age 40. Conclusions As education is a social determinant of health that is amenable to intervention after a teen gives birth, our results are supportive of higher educational attainment as a potential pathway to improving long-term health outcomes of women who begin childbearing early.
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Affiliation(s)
- Julie Maslowsky
- Department of Kinesiology and Health Education, University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX, 78712, USA. .,Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA. .,Population Research Center, University of Texas at Austin, Austin, TX, USA.
| | - C Emily Hendrick
- School of Community Health Sciences, University of Nevada Reno, Reno, NV, USA
| | - Haley Stritzel
- Population Research Center, University of Texas at Austin, Austin, TX, USA
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Van Lieshout RJ, Savoy CD, Boyle MH, Georgiades K, Jack SM, Niccols A, Whitty H, Lipman EL. The Mental Health of Young Canadian Mothers. J Adolesc Health 2020; 66:464-469. [PMID: 32057608 DOI: 10.1016/j.jadohealth.2019.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Although many young mothers (aged <21 years) are exposed to multiple adversities that increase their risk for mental illness, prevalence data are largely limited self-report questionnaires estimating only the prevalence of postpartum depression. Gaining a greater understanding of the burden of a broader range of common mental illnesses affecting these young women has the potential to improve their health as well as the development and functioning of their children. METHODS The Young Mothers Health Study recruited 450 mothers aged <21 years and 100 comparison mothers (aged >20 years old at first delivery) living in urban and rural central-west Ontario. Age-matched young mothers were also compared with 15- to 17-year-old women without children (N = 630) from the 2014 Ontario Child Health Study. The prevalence of current mental disorders was assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents. RESULTS Nearly 2 of 3 young mothers reported at least one mental health problem, and almost 40% had more than one. Young mothers were 2 to 4 times as likely to have an anxiety disorder (generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia), attention-deficit/hyperactivity disorder, oppositional defiant disorder, or conduct disorder and were 2 to 4 times more likely to have more than one psychiatric problem than older comparison mothers or women aged 15-17 years. CONCLUSIONS Given the high rates of mental health problems and complex needs of young mothers in Canada and the possible adverse effects of maternal psychopathology on their children, further efforts should be directed at engaging and treating this high-risk group.
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Affiliation(s)
- Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Alison Niccols
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Heather Whitty
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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