The Role of Cultural Beliefs in Accessing Antenatal care in Malawi: A Qualitative Study.

BACKGROUND: The World Health Organization in 2002 recommended a focused antenatal care model of four visits for women in low-income countries. Despite the high percentage of mothers (95%) who see a skilled attendant and the adaptation of the recommended antenatal model, only 46% of Malawian mothers meet the recommendation. The purpose of this study was to identify the cultural beliefs that influence women's antenatal care or pregnancy-related health care decisions. METHODS: Twenty pregnant mothers and eight health workers from two urban tertiary care hospitals in Malawi were recruited to participate in a qualitative study assessing barriers to antenatal care. Data were collected between September and December 2014 through face-face, audio-recorded interviews, and a demographic survey. RESULTS: Identified maternal cultural beliefs included: seeking advice from village elders, spousal fidelity, and disclosing pregnancy. Health workers mentioned that providers often held the same cultural beliefs and, therefore, turned women away if they tried to go against cultural norms. CONCLUSIONS: Cultural beliefs play an integral role in the decision-making process of antenatal care. Specifically, the belief and practice of when to disclose pregnancy prohibits women from seeking antenatal care in the first trimester.

Saudi women's beliefs on the use of car infant restraints: a qualitative study.

OBJECTIVE: The focus of this study was to identify the salient beliefs of pregnant women in Saudi Arabia that may influence their intentions to use infant restraints for their children. These beliefs were later used to inform a subsequent quantitative study. METHODS: This qualitative study employed Ajzen's theory of planned behavior to elicit the salient behavioral, normative, and control beliefs of Saudi pregnant women regarding the use of infant restraints for their future children. Twenty-five pregnant women participated in 2 focus groups conducted in June 2013 at Dallah Hospital in Riyadh. RESULTS: Lack of health education and law enforcement; cultural pressure and traditions; counsel from family, specifically from husbands and mothers; desire to stay close to the child; family size; and car size were key factors in deciding whether or not to use car seats; the high cost of car seats was not. CONCLUSIONS: Aside from providing awareness to future mothers and the general public, health interventions should target the specific beliefs identified in this study. Because participants identified husbands as significant referents, further studies are needed to examine the husbands' attitudes and beliefs.

Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey.

Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans (N = 665,195) were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian (OR = 3.05, 95% CI = 1.55, 5.98) and monolingual (English only) Vietnamese (OR = 3.00; 95% CI = 1.58, 5.70), especially among females. Other factors associated with increased binge drinking were being female (Chinese only), not being current married (South Asian only), and being an ever smoker (all subgroups except South Asians). Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults.

Sexual and reproductive health behaviors of California community college students.

OBJECTIVE: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. PARTICIPANTS: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). METHODS: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was administered in class to randomly selected classrooms at 12 institutions and electronically to randomly selected e-mails of students at 1 institution from March through April 2007. RESULTS: This sample of community college students reported higher rates of risky sexual behaviors, unintended pregnancy, emergency contraception, and sexually transmitted diseases, and lower rates of human immunodeficiency virus (HIV) testing, than the overall ACHA-NCHA reference group. Those who had been tested for HIV reported more sexual partners, and lower rates of condom use. CONCLUSIONS: The data provide justification for broader educational programs and access to family planning services, condoms, and HIV testing on community college campuses.

The role of health promotion in physical therapy in California, New York, and Tennessee.

BACKGROUND AND PURPOSE: As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. SUBJECTS: A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. METHODS: Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, which was then pilot tested with 20 physical therapists in California. The total number of qualitative instruments used in the data analyses was 417 (145 from California, 127 from New York, and 145 from Tennessee) or 11.9%. RESULTS: The health promotion behavior most commonly thought to be practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and overweight issues (19%), and smoking cessation (17%). Self-efficacy predicted all 4 behaviors beyond the control variables. Minimal state-to-state differences were noted. DISCUSSION AND CONCLUSION: Physical therapists believe they are addressing health promotion topics with patients, although in varying degrees and in lower than desirable percentages based on Healthy People 2010 goals. This study demonstrated that a physical therapist's confidence in being able to perform a behavior (self-efficacy) was the best predictor of perceptions of practice patterns and is an area to target in future interventions.