Health and Medical Care among the Children of Immigrants

Using data spanning 1996–2009 from multiple panels of the Survey of Income and Program Participation, this study investigates children’s (average age 8.5 years) physical health, dental visits, and doctor contact among low‐income children (n = 46,148) in immigrant versus native households. Immigrant households are further distinguished by household citizenship and immigration status. The findings show that children residing in households with non‐naturalized citizen parents, particularly those with a nonpermanent resident parent, experience worse health and less access to care even when controlling for important demographic, socioeconomic, and health insurance variables.     

Unzip the Truth: Results from the Fort Peck Men's Sexual Health Intervention and Evaluation Study

American Indian (AI) men experience sexual and reproductive health disparities including sexually transmitted infections, unplanned pregnancy, absent fatherhood, and intimate relationship violence. Using a case-control study within a community-based participatory research framework, we investigated the effectiveness of a sexual and reproductive health peer led education intervention model for AI men, ages 18–24. Intervention results demonstrated the greatest impact on attitudes regarding contraceptives, commitment in relationships, and consistency of condom use. Our study provides insights into how to access education and influence sexual risk behaviors among a diverse group of hard to reach young adult males.     

Learning about sex and relationships among migrant and refugee young people in Sydney,Australia: ‘I never got the talk about the birds and the bees’

In a multicultural nation such as Australia, it is important for young people from migrant and refugee backgrounds to have access to quality relationships and sexuality education, as they are known to be less well engaged with mainstream services. A study was undertaken to explore the complexities and opportunities for engaging this group with sexual and reproductive health information and care in Sydney, Australia. Interviews were undertaken with 27 migrant and refugee young people (aged 16–24 years), and 34 expert informants. Relationships and sexuality education was a dominant theme throughout both data sets. Nearly all young people reported that they were unable to discuss sexuality or sexual health with their parents, and most identified secondary school as the place where they first learned about these issues. Other sources of information were identified as the Internet, friends, health professionals and pornography. Participants appeared to have limited awareness of the different services available to them. Schools, as well as other education settings such as universities, private colleges and intensive English centres, are well placed to deliver relationships and sexuality education, and for migrant and refugee young people these may be valuable settings in which to access information rarely discussed in family or community environments.     

Promotion of adolescent reproductive health and healthy living. Malaysia

This article discusses a 3-year project, "Promotion of Adolescent Reproductive Health and Healthy Living," which was implemented by the Federation of Family Planning Associations, Malaysia. The project seeks to achieve the following: 1) development of a reproductive health of adolescent module (RHAM) for trainers and educators; 2) training of trainers; 3) sharing of adolescent reproductive health experiences in Asian countries; and 4) setting up three service models in Sabah, Selangor, and Terengganu to provide reproductive health (RH) care to adolescents and youth. The first part of the RHAM with the trainer's manual has been finalized and will be tested in a workshop. The second part, a teacher's guide, is under preparation. A series of training on the use of the RHAM will be conducted including a 5-day national workshop, which will be followed by several state level workshops. The three service models being set up have specific orientations. The Sabah model is putting up a youth clinic for adolescents within its clinic network. The Selangor model is developing a Youth Resource Center for training and youth involvement in RH activities. Lastly, the Terengganu family planning association (FPA) has developed a Youth Center web site, which features the history, mission, and activities of the Terengganu FPA.     

Evaluation in school‐based health centers

School‐Based Health Centers (SBHCs) are ideal primary care settings for improving children's access to and utilization of health care services. In this era of shrinking funding for social service programs, SBHCs may provide services to youth from low‐income families, who otherwise might lack access to health care services. However, the growth of SBHCs has outpaced evaluation efforts. More information is needed about what services are being provided, and for whom services are effective. This article reviews information that will assist in the development of evaluation efforts for SBHCs. A review of evaluation theory, ideas for evaluation in SBHCs, challenges to implementing research in schools, and future directions for evaluation efforts are presented. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 309–320, 2003.     

Expanding access to quality reproductive health services in underserved outlying districts in Bangladesh. RAS/98/P65

In Bangladesh, the International Planned Parenthood Federation, through the Family Planning Association of Bangladesh, works to increase access to quality reproductive health (RH) care services among low- and medium-income groups in underserved outlying districts. The strategies being pursued are as follows: 1) expand RH services (with special emphasis on long-term methods) through special work units/upgraded clinics and mobile clinics; 2) develop and use information, education and communication materials for information and awareness raising; 3) hold community-based meetings for information dissemination, RH awareness and motivation, and clinical contraception; 4) conduct advocacy campaigns to increase demand for RH services; 5) organize adolescent school-based programs and peer group meetings on awareness raising and RH; 6) strengthen field units/local nongovernmental organizations and community based organizations through training and support; 7) promote inter-linkages with other RH information partners, government agencies and other nongovernmental organizations; and 8) establish a cost recovery process for sustainability. A summary of the main activities of the program is provided.     

A Quantitative Survey of Knowledge of Reproductive Health Issues of 12-14-year-old Girls of Different Ethnic and Religious Backgrounds in Iran: Implications for education

A quantitative research study was conducted to examine the knowledge of girls aged 12-14 years regarding reproductive health in five cities in Iran with different ethnic and cultural majorities. A cross-sectional study using a self-administrated questionnaire was conducted among guide school (middle school) pupils. Data analysis was based on 1,893 questionnaires. The internal consistency of the items was 0.80. Overall, knowledge level was unsatisfactory. An association between age and knowledge about reproductive health was found. Additionally, there was a statistically significant difference in the knowledge of reproductive health between cities. The findings suggest that reproductive health education initiatives that involve mothers may be most appro priate in terms of cultural and religious sensitivities, and be in keeping with the wishes of the girls themselves.     

Community Colleges: Rethinking STD Prevention for the Nontraditional College Campus

ABSTRACT

As increased attention and proposed funding are being directed toward community colleges, it is important to consider the sexual and reproductive health care needs of this growing population. Existing data suggest there are significant sexual health needs among this population and often insufficient provision of services. Some community college students are more likely than students at 4-year colleges to test positive for sexually transmitted diseases (STDs). Given resource constraints, creative solutions are required. These may include campus-wide policies addressing STD/HIV (human immunodeficiency virus) prevention, referral systems to connect students to care in the community, and partnerships with local health departments, Federally Qualified Health Centers, or community-based organizations to assist with the provision of services. Colleges have the unique opportunity to provide students with valuable information about sexual health and services. Community colleges, in particular, are uniquely positioned to reach at-risk community members for STD testing and sexual health care who might otherwise be lost to care. More research is needed on the sexual health needs of community college students, especially on factors such as geographic location, how embedded the school is into the community, social norms around sexual health on college campuses, and health services offered. New and innovative ways to promote linkage to care for testing and counseling could offer potential health benefits to this growing at-risk population.     

Counseling services in the Peoples Republic of China

The principal vehicles for counseling in the Peoples Republic of China are the neighborhood council and the extended family. In addition to providing access to many services, the local council offers informal counseling to families and individuals in the neighborhood through peer helpers. This council is also the first level in a three-tiered health care delivery system. Informal counseling is sup-plemented with counseling from paraprofessional health care providers in the neighborhood clinics. Severe problems are referred to the second level — the district hospital — which usually has a psychiatric unit with medical psychologists able to deal with problems on both inpatient and outpatient bases. The third level of assistance is provided through specialized institutes that take a few severe psychological problems for treatment, research, and teaching purposes. Schools refer special behavior problems through the health care or political systems, but care for minor behavior and educational problems is provided through the teacher working with the family in the educational setting. While most counseling services are conducted informally through family and neighborhood council members, the disadvantage is the close linkage of counseling regulatory tasks with functions monitoring behavior and enforcing political policy. On balance, however, it appears that the array of services offered through local councils with a caring neighborly attitude outweighs the disadvantages of loss of privacy and pressures to conform to local behavioral expectations and political demands.     

Strengthening strategies to improve adolescent reproductive health through materials development. Indonesia

This article concerns a 3-year materials development project that was implemented by the Indonesian Planned Parenthood Association and the Bureau of Non-Physical Family Resilience. The project was developed in response to the need for improving adolescent reproductive health in Jakarta, Yogyakarta and West Java, where adolescent problems have been increasing during the last decade. The project's long-term goal is centered on raising the commitment of families to instill in their children a better understanding of adolescent reproductive health concepts and desirable family values. For its short-term objectives, the project seeks to develop a basic information, education and communication (IEC)/counseling strategy and policy in support of a family-centered approach to adolescent reproductive health; promote better understanding of reproductive health needs of adolescents among the policy-makers; and improving the IEC/counseling skills of personnel at the community level. The project used five strategies to achieve its goals; namely, 1) preparation of a media development and production plan; 2) conducting a needs assessment; 3) production of three types of materials; 4) implementation of three key activities; and 5) periodic monitoring of activities.     

Promoting ecologic health resilience for minority youth: Enhancing health care access through the school health center

Ethnic minority youth experience problems in access to healthcare, yet little is known about how to enhance utilization. This article will discuss the demographic realities of children of color in the United States, with a focus on health care needs and access issues that have an enormous influence on health status. The article will consider health policy as it describes the considerable barriers to quality health care for minority youth such as a lack of a usual source of care and limited health insurance. An ecologic model is presented that incorporates cultural values and community structures into the school health center. Enhancing access and utilization through the school setting is viewed as promoting ecologic resilience in youth. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 265–278, 2003.     

Giving adolescent reproductive health and population issues a world view. Sri Lanka

This article reports on the production of 52 video programs addressing reproductive and sexual health and reproductive rights issues by the Colombo-based Worldview International Foundation. The UN Population Fund (UNFPA) and relevant NGOs and institutions chose the themes. Following the production, the video programs will be broadcast through Young Asia Television, which covers 18 countries in Asia and reaches over 385 million viewers, and other channels. This advocacy program is under the Television Advocacy Program for Adolescent Reproductive Health and Population Issues project, which complements special strategies under the European Commission/UNFPA Initiative for Reproductive Health in Asia. By promoting the global dissemination of information and education, the Worldview project aims to 1) strengthen young people's participation; 2) advance TV media advocacy; 3) advocate the inclusion of population, gender, sexual and reproductive health issues; 4) provide extended knowledge of adolescent reproductive health to all concerned groups; 5) encourage positive attitudes towards preventive methods among the target groups; 6) promote the importance of incorporating gender perspectives and child abuse issues; and 7) establish close cooperation among organizations at the national, regional and international levels.     

DEA在农村预防保健工作效率评价中的应用

文章采用数据包络分析(DEA)方法对7个省(市)394家乡镇卫生院的预防保健工作覆盖情况进行调查研究,发现东部地区和中部地区预防保健各项工作覆盖率已达到较高水平,但也存在资源配置不合理、利用率不高的问题,而西部地区预防保健工作覆盖率、运转效率较低。今后农村预防保健工作的重点是提高资源配置和使用效率。     

Voices of senior rural men and women on falls and fall-related injuries: “If I fall outside and get hurt,what would I do?”

ABSTRACT

This qualitative study examined the falls and fall-related injury experiences of community-dwelling rural seniors. 42 senior men and women living in two rural areas in Saskatchewan, Canada were recruited, and in-depth interviews were conducted. Analysis revealed three main themes among responses: nature of falls and injuries, causes of falls and injuries, and consequences of falls and injuries. Men and women expressed a fear of falling, which led to activity limitations; however, women were more reflective on their potential to fall and showed an increased level of preparedness compared to men. The causes of falls included activities at the time of a fall, functional limitations, chronic diseases, and personal factors such as type shoes worn. While men and women downplayed the seriousness of their falls or injuries, indicating a level of hardiness, this trend was stronger among men. None of the participants discussed the role of health care professionals or the health care system in relation to fall risk and ways of preventing falls, despite reporting adaptations to prevent and deal with consequences of falls. Overall, these findings may allude to the scarcity of health care services provided in rural communities, highlighting a need to focus on falls prevention for community-dwelling rural seniors.     

Knowledge of Alzheimer's Disease Among Norwegian Undergraduate Health and Social Care Students: A Survey Study

With an aging general population and a concurrent increase in the prevalence of dementia, health and social care professional students are increasingly exposed to this group of patients during their clinical placements and after graduation. A sound dementia-related knowledge base among health and social care students is important in providing high-quality dementia care. The present study assessed dementia-related knowledge in health and social care students. The Alzheimer's Disease Knowledge Scale (ADKS) was utilized to measure the level of dementia knowledge. A total of 321 undergraduate students from various disciplines in their final years of study, but prior to graduation, participated in this study. The study identified a moderate dementia knowledge base (mean score: 23.51 out of 30) among health and social care students. The results revealed that the students were also ignorant of many facts and had many misconceptions pertaining to Alzheimer's Disease (AD). In addition, significant differences in knowledge were evident between student groups. These results suggest that the current dementia curriculum should be evaluated in an attempt to improve the dementia knowledge base of health and social care students.     

An Exploration of Sexual Health Education Among Individuals with Skeletal Dysplasia (Dwarfism)

Using quantitative and qualitative measures, this study examined reports of sexual health education among 300 individuals with skeletal dysplasia (dwarfism). Many participants felt their sex education neglected their specific minority needs. These needs may include body image concerns, medical considerations in sex or pregnancy, and logistics of physically having sex. Medical professionals may provide more sexual health education than mental health providers, but all may ignore or minimize the sexual health needs of this population. Health care systems and communities of individuals with skeletal dysplasia need to work together to increase their access to sexual health education.     

India: nationwide reproductive and child health programme

This article presents an outline of India's Reproductive and Child Health (RCH) Programme. This program provides special interventions for the country's adolescent population. One of its main objectives is to help stabilize population numbers, including adolescents, at a level consistent with the needs and goals of national development. A committee of experts constituted in the Department of Family Welfare developed an appropriate package for adolescents, focusing on counseling and the provision of reproductive health services through the existing health care delivery system. In addition, special projects for people living in urban slums and tribal areas have been incorporated in the RCH Programme. Its view has been to improve the delivery of family health care services. The success of the Programme has depended on the development of a strong partnership between the Government and non-Governmental organizations, and in overcoming age-old values and prejudice against adolescent girls. Moreover, India's reconceptualized population education, which brings the education of adolescents into focus, includes elements of adolescent reproductive health.     

襄阳地区老年人健康知识、生活习惯与健康状况调查

目的调查襄阳地区老年群体(60岁以上)的健康知识知晓率及生活习惯,以便为实施健康教育和干预提供参考。方法随机抽样500名老年人进行问卷调查。结果老年人获取健康知识的途径主要为报刊杂志(占64.1%),而老年人期望自己获得健康知识的途径依次为医生(占61.1%),健康知识讲座(51.2%);健康知识知晓率与文化层次有一定的关系;部分健康行为(如多吃水果、常喝牛奶、经常洗澡等)与经济水平有关;普遍患有老年常见慢性病。结论应该加强社区了卫生服务,多向老年人宣讲健康知识,增强老年人常见病的家庭保健与护理意识,从而提高老年人的生活质量与健康水平。     

The Davao Teen Centre empowers the youth of Mindanao. Philippines

This article discusses the Development and Family Life Education for the Youth (DAFLEY) Project in Davao City, Philippines. The DAFLEY aimed to make the youth enlightened citizens of the future by educating them on reproductive health care services, gender equality, and responsible parenthood. It was established by the Family Planning Organization of the Philippines and is being carried out through the Davao Teen Centre (DTC), which provides reproductive and sexual health care services through counseling, face-to-face or by telephone. In an effort to reach out to more teenagers in Mindanao, the DTC introduced radio programs offering on-the-air advice to adolescents with problems ranging from boy-girl relationships and unplanned pregnancies to more complex and serious problems. Public response to the programs has been enthusiastic. The youth that have benefited from the DTC counseling refute a conservative belief that sex education leads to promiscuity and sexual experimentation. They state the respect they have for their bodies and their sense of responsibility as proof of the value of the reproductive health education and services that they have received.