Background: Measuring dietary intake by self-report methods have challenges for children and adults. Among an infant population, research showed that caregivers tend to overestimate their childs ...consumption. Limited research has examined the association between caregiver-report of infant total caloric consumption and their weight gain longitudinally. Methods: Intake data were collected from 90 healthy infants aged 9 - 15 months old as part of a 2-year randomized controlled trial. Infant dietary intake, height, and weight were collected at baseline, 12- and 24-month follow-up. Using WHO standard growth charts, weight for length z-score (zWFL), weight for age z-score (zWFA) and body mass index z-score (zBMI) were calculated. Caregivers completed three 24-hr dietary recalls (2 weekday and 1 weekend day) for their child, which reported all the food and beverages consumed in addition to breastmilk and infant formula. Dietary data were analyzed using the Nutrition Data System for Research (NDSR). Change in total caloric consumption and change in weight status were examined. Results: Changes in caloric intake (kcals) positively correlated with changes in infant raw weight (r=0.335, p = 0.004), zWFL (r=0.278, p=0.017), zWFA (r=0.380, p=0.001), and zBMI (r=0.294, p=0.012) from baseline to 12-month follow-up. Similarly, changes in caloric intake (kcals) positively correlated with changes in infant raw weight (r=0.379, p=0.002), zWFL (r=0.355, p=0.003), zWFA (r=0.366, p=0.003), and zBMI (r = 0.367, p = 0.002) from baseline to 24-month follow-up. Conclusions: Caregiver-reported 3-day dietary recalls may be a valid tool in estimating infant dietary intake.
Background: Previous research demonstrated effectiveness of a 10-week family meals intervention(Simple Suppers, SS) in improving the nutritional health of children/caregivers from underserved ...households. The objective of this pre-,post-test study was to facilitate the translation of this science by scaling up SS in Head Start. Due to COVID-19, SS was delivered in 3 different modes: in-person, online, hybrid. Effectiveness(participant) and implementation(process) outcomes were compared across delivery modes. Methods: SS was offered weekly, 3 times/year(fall, winter, spring) (2019-2022). In-person occurred on site(2019-2020), online occurred via Zoom, and included weekly meal kits and on demand videos(2020-2021). Hybrid alternated weekly between in-person and online(2021-2022). Participant outcomes included: caregiver self-efficacy for healthy family mealtime routines, weekly frequency of family dinners, and child food preparation skills. Process evaluation outcomes included: adherence(weekly attendance), acceptability(program satisfaction, 0-10(unsatisfied to satisfied)), and implementation cost(FTEs, direct education). Descriptive statistics were calculated for process outcomes. Kruskal-Wallis was used to determine differences in change in participant outcomes between delivery modes(p<0.05). Results: Study completion rates (caregiver-child dyads) were 69% (n=22) for in-person, 56%(n=5) for online, and 100%(n=7) for hybrid. There were no differences between delivery mode in caregiver selfefficacy or family meals. Scores for child food preparation skills were higher for in-person (p=0.04) versus online and hybrid delivery. Average weekly attendance rate was 69% for in-person, 29% for online, and 61% for hybrid. M(SD) program satisfaction was 7.10(2.56) for inperson, 8.50(2.38) for online, and 10.00(0) for hybrid. FTEs for direct education was 0.2 for in person, 0.2 for online, and 0.1 for hybrid. Conclusions: Findings suggest hybrid vs. in-person and online is optimal in terms of participant and process outcomes.
Domestic and caregiving work has been at the core of human existence throughout history. A team of international scholars addresses the issues of state, agency, and domestic service in colonizer ...frames globally in historical perspectives.
According to the Bureau of Labor Statistics, there were approximately 1.7 million home health aides and personal and home care aides in the United States as of 2008. These home care aides are rapidly ...becoming the backbone of America's system of long-term care, and their numbers continue to grow. Often referred to as frontline care providers or direct care workers, home care aides-disproportionately women of color-bathe, feed, and offer companionship to the elderly and disabled in the context of the home. InThe Caring Self, Clare L. Stacey draws on observations of and interviews with aides working in Ohio and California to explore the physical and emotional labor associated with the care of others.
Aides experience material hardships-most work for minimum wage, and the services they provide are denigrated as unskilled labor-and find themselves negotiating social norms and affective rules associated with both family and work. This has negative implications for workers who struggle to establish clear limits on their emotional labor in the intimate space of the home. Aides often find themselves giving more, staying longer, even paying out of pocket for patient medications or incidentals; in other words, they feel emotional obligations expected more often of family members than of employees. However, there are also positive outcomes: some aides form meaningful ties to elderly and disabled patients. This sense of connection allows them to establish a sense of dignity and social worth in a socially devalued job. The case of home care allows us to see the ways in which emotional labor can simultaneously have deleterious and empowering consequences for workers.
Purpose: Many care settings are characterized by collaboration between a variety of stakeholders. People without natural speech who rely on augmentative and alternative communication (AAC) are often ...strongly dependent on the involved stakeholders and collaboration among them. Since collaboration can be challenged by many barriers, this study examines the impact of a complex intervention on collaboration in AAC care. Methods: In a quasi-experimental mixed methods intervention study which include AAC training, AAC therapy and case management, caregivers of AAC users were surveyed at 3 time points to assess collaboration and case management in the intervention versus comparison group. In addition, semi-structured focus group interviews were conducted with caregivers in the intervention group. Quantitative data were analyzed descriptively and by comparison of means. Qualitative data were analyzed using qualitative content analysis. Results: The Mann-Whitney U-test showed significantly better collaboration in the intervention group with stakeholders that are more actively involved in AAC care, such as schools (p=0.026) and residential or social facilities (p=0.010), but not with passive stakeholders such as health insurance companies. Most aspects of case management were rated significantly better in the intervention group (p <0.001). The focus group results show mainly positive changes in collaboration with the active stakeholders, such as more commitment and openness toward AAC. Conclusion: The results show a positive impact of the intervention on the collaboration between stakeholders involved in AAC care especially with active stakeholders. In particular, the organization of care and the accompanying case management by the AAC consultation centers seem to positively affect collaboration. Keywords: stakeholders, teamwork, mixed methods, focus groups, complex care
La sobrecarga es uno de los fenómenos presentados en los cuidadores de pacientes con Alzheimer. El objetivo de esta investigación fue identificar los factores que influyen en la sobrecarga de ...cuidadores informales de pacientes con Alzheimer, partícipes de un programa de intervención en Bucaramanga, Santander, Colombia. El estudio fue transversal anidado en un ensayo controlado aleatorizado con 3 grupos en paralelo, y con una muestra a conveniencia de 58 cuidadores. Adicionalmente, se aplicó la escala de carga del cuidador de Zarit y una entrevista estructurada, al igual que se utilizó un modelo de efectos mixtos con varianza no estructurada. Se encontró que la edad media fue de 55.6 años (79.3 %), mujeres e hijos (70.7 %), un bajo uso de redes de apoyo (8.6 %) y una mediana de dedicación al cuidado de 24 horas/día. Como factores asociados a la sobrecarga, por cada año del cuidador, la sobrecarga disminuye 0.5 puntos (p = 0.005), así como se encuentra con más sobrecarga a los cuidadores cuyos pacientes tienen una mayor afectación del comportamiento (p = 0.003), los cuidadores que tienen otro empleo (p = 0.025) y la falta de apoyo brindado por otros familiares (p = 0.014). Estos resultados permiten caracterizar a familiares cuidadores en quienes se requiere una intervención multidisciplinaria.
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