Social Support in the "Fourth Trimester": A Qualitative Analysis of Women at 1 Month and 3 Months Postpartum.

Social support is essential in the postpartum period when support is positively associated with infant care and maternal adaptation and its absence is associated with postpartum depression. The aim of this qualitative study was to explore how postpartum women experience social support and variations in the type and quantity received. Researchers conducted two semistructured interviews with a convenience sample of 22 participants at approximately one month and three months postpartum. Social support varied in quality and quantity. Respondents indicated that the presence of support made the postpartum period easier, less stressful, and more enjoyable. Efforts to help women plan for postpartum social support during pregnancy should focus on relationships and social networks as well as individual behaviors and community services.

The Speak UP! Salon Project: Using Hair Stylists as Lay Health Educators About Unintended Pregnancy.

The Speak UP! Salon Project trained 126 hair stylists from 60 salons as lay health educators to increase knowledge about contraceptives and inform clients about financial support for long-acting reversible contraceptives at local family planning clinics. Stylists' informal social support system, combined with the rapport built with clients over time, make them excellent candidates for lay health educator projects. This 3-year salon-based intervention was implemented in nine counties in a Midwestern state. Results from a subsample of participants who completed an online questionnaire (n = 177) indicate that hair stylists are a feasible method to link target populations to health information and to the health care system. The benefits and challenges of collecting data in a salon environment are also discussed.

Lessons from the field: A mixed methods analysis of hair stylists' reflections on their experience as lay health educators.

Beauty salons are unique settings to provide community-based health education. The Speak UP! Salon Project trained hair stylists to deliver health messages related to reducing unintended pregnancy to female clients in the 18-30-year age range. The project ran from 2009 through 2011. Midway through the project, we held focus groups with stylists and administered a questionnaire as concurrent process evaluation measures. Forty-seven of the ninety-three stylists then active in the project attended one of eleven focus groups. The focus groups included questions about stylists' experiences and their reflections on their role as lay health educators. Using Krueger's qualitative methodology, we systematically analyzed the focus group transcripts. Six themes emerged from the focus groups, including stylists' ability to deliver lay health education, increased comfort levels, stylists' self-monitoring, support materials, messaging outside the target audience, and intangible benefits to the stylists. The questionnaire included twenty-six items and provided quantitative support for identified themes. Findings indicated that stylists were a strong and willing community partner for delivering health education, they received substantial positive feedback from clients, and their efforts reached individuals far beyond the target audience; however, professional health educators must provide substantial training and support to ensure the program's success.

Differences in beliefs about the causes of health disparities in Black and White nurses.

PURPOSE: To determine whether Black and White nurses' beliefs about causes of health disparities differ. CONCLUSIONS: Analyses reveal that overall Black nurses perceived external factors to contribute significantly more to health disparities than White nurses. Black nurses considered four specific causes dealing with physician and societal factors, such as "discrimination in society," to be more significant contributors to health disparities than White nurses, whereas White nurses considered genetic factors to be a greater contributor. PRACTICE IMPLICATIONS: Different views of the causes of health disparities are discussed, particularly in light of cultural competency training and other efforts to ameliorate health disparities.

The numeracy demands of health education information: an examination of numerical concepts in written diabetes materials.

The comprehension of numerical concepts that appear in written health educational materials is an important aspect of health literacy. Health materials that include many advanced numerical concepts may place high demands on readers, especially those with low health literacy levels. The purpose of this study was to examine and document the types of numerical concepts that appear in passages selected from written diabetes educational materials that varied in their type of content. Readability of the passages was also analyzed. One hundred and fifty passages of 100 words each were selected from 50 diabetes-related educational documents, produced by major health organizations. Passages were coded for type of numerical concept, SMOG Reading Grade Level, Flesch Reading Ease, and features that elaborated the numerical concepts, such as pictures or explanations. Findings indicate that passages containing general information about diabetes and its prevention contained significantly more advanced numerical concepts, the highest reading grade level, the lowest reading ease scores, and the lowest frequency of elaborative features, relative to many other types of content. Recommendations are made for enhancing the presentation of numerical concepts in written diabetes educational materials.

School counselors and student self-injury.

BACKGROUND: The purpose of this study was to examine the experience, knowledge, and needs of school counselors in relation to students' self-injurious behaviors. METHODS: One thousand members of the American School Counselor Association were randomly selected to receive a questionnaire on the study of self-injury. Four hundred forty-three school counselors returned usable questionnaires. RESULTS: Most (81%) reported working with a self-injurer during their career, and 51% reported working with a self-injurer during the 2002-2003 school year. Findings suggest that counselors feel they are the appropriate person to work with students who self-injure but need more training to identify self-injurers and refer them to appropriate resources outside of the school. Counselors identified a number of barriers to successfully working with students who self-injure, such as lack of training, lack of cooperation with school personnel, and lack of policy on school injury. CONCLUSIONS: The authors suggest a model where the school counselor acts as a liaison to ensure the coordination of education about self-injury for students, parents, and school staff and as a conduit to refer students to therapists in the community.

Incentives in smoking cessation: status of the field and implications for research and practice with pregnant smokers.

We review the rationale and empirical evidence for the use of incentive and contingency management strategies for smoking cessation. Plausible theoretical rationales exist for the application of these strategies to smoking cessation, and a great deal of research with illicit drug users in laboratory or controlled treatment settings suggests such strategies can be effective. Contingency management methods have been effective in modifying smoking behavior in volunteers not seeking cessation assistance in highly controlled settings. Incentives have been used primarily as a component of worksite interventions, in community-wide quit-and-win programs, in quasiexperimental and experimental trials, and more recently with low-income pregnant women. Worksite studies have rarely been designed to isolate the impact of incentives. Nevertheless, they appear to be useful in these settings especially in increasing participation and increasing awareness about the deleterious effects of smoking. Quit-and-win programs are used widely in the United States and internationally and appear to attract many participants and produce modest quit rates. The quality of the evaluations of quit-and-win programs varies considerably, and none has employed rigorous control or comparison groups to sufficiently identify the effect of incentives. Recent controlled studies have yielded promising results with pregnant smokers, and larger trials are in progress. We discuss key methodological issues in mounting and evaluating incentive interventions, particularly during pregnancy, and discuss the practical and ethical issues arising from the use of incentives.