Perceptions of Urban Father Support in Early Parenthood: A Critical Incident Analysis.

Becoming a father is a common transitional event, however men are often not adequately prepared for their fathering role. The United States (U.S.) health care system does little to support fathers' parenting needs during the postnatal and infancy period. Moreover, father's support needs are often perceived as secondary to the mother's needs in the maternal-child system. It is important that fathers' social support needs be investigated in the first year of his newborn's life, especially in diverse populations. Therefore, the purpose of this study was to determine the social support needs of urban, African American fathers during early parenthood. Using the Critical Incident Technique (CIT), a descriptive, qualitative design was used to interview 35 fathers about their social support at 2-12 months after the birth of their baby. Using a semi-structured interview guide, fathers were asked to describe helpful and unhelpful events they experienced since the birth of their baby. Fathers reported 36 helpful events and 32 unhelpful events for an overall total of 68 events. Data was analyzed using House's Social Support Theory and the four social support categories: instrumental, informational, emotional, and appraisal. Using the CIT, main categories and subcategories were developed. The helpful categories included: 1) Helping father with infant care, 2) Providing information on infant care, 3) Receiving HCP assistance, 4) Managing relationships, and 5) Becoming a father. The unhelpful categories included: 1) Receiving unhelpful assistance, 2) Receiving unreliable or unwanted assistance, 3) Offering bad advice, 4) Conflicting relationships, 5) Conflicts with friends, 6) Unsatisfying HCP experience, and 7) Receiving no support from family/organizations. The results of the study validated House's Social Support Theory and served as an excellent framework for exploring social support needs in fathers. More research needs to be conducted on the social support needs of fathers during the first year of their infants' lives, especially with experienced African American fathers and nonresidential fathers, and how health care professionals (HCPs), specifically postnatal and child health nurses, can better support fathers during the infancy period.

Breastfeeding History, Preschool Children's Sleep, and Obesity.

Breastfeeding and sleep are both considered medically and physiologically protective factors for child health. Most existing research studied their impact on child health outcomes, respectively. Few studies examined the two factors collectively to explore any potential associations among a history of breastfeeding and quantity of sleep in children and child health. This study sought to uncover the association among breastfeeding history, the amount of sleep, and obesity in preschool-aged children to provide additional insights into their protective physical and psychological effects on health outcomes. As part of a larger study examining obesity in preschool children, the current investigation explored the association among obesity, a history of breastfeeding, and the total number of hours of preschool children's sleep, as reported by parents. Actual heights and weights were collected on a total of 1,693 children 3-5 years of age enrolled in licensed child care facilities in Mississippi. Descriptive analyses of the demographic and parent survey variables were conducted to explore the status related to breastfeeding in Mississippi. To understand the relationships between breastfeeding and covariates, bivariate analyses such as chi-square independent tests, Cochran-Mantel-Haenszel chi-square tests, and Fisher's exact tests were performed. Obesity was negatively correlated to breastfeeding, and Caucasian mothers were significantly more likely to breastfeed than African American mothers. Obesity was also negatively correlated to the amount of sleep, and African American children reportedly slept significantly less than Caucasian children. The average amount of time of sleep reported for children with a history of being breastfed was significantly higher than for those who were not breastfed, suggesting that breastfeeding could have a significant positive association with preschool children's sleep, serving as an additional protective factor obesity. The interaction between breastfeeding and subsequent sleep as children mature is an important area for future research to fully explore their foundational impact in family health practices that combat obesity in children and promote other subsequent health outcomes.

"It's Hard Being a Mama": Validation of the Maternal Distress Concept in Becoming a Mother.

New mothers actively adapt to new demands and challenges in the mothering role but some may find this adjustment difficult and distressing, depending on their perceptions and resources. Previous research on maternal distress is primarily concentrated on needs of mothers with depression but nonpathological approaches of viewing difficulties in early parenting should be explored. A secondary analysis of a descriptive, qualitative study was completed on new, low-income mothers in early parenthood to determine how maternal distress influences mothers' transition to becoming a mother and to validate the use of the Maternal Distress Concept in the clinical setting. Findings reveal new mothers experience maternal distress on various levels: stress, adaptation, functioning, and connecting. Implications for practice and education are discussed.

Overweight and Obesity Prevalence and Trends Among Mississippi Public School Students: A Decade of Data Between 2005 and 2015.

This study estimated. the prevalence of overweight and obesity in Mississippi public school students in grades K-12 and examined changes between 2005 and 2015. In 2015, the prevalence of overweight, obesity, and both combined remained higher than national averages, yet the rates have neither increased nor decreased significantly since 2005 (p = 0.6904). In 2015, as with all previous years, there was no difference between boys and girls (p=0.570). As in all previous years, the prevalence of obesity in 2015 was significantly higher among black students (p < 0.001) than among white students. Similar to 2011 and 2013, there was a significant difference by grade level in 2015 (p=0.0029), with the lowest prevalence again among the elementary students. The significant linear decrease in obesity prevalence among elementary school students observed during 2013 continued to 2015 (p = 0.0209). Trends are discussed in the context of state policy and recent research.

Prevalence of overweight and obesity among Iranian preschoolers: Interrelationship with physical fitness.

BACKGROUND: The preschool years are a crucial time to study the determinants of childhood obesity, as it is when eating and physical activity habits are becoming established. The purpose of this study was to compare the prevalence of overweight and obesity among preschoolers living in the capital of Iran and to determine relationships between overweight and obesity and selected motor- and health-related fitness parameters. MATERIALS AND METHODS: This exploratory cross-sectional study was conducted with 190 boys and 191 girls aged 5-6 years. Study children were selected from the kindergartens in Tehran, the capital of Iran. All children underwent anthropometric, motor- and health-related fitness tests. Height, body mass, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and percentage of body fat (PBF) were measured for anthropometric assessments. Sit-and-reach, modified sit-ups, modified pull-ups, the 4 m × 9 m shuttle run, the 20 m sprint test and the 20 m multistage shuttle run test were measured for motor- and health-related fitness tests. Overweight and obesity prevalence was determined by the International Obesity Task Force, Centers for Disease Control and Prevention and World Health Organization standard criteria. RESULTS: International Obesity Task Force criteria indicate almost 12% (23/190) of boys and 22.5% (43/191) of girls were overweight or obese with 4.73% (9/190) of boys and 10.99% (21/191) of girls in the obese category. Significant correlations were found between modified pull-ups test and body mass, BMI, WC, WHR, WHtR, PBF in boys and modified pull-ups and modified sit-ups tests were significantly correlated with body mass, BMI, WC, WHR, WHtR, and PBF in girls. Compared to their counterparts, overweight and obese boys demonstrated inferior performance in modified pull-ups and predicted VO2max and overweight and obese girls demonstrated inferior performance in modified pull-ups, modified sit-ups, 4 m × 9 m agility shuttle run and predicted VO2max. CONCLUSION: This study highlighted the relatively high prevalence of overweight and obesity in both genders of preschoolers and found that overweight and obesity were associated with poor fitness performances. The findings provided evidence to support the establishment of tailored physical fitness intervention programs to manage and prevent obesity in preschoolers.

Prevalence and trends in overweight and obesity among Mississippi public school students, 2005-2013.

This study estimated the prevalence of overweight and obesity in Mississippi public school students in grades K-12 and assessed changes in the prevalence between 2005 and 2013. In 2013, Body Mass Index was calculated using measured height and weight data for a weighted representative sample of 4,402 public school students. Additional analyses compared 2013 prevalence estimates by gender, race, and grade levels and for changes between 2005 and 2013. The prevalence of overweight and obesity among public school students no longer appears to be increasing although no significant downward trend was observed (p = 0.0862), and rates remain higher than national averages. In 2013, the combined prevalence of overweight and obesity for all students in grades K-12 was 41.8%, as compared to 40.9% in 2011, 42.4% in 2009, 42.1% in 2007 and 43.9% in 2005. Significant decreases in overweight and obesity were found among white students and elementary school students from 2005 to 2013. White students' combined rates fell from 40.6% in 2005 to 36.8% in 2013 (p = 0.0007). Similarly, combined rates in elementary school students dropped from 43.0% in 2005 to 38.0% in 2013 (p = 0.0002). Additionally, 2013 marked the first year that a significant decline in obesity prevalence was noted among elementary school students, from 25.0% in 2005 to 22.0% in 2013 (p = 0.0163). In 2013, the prevalence of obesity was significantly higher among black students (p < 0.001) and middle school students (p = 0.048). These findings are discussed in light of recent state-wide educational and policy initiatives and on health disparities. Implications for future practice, policy and research are presented.

Prevalence and trends in overweight and obesity among Mississippi public school students, 2005-2011.

This study estimated the prevalence of overweight and obesity in Mississippi public school students in grades K - 12 and assessed changes in the prevalence between 2005 and 2011. In 2011, Body Mass Index was calculated using measured height and weight data for a weighted representative sample of 4,235 public school students. Additional analyses compared 2011 prevalence estimates by gender, race, and grade levels and for changes between 2005 and 2011. The prevalence of overweight and obesity among public school students no longer appears to be increasing although a significant downward trend was not observed (p = 0.0845), and rates remain higher than national averages. In 2011, the combined prevalence of overweight and obesity for all students in grades K - 12 was 40.9% as compared to 42.4% in 2009, 42.1% in 2007 and 43.9% in 2005. Significant decreases in overweight and obesity were found among white students and elementary school student groups from 2005 to 2011. White students' combined rates fell from 40.6% in 2005 to 34.8% in 2011 (p = 0.0006). Similarly, combined rates in elementary school students dropped from 43.0% in 2005 to 37.3% in 2011 (p = 0.0045). In 2011, the prevalence of overweight and obesity was significantly lower among white students than black students (p < 0.001) and significantly lower among white female students than black female students at all three grade levels. These findings are discussed in light of recent statewide educational initiatives and health disparities. Implications for future practice, policy, and research are presented.

Obesity and Overweight Prevalence among a Mississippi Low-Income Preschool Population: A Five-Year Comparison.

Purpose. This study determined 2010 rates of overweight/obesity in a representative sample of low-income preschoolers in Mississippi, USA and compared rates between 2005 (N = 1250) and 2010 (N = 1765). Significance. Obesity is a significant global health issue because of its well-established negative health consequences. Child obesity is a concern due to risk of early-onset obesity-related illnesses and the longevity of lifetime exposure to those illnesses. Methods. Identical measures were used in 2005 and 2010 with complex-stratified sampling designs. Results. Chi-square tests revealed that overall obesity/overweight rates between 2005 (20.6%/17.9%) and 2010 (20.8%/17.0%) had not changed significantly for the samples as a whole, nor by gender or race. Age group comparisons indicated a significant decline in obesity rates of 3 year olds (20.3% in 2005, reduced to 13.1% in 2010, P = 0.035). These findings mimic the trend toward stabilization of obesity rates noted in national low-income preschool populations.

Prevalence and trends in obesity among Mississippi public school students, 2005-2009.

The purpose of this research was to determine the prevalence of overweight and obesity in Mississippi children and youth in grades K-12, and to assess any changes in the prevalence during 2005, 2007, and 2009. Body Mass Index was calculated using measured height and weight data for 3,703 public school students, and the prevalence of overweight and obesity was estimated. Additional analysis compared prevalence estimates by gender, race, and grade for the 2009 data, and comparisons were made between the 2005, 2007, and 2009 data. In 2009, the prevalence of obesity for all students in grades K-12 was 23.9%, as compared to 23.5% in 2007 and 25.5% in 2005. However, no statistically significant differences were found over the three time periods. The disparity between races appears to be increasing over time with the prevalence remaining level for Nonwhite students while dropping each year for White students.

Psychosocial differences related to parenting infants among single and married mothers.

BACKGROUND: This study compared the psychosocial factors, self-esteem, sense of mastery, life stress, and social support among first-time married and single mothers in early parenthood. METHODS: A cross-sectional comparative design was used to study secondary data. A convenience sample of 80 first-time mothers completed self-report instruments on self-esteem, sense of mastery, social, and life stress at 6-8 weeks after birth. The data were analyzed using descriptive statistics, chi-square tests and ANOVA. A statistically significant difference was found between married and single mothers on self esteem (F = 9.314, df = 1, p = .003) and sense of mastery (F = 4.919, df = 1, p = .030). RESULTS: There were no statistical differences found between married and single mothers on social support and life stress. Findings support Belsky's (1984) theoretical assertion that personal psychological resources are most indicative of successful parenting. CONCLUSION: Further, interventions directed toward enhancing single mothers' sense of mastery and self-esteem may be needed to facilitate maternal role transition.

Prevalence estimates of overweight in Head Start preschoolers.

This study estimates prevalence of overweight and at risk of overweight among low-income predominately non-Hispanic Black Head Start Mississippi preschoolers. A two-stage stratified probability design produced a representative sample of 1,250 preschoolers aged 3 to 5 years. Height, weight, age, gender, and race data were obtained. The prevalence of overweight (20.6%) and at risk of overweight (17.9%) combined was 38.5%. Moreover, highest rates were found in boys, non-Hispanic Blacks, and 5-year-olds. The prevalence of overweight in Mississippi Head Start children exceeds national averages, reinforcing the need for early-childhood health promotion and prevention.

Prevalence of obesity and overweight among children and youth in Mississippi: current trends in weight status.

The purpose of this research was to estimate the 2007 prevalence of obesity and overweight among children and youth and to compare these data with previous prevalence data to determine current trends in weight status in Mississippi. Measured height and weight data were collected on a weighted sample of 3,837 public school students in grades K-12. Prevalence estimates of obesity and overweight, as indicated by Body Mass Index, were calculated. Analyses were made by gender, race, and grade level for 2007 data, and these data were compared to the 2005 findings. In 2007, 23.5% of the students were obese. The prevalence was highest among elementary school students, males and nonwhite students. The prevalence of obesity in 2007 was lower than in 2005, and the decline occurred primarily among middle and high school students. While the 2007 prevalence was still high, the decline suggests that recent obesity initiatives may be having a positive impact.

A worksheet for critiquing quantitative nursing research.

Teaching an introductory course in research methods and critique to baccalaureate nursing students can be challenging for both students and instructor. One of the difficulties is teaching students to critique research while simultaneously learning basic terminology and research processes. A critique worksheet was developed to help students extract complex information from a research report for analysis and critique.

Differences in parenting stress between married and single first time mothers at six to eight weeks after birth.

Parenting stress has been shown to affect relationships between mothers and their infants. Single mothers may experience more parenting stress due to exposure to stressors that are unique to their environment. The purpose of this secondary analysis was to determine the differences between married and single first-time mothers on the Parenting Stress Index/Short Form (PSI/SF Abidin, 1995). A convenience sample of 22 single and 52 married first-time mothers were recruited from postpartum units in two large metropolitan hospitals in the southeastern United States. During hospitalization, participants completed a demographic sheet and at six weeks postpartum, were mailed the PSI/SF. T-tests were assessed for differences between mean scores. Study findings indicate significant differences between single and married first-time mothers on the Parental Distress subscale (t = -3.468, p = .001), the Difficult Child subscale (t = -2.032, p = .046), and Defensive Responding subscale (t = -3.720, p = .000), with single mothers consistently scoring higher than married mothers; however, there was not a significant statistical difference between mothers on the Parent-Child Dysfunctional Interaction subscale (t = -1.290, p = .201). Overall, single mothers scored higher on the Total Parenting Stress scores of the PSI/SF than married mothers (t = -2.858, p = .005), suggesting that single women experience more stress as a new mother than married new mothers. It is important to understand the specific stressors of new, single mothers and to develop nursing interventions that decrease parenting stress in single mothers.

Parents' perceptions of nurses' caregiving behaviors in the pediatric intensive care unit.

It remains a challenge for intensive care nurses to humanize highly technological health care environments while simultaneously maintaining the benefits this technology can offer. Helping nurses to understand the parent perceptions of pediatric intensive care hospitalization may assist nurses with addressing the need to humanize the experience. This qualitative study describes parents' perceptions of nurses' caregiving behaviors in a Pediatric Intensive Care Unit (PICU) in the Midwestern United States. Mothers (n = 10) and fathers (n = 9) of 10 children were asked questions using a semistructured interview. Content analysis was used to analyze parents' verbal descriptions of nurses taking care of their child in a large midwestern metropolitan area PICU. Parents reported nurses engaged in nurturing and vigilant behavior, namely showing affection, caring, watching, and protecting. Parents' reports suggest that the best nursing behaviors are those that facilitate and complement critical aspects of the parental role, thus reinforcing family integrity during a time of turmoil and uncertainty. Incorporating this knowledge into practice contributes to nurses' understanding of PICU hospitalization as a family event, and also helps to inform interventions to improve family-centered care in the PICU.

Transition of maternal competency of married and single mothers in early parenthood.

Women who perceive maternal competency in early parenthood feel comfortable with infant care. A convenience sample of 58 married, first-time mothers and 22 single, first-time mothers was surveyed at six to eight weeks after childbirth to determine the differences in maternal competence perception between married and single mothers. Findings in this pilot study reveal that single mothers significantly reported less comfort in the maternal role as compared to married mothers. Implications for practice, research, and education are discussed.

Assessing ambiguity at the family-nurse boundary interface in pediatric health crisis.

This article discusses the conceptualization and measurement of family-nurse relationships in pediatric intensive care unit (PICU) from the perspective of family systems and boundaries. The 14 items for the Family-Nurse Boundary Ambiguity Scale for PICU (FNBAS-PICU) were developed from a qualitative study. Nurse panels established face and content validity. Parents (156) from four PICUs participated in reliability estimates (Cronbach's alpha = .81) and validity testing with measures of illness uncertainty and role alteration stress. Principal components analysis confirmed the conceptual intent of the FNBAS-PICU.