Barriers to accessing and receiving antenatal care: Findings from interviews with Australian women experiencing disadvantage.

AIM: To identify the barriers associated with inadequate antenatal attendance by disadvantaged women in Australia and to further explore how these barriers are experienced by this population group. DESIGN: A qualitative descriptive study utilizing semi-structured interviews and thematic analysis. METHODS: Interviews were conducted with 11 pregnant women who self-identified as experiencing disadvantage, purposively sampled from a local government area of Victoria, Australia, characterized by socio-economic disadvantage. Data were collected from February to July 2019. RESULTS: Study participants reported a range of barriers to receiving timely and adequate antenatal care (ANC). For several women, a combination of personal (e.g., emotions, knowledge), health service provision (e.g., limited access to continuity of care provider and continuity of information, inflexible scheduling, difficulty travelling, staff attitudes), and broader social-contextual factors (e.g., financial situation, language, cultural norms) were ultimately insurmountable. Whereas some barriers were experienced as hassles or annoyances, others were unacceptable, overwhelming, or humiliating. CONCLUSION: Women experiencing disadvantage in Australia value ANC but face multiple and complex barriers that undermine timely and regular access. IMPLICATIONS FOR THE PROFESSION AND/PATIENT CARE: A wide range of strategies targeting barriers across multiple levels of the social-ecological environment are required if ANC attendance rates are to improve and ultimately redress existing health disparities. Various continuity of care models are well-placed to address many of the identified barriers and should be made more accessible to women, and particularly those women experiencing disadvantage. IMPACT: Antenatal care appointments promote the health of women and their babies during pregnancy, but for many women, particularly those experiencing disadvantage, access is delayed or inadequate. ANC providers play a critical role in facilitating timely and adequate care. Health service practitioners and management, and health services policymakers need to understand the complexity of the barriers women encounter. These stakeholders can utilize the findings reported herein to develop more effective strategies for overcoming multiple and multi-level barriers. REPORTING METHOD: The study is reported in accordance with the relevant EQUATOR guidelines: the standards for reporting qualitative research (SRQR) and consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Effect of hierarchy legitimacy on low status group members' attributions for ingroup and outgroup failures.

Previous research has shown that people have a tendency to explain successes and failures in ways that favor their ingroups relative to outgroups. However, there has been a dearth of research examining whether social-contextual factors such as group status and hierarchy legitimacy moderate such intergroup attributions. Participants in this study were assigned to a low status group, and perceived hierarchy legitimacy was then experimentally manipulated; the extent to which ingroup versus outgroup failures were attributed to several causes was measured. When low status was considered illegitimate, ingroup failure was attributed to external causes (task difficulty, bad luck) more so than outgroup failure. Implications and directions for future research examining consequences and mediating processes are discussed.

Humans rule! The effects of creatureliness reminders, mortality salience and self-esteem on attitudes towards animals.

This research paper presents findings from an experimental investigation of the attitudes that people hold towards animals when they are reminded of the fact that humans and animals are creatures alike. We tested the hypothesis that mortality salience (MS) would lead participants reminded of human creatureliness to evaluate animals more negatively, especially when they reported lower self-esteem. Student participants were randomly assigned to conditions in which MS was made salient and thoughts about human creatureliness were manipulated. Participants then reported their attitudes towards animals. Lending support to the hypothesis of this study, MS led participants with lower self-esteem to rate animals more negatively, when they were reminded of human-animal similarity. The implications of these results for understanding people's attitudes towards animals were discussed.