Despite the high prevalence of obesity and the clustering of risk by neighborhood, few studies have examined characteristics which promote healthy child weight in neighborhoods with high obesity ...risk. We aimed to identify protective factors for children living in neighborhoods with high obesity risk.
We identified neighborhoods with high obesity risk using geolocated electronic health record data with measured body mass index (BMI) from well-child visits (2012–2017). We then recruited caregivers with children aged 5 to 13 years who lived in census tracts with mean child BMI percentile ≥72 (February 2020–August 2021). We used sequential mixed methods (quantitative surveys, qualitative interviews) to compare individual, interpersonal, and perceived neighborhood factors among families with children at a healthy weight (positive outliers PO) versus families with ≥1 child with overweight or obesity (controls). Regression models and comparative qualitative analysis were used to identify protective characteristics.
Seventy-three caregivers participated in the quantitative phase (41% PO; 34% preferred Spanish) and twenty in the qualitative phase (50% PO; 50% preferred Spanish). The frequency of healthy caregiver behaviors was associated with being a PO (Family Health Behavior Scale Parent Score adjusted β 3.67; 95% CI 0.52–6.81 and qualitative data). Protective factors also included caregivers’ ability to minimize the negative health influences of family members and adhere to family routines.
There were few differences between PO and control families. Support for caregiver healthy habits and adherence to healthy family routines emerged as opportunities for childhood obesity prevention in neighborhoods with high obesity risk.
Background and purpose: The main purpose of this study was to assess the level of knowledge of Family Health Unit employees in healthcare centers in Sari with regard to the relactation and induced ...lactation in 2023. Materials and methods: In this qualitative and cross-sectional study, the level of knowledge of the healthcare service employees for mothers and children in healthcare centers in Sari in increasing breastfeeding were evaluated. Results: The result of this study revealed that only 9 participants (18%) reported previous activity in promoting relactation and induced lactation, and all of these participants also had successful experience in increasing relactation and induced lactation. The mean score (standard deviation) of participants' knowledge level was 15.28 (2.33). Conclusion: The findings of the present study highlighted that Family Health Unit employees who are effectively involved with mothers and infants can have successful experience in exclusive breastfeeding with breast milk, both naturally and induced, if they have sufficient knowledge.
The Family Health Strategy is the main form of organization of the Brazilian health system. However, the third edition of the National Primary Health Care Policy (PNAB) recognized other types of ...teams financially. A time series study was conducted from 2007 to 2019 using data from the National Register of Health Facilities (CNES) of jobs, teams and national coverage of Family Health to analyze the effects of the 2017 National Primary Health Care Policy (PNAB) on team composition. We observed the concentration of doctors in the Southeast and Northeast and variation of this professional category before the events of the "Mais Médicos" (More Doctors) Program. The number of nurses increased 5% and Community Health Workers (ACS) dropped 0.3% in the country. Despite the authorization and funding for the implementation of "Primary Care" teams (eAB), they correspond to less than 1% of the total teams. It is noteworthy that the municipal managers' preferred mode is the traditional Family Health Teams, equivalent to 75% of the total and growing. While the questionings and expectations generated by the 2017 PNAB in the context of Primary Health Care, we can conclude that, regarding the teams and their compositions, no significant change was identified two years into its coming into force.
The COVID-19 pandemic poses an acute threat to the well-being of children and families due to challenges related to social disruption such as financial insecurity, caregiving burden, and ...confinement-related stress (e.g., crowding, changes to structure, and routine). The consequences of these difficulties are likely to be longstanding, in part because of the ways in which contextual risk permeates the structures and processes of family systems. The current article draws from pertinent literature across topic areas of acute crises and long-term, cumulative risk to illustrate the multitude of ways in which the well-being of children and families may be at risk during COVID-19. The presented conceptual framework is based on systemic models of human development and family functioning and links social disruption due to COVID-19 to child adjustment through a cascading process involving caregiver well-being and family processes (i.e., organization, communication, and beliefs). An illustration of the centrality of family processes in buffering against risk in the context of COVID-19, as well as promoting resilience through shared family beliefs and close relationships, is provided. Finally, clinical and research implications are discussed.
Public Significance Statement
The current paper reviews the literature on historical adversities that have threatened societies, such as natural and human-made disasters and recessions, in order to highlight the possible consequences of the current crisis on the well-being of families and children. Families are facing imminent threats to their relationships, rules, rituals, and routines due to COVID-19, which can have major implications for children's coping during this time. Some families will be more impacted than others, due to their prior circumstances, such as those with lower income, mental health and/or special needs, and/or experiences of racism or marginalization. It is important for families to preserve and nourish their relationships and shared beliefs as a way to provide security and hope for children during this time of stress and uncertainty.
The present study aimed to analyze the evolution of the implementation of Family Health and Primary Health Care Expanded Support Centers (NASF-AB, in Portuguese) in the municipalities of Southern ...Brazil, from 2008 to 2019, in light of the inverse equity hypothesis. This was an ecological study, considering 1,188 municipalities of Southern Brazil. The analyses were separated by state, with municipalities divided into quartiles of Municipal Human Development Index - Income (MHDI-Income). Our study calculated the cumulative percentage of the implementation of NASF-AB within the given period and the inequality between Q1 (richest) and Q4 (poorest), assessed by the absolute and relative inequality measures. In Paraná, Q1 presented a higher coverage of NASF-AB than did Q4, and, although the inequality had decreased at the end of the period, it was still quite distinct, according to the "top inequality" pattern. In Santa Catarina, the predictions of the hypothesis were confirmed, with inequalities found in the beginning of the period and a near 90% decline once NASF-AB had been implemented in the municipalities of Q1, characterizing the "bottom inequality" pattern. In Rio Grande do Sul, the hypothesis was refuted observing that since 2014 there was a greater implementation in Q4 as compared to Q1 was observed.
Flood cases in so many parts of Nigeria, especially in Anambra state and the accruing psychological and health related problems, affecting members of families and society necessitated this study. In ...view to assist and help affected individuals who specialized in farming therapeutically, this study investigated the effect of rational emotive family health therapy (REFHT) on flood-induced anxiety disorders among farmers in Anambra state Nigeria. This study was guided with 3 null hypotheses.
This is a group randomized control study, conducted in Anambra state Nigeria. The sample size was 120 registered cassava farmers in Anambra State Nigeria. A measure of anxiety disorders was used to assess the baseline data of the condition before the treatment, immediately after treatment, and after 3 weeks. The treatment was a self-developed REFHT manual that lasted for 12 sessions, 60 minutes per session with aim of reducing anxiety disorders among farmers who are victims of flood. The manual was delivered by counseling psychologists with orientation in rational emotive behavior and family therapies. Data collected were analyzed using descriptive (mean, standard deviation, chi-square, and percentage) and inferential (Partial Eta Squared, and Analysis of Covariance) statistical tools.
The result revealed no significant gender difference was observed among the study participants' socioeconomic, working status, and loan status. REFHT was significantly effective in reducing flood-induced anxiety disorders among farmers. There was no significant moderating effect of gender on flood-induced anxiety disorders among farmers. There was no significant interaction effect of gender and REFHT treatment on anxiety disorders among farmers.
REFHT was significantly effective in reducing flood-induced anxiety disorders among farmers. Based on the findings, this study recommended among others that rational-emotive therapists and family health professionals should liaise with community leaders to provide career counseling services to farmers and establishment of community-based rational emotive institute for each state in Nigeria.
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