Drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women: A systematic review.

Women in the preconception, pregnant, or postpartum period are susceptible to weight stigma, particularly due to the risk of excess weight gain during the reproductive life period and the negative effects of stigma on the health of both the mother and the child. Identifying the drivers and facilitators of weight stigma will help guide focused weight stigma prevention interventions. This systematic review aimed to identify the drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women. In May 2022, Medline, Embase, PsycINFO, and the Maternity and Infant Care Database were searched for peer-reviewed articles published since 2010 using search terms weight AND stigma AND preconception, OR pregnant, OR postpartum. Of the 1724 articles identified, 34 fulfilled the inclusion criteria and were included in a narrative synthesis. Women reported facing insensitive language, misconceptions about obesity across all settings, and inappropriate media representation. The unavailability of appropriate equipment at facilities was reported by both women and health professionals. Our findings indicate that a rigorous effort by all stakeholders is necessary to promote regulatory, legal, and educational initiatives designed to reduce weight stigma and discrimination against women in the reproductive period.

A rapid review of implementation frameworks underpinning Aboriginal and Torres Strait Islander children's health and social care programs.

OBJECTIVE: This rapid review aimed to identify (1) key frameworks and components underpinning the effective implementation of Health and Social Care (HSC) programs for Aboriginal and Torres Strait Islander children; and (2) participatory and co-design frameworks guiding the implementation. METHODS: Four databases were searched for peer-reviewed English-language articles published between 2015 and 2021. The focus was on HSC models, frameworks, projects or services with an implementation focus for Aboriginal and Torres Strait Islander children aged 0-12 years. RESULTS: Seven studies identifying components supporting effective implementation of Aboriginal and Torres Strait Islander HSC programs were included. Continuous Quality Improvement was the most widely applied approach. Most studies described participatory and co-design approaches to ensure suitability for Aboriginal and Torres Strait Islander children and families. CONCLUSIONS: There remains a paucity of evidence on the effective implementation of Aboriginal and Torres Strait Islander children's HSC programs. Implementation approaches that foster cultural safety and Aboriginal and Torres Strait Islander leadership, support diverse partnerships and promote localised application may facilitate the effective implementation of HSC programs. IMPLICATIONS FOR PUBLIC HEALTH: Future research in this area would benefit from greater consideration of appropriate implementation frameworks and co-design approaches, and emphasis on reporting interventions, implementation frameworks and co-design approaches for HSC programs for Aboriginal and Torres Strait Islander children.

Residential Out-of-Home Care Staff Perceptions of Implementing a Trauma-Informed Approach: The Sanctuary Model.

The aim of this study was to explore and better understand the enablers and barriers of implementation and how these impact on the organisational successes and challenges of adopting The Sanctuary Model, as perceived by residential care staff. Following ethics approval, three semi-structured interviews and six focus groups were conducted with residential care staff between February and July, 2020. Participants identified a number of enablers, presented in the subthemes: (a) social support systems and resources; (b) shared trauma-informed knowledge and understanding; and (c) leadership and champions. These enablers influenced organisational successes in adopting: (a) the Sanctuary Commitments; (b) the S.E.L.F Framework; (c) Reflective Practice and Supervision; and (d) Trauma Theory. A number of barriers hindering implementation were identified. These were reflected in the subthemes: (a) informal practice; (b) lack of practice-based training; (c) poor introduction to young people; and (d) resources. These barriers impacted on organisational challenges faced in residential out-of-home care including: (a) The Sanctuary Model Toolkit and (b) young people's behaviour and engagement. Comparisons from this study and previous findings identified by executive and upper management staff (decision makers) are discussed. Key findings indicate that when implementing, sustaining and embedding The Sanctuary Model, organisations need to become trauma-informed rather than 'do' trauma-informed care and organisations need to "live and breathe" The Sanctuary Model Commitments, be connected and inclusive of one another, use trauma-informed language and feel safe.

Systematic Review of School-Wide Trauma-Informed Approaches.

Extensive research on traumatic life experiences reveals how healthy development can be derailed and brain architecture altered by excessive or prolonged activation of the body's stress response, impacting health, mental health, learning, behavior and relationships. Schools offer a unique environment to prevent and counter the impacts of childhood trauma. This study aimed to investigate empirical evidence for school-wide trauma-informed approaches that met at least two of the three essential elements of trauma-informed systems defined by SAMSHA (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville: Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/shin/content/SMA14-4884.pdf) and consider commonalities in approaches, drivers of change, challenges and learnings related to implementation, sustainability and outcomes for students. A systematic review searching foremost databases was conducted for evidence of trauma-informed school-wide approaches used between 2008 and 2019. Four papers were identified, incorporating four school-wide approaches, The Healthy Environments and Response to Trauma in Schools (HEARTS) Model; The Heart of Teaching and Learning (HTL): Compassion, Resiliency, and Academic Success Model; The New Haven Trauma Coalition (NHTC) and The Trust-Based Relational Intervention. Although heterogeneous, the models shared core elements of trauma-informed staff training, organization-level changes and practice change, with most models utilizing student trauma-screening. Generalizability of the findings was low given the small number of studies, the mix of mainstream and specialist schools and high risk of bias. Given the limitations of research in this emergent but rapidly accelerating field, future research is urgently required to understand the interaction between core elements of a trauma-informed approach, teaching pedagogy and organizational factors that support the embedding, use and transferability of school-wide approaches.

Correction to: Systematic Review of School-Wide Trauma-Informed Approaches.

[This corrects the article DOI: 10.1007/s40653-020-00321-1.].

Interventions and practice models for improving health and psychosocial outcomes of children and young people in out-of-home care: protocol for a systematic review.

INTRODUCTION: Children and young people placed in out-of-home care (OoHC) are often affected by a history of trauma and adverse childhood experiences. Trauma in early childhood can impact on children's health and psychosocial development, whereas early interventions can improve children's development and placement stability. Although several interventions and practice models have been developed to improve health and psychosocial outcomes for children and young people in OoHC, there remains a lack of rigorous research examining the impact of these interventions in OoHC settings, as there are no systematic reviews examining the impact these interventions and practice models have on the children and young people they serve. We aim to conduct a comprehensive systematic review to examine the effectiveness of interventions and practice models for improving health and psychosocial outcomes in children and young people living in OoHC and to identify relevant knowledge gaps. METHODS AND ANALYSIS: Major electronic databases including Medline, Medline in-process and other non-indexed citations, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Sociological Abstracts and all Evidence-Based Medicine Reviews incorporating: Cochrane Database of Systematic Reviews, American College of PhysiciansJournal Club, Database of Abstracts of Reviews of Effects,Cochrane Central Register of Controlled Trials, CochraneMethodology Register, Health Technology Assessment and National Health Service Economic Evaluation Database, will be systematically searched for any studies published between 2008 and 2018 of interventions and practice models developed to improve health and psychosocial outcomes for children and young people in OoHC. Two independent reviewers will assess titles and abstracts for eligibility according to prespecified selection criteria and will perform data extraction and quality appraisal. Meta-analyses and/or metaregression will be conducted where appropriate. ETHICS AND DISSEMINATION: This study will not collect primary data and formal ethical approval is therefore not required. Findings from this systematic review will be disseminated in a peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019115082.