Food security, maternal feeding practices and child weight-for-length.

BACKGROUND: Over consumption of energy-dense nutrient-poor foods may contribute to childhood obesity. We hypothesized that greater than recommended servings of sugar sweetened beverages and foods, indicators of food security, and a high maternal recumbent weight-for-length are positively associated with high percentages of child overweight/obesity. METHODS: This secondary data analysis consisted of a sample of 240 mother-child dyads. The original studies were designed to examine the effect of a public health nursing intervention on optimal childhood growth for low-income, minority children. Eligibility to participate included: 1) mothers self-identified as Hispanic; 2) children were 12-24 months old; and 3) children were enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and 4) children were free of any major disease. Multivariate logistic regression examined the association between child weight, weight-for-length, maternal recumbent weight-for-length, child's eating schedule, maternal attitudes on feeding, food security, and consumption of sugar-sweetened beverages, desserts and fatty meats. RESULTS: Receiving SNAP was positively associated with child weight-for-length (WL). Children whose mothers reported ever having received SNAP were 2.01 times more likely to be overweight compared to children whose mothers did not report ever having received SNAP (95% CI=1.04-3.90). Children who consumed desserts were 2.87 times more likely to be overweight compared to children who did not consume desserts (95% CI=1.19-6.88). Also, child's caloric intake was significantly associated with child WL. Children who consumed more calories were 1.00 times more likely to be overweight compared to children who consumed fewer calories (95% CI=1.00-1.00). DISCUSSION: Research on food security and children's weight has reported mixed findings. Methodological issues have been identified as contributory to the inconsistent findings. Of paramount importance to these studies is the measurement of low food security. CONCLUSION: Children in this sample who were food insecure, as indicated by SNAP recipients, were more likely to have a higher WL measurement. Future studies should focus on the correlation between food security and hunger/satiety cues.

Reduced breastfeeding rates among obese mothers: a review of contributing factors, clinical considerations and future directions.

Maternal obesity is associated with significantly lower rates of breastfeeding initiation, duration and exclusivity. Increasing rates of obesity among reproductive-age women has prompted the need to carefully examine factors contributing to lower breastfeeding rates in this population. Recent research has demonstrated a significant impact of breastfeeding to reduce the risk of obesity in both mothers and their children. This article presents a review of research literature from three databases covering the years 1995 to 2014 using the search terms of breastfeeding and maternal obesity. We reviewed the existing research on contributing factors to lower breastfeeding rates among obese women, and our findings can guide the development of promising avenues to increase breastfeeding among a vulnerable population. The key findings concerned factors impacting initiation and early breastfeeding, factors impacting later breastfeeding and exclusivity, interventions to increase breastfeeding in obese women, and clinical considerations. The factors impacting early breastfeeding include mechanical factors and delayed onset of lactogenesis II and we have critically analyzed the potential contributors to these factors. The factors impacting later breastfeeding and exclusivity include hormonal imbalances, psychosocial factors, and mammary hypoplasia. Several recent interventions have sought to increase breastfeeding duration in obese women with varying levels of success and we have presented the strengths and weaknesses of these clinical trials. Clinical considerations include specific techniques that have been found to improve breastfeeding incidence and duration in obese women. Many obese women do not obtain the health benefits of exclusive breastfeeding and their children are more likely to also be overweight or obese if they are not breastfed. Further research is needed into the physiological basis for decreased breastfeeding among obese women along with effective interventions supported by rigorous clinical research to advance the care of obese reproductive age women and their children.

We stop for no storm: coping with an environmental disaster and public health research.

Coping with natural disasters is part of the public nurses' role, and the public health nursing (PHN) researcher is doubly challenged with continuing to conduct community-based research in the midst of the disaster. The PHN may provide service along with attempting to continue the research. The challenges faced by public/community health nurse researchers as a result of hurricane Ike are discussed to provide lessons for other public/community health researchers who may be affected by natural disasters in the future. It is important to consider challenges for recruitment and retention of research subjects after a disaster, impact of natural disasters on ongoing research, and opportunities for research to be found in coping with natural disasters. A community-based study that was in progress at the time of hurricane Ike will be used as an example for coping with a natural disaster. We will present "lessons learned" in the hope of helping researchers consider what can go wrong with research studies in the midst of natural disasters and how to proactively plan for keeping research reliable and valid when natural disasters occur. We will also discuss the opportunities for collaborations between researchers and the community following any disaster.

Familismo: influence on Hispanic health behaviors.

This study explored the impact of hepatitis C infection among a convenience sample of adult Hispanic men and women. Data were collected through a demographic form and audiotaped responses to a vignette. Krueger's transcription-based focus group method of analysis was used to analyze the qualitative data. The major theme, familismo (importance of family), emerged from the data with individual health behavior defined by family needs and expressed by "doing right" by the family. Therefore, health promotion and disease treatment framed within a "healthy family" philosophy and health intervention message may be more culturally acceptable and effective among Hispanic populations.

Pilot testing HIV and intimate partner violence prevention modules among Spanish-speaking Latinas.

The purpose of this study was to test two modules of a theoretically based, gender- and culturally specific HIV intimate partner violence risk reduction intervention for Spanish-speaking Latinas. The themes of the modules were "Estás en una relación sana y segura?" (Are you in a healthy and safe relationship?) and "Mantenerse sana y segura" (Keeping yourself healthy and safe). An evaluative one-group, repeated measure design with measures collected at preintervention (N = 31), immediate postintervention (n = 26), and 1-month postintervention follow-up (n = 20) design was used to evaluate the intervention. Study results represent a small but significant first step toward an integrative approach to the prevention of two major and interrelated public health issues among an at-risk and underserved population.

Increasing nurses' knowledge and skills for enhanced response to intimate partner violence.

BACKGROUND: A theoretically based intimate partner violence in-service program was developed, implemented, and evaluated among public health nurses. METHODS: A two-phase, mixed-methods design was used. Phase 1 used qualitative methods for content development of the in-service program. Phase 2 used a one-group pretest-posttest design to evaluate the effectiveness of the program. RESULTS: In Phase 1, nurses perceived a need for knowledge about community intimate partner violence prevention resources and enhancement of interviewing skills. In Phase 2, no significant difference was noted in level of intimate partner violence knowledge between pretest and posttest (p < .107). However, a significant difference in skill level was noted between pretest and posttest (p < .003). CONCLUSIONS: Results support the use of an in-service program as an effective method of enhancing the intimate partner violence clinical skills of nurses.

The social construction and conceptualization of sexual health among Mexican American women.

Research on the social construction and contextualization of sexual health among Latina women is sparse. This ethnographic study was aimed to bridge this gap by exploring sexual health experiences and behaviors of a Latina subgroup, Mexican American women. A series of individual semistructured, in-depth interviews were conducted with 20 Mexican American women from a sexual and reproductive health clinic in a large Southwestern city with a predominantly Mexican American population. Through thematic analysis, sacrificing of self, sexual silence, and taking control of self emerged as themes. These themes reflect the context within which construction of sexual health occurs and sexual health behaviors are influenced. Study findings are discussed within a socio-cultural framework for sexual health promotion intervention for both adolescent and adult Mexican American women.

Teaching nursing students to assess and intervene for domestic violence.

Domestic violence is recognized as a priority women's health issue. Despite its prevalence, the majority of accredited nursing schools in the United States has yet to adequately integrate violence assessment and intervention content and planned clinical experiences into their curriculum. Therefore, the author has developed a theoretically based one-day domestic violence immersion activity to enhance the teaching of domestic violence assessment and intervention skills to baccalaureate nursing students.

Influence of abuse on condom negotiation among Mexican-American women involved in abusive relationships.

This study explored cultural and gender perspectives of abuse on condom negotiation behaviors for AIDS prevention among Mexican-American women in abusive intimate relationships. A convenience sample of 20 abused women participated in the study. Data were collected through a demographic questionnaire and audiotaped responses to a semistructured interview guide. Content analysis using QSR NUDIST was used to analyze the verbatim transcriptions of all participant interviews. The predominant category, "He always got his way," was developed in response to the content of the verbatim transcriptions. The category was further expanded to include the self-descriptive subcategories of "He beat me," "He made me feel bad," and "He forced me." Through content analysis, a relationship between abuse by male sexual partners and condom negotiation for AIDS prevention was identified. Trustworthiness of the data collection and analysis was established through methods suggested by Lincoln and Guba.