Research

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15 pages, 1781 KiB

Open AccessArticle

Can the Timed and Targeted Counseling Model Improve the Quality of Maternal and Newborn Health Care? A Process Analysis in the Rural Hoima District in Uganda

by Geoffrey Babughirana, Sanne Gerards, Alex Mokori, Isaac Charles Baigereza, Alex Mukembo, Grace Rukanda, Stef P. J. Kremers and Jessica Gubbels

Int. J. Environ. Res. Public Health 2021, 18(9), 4410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094410 - 21 Apr 2021

Cited by 4 | Viewed by 2242

Abstract

Each year, more than half a million women die worldwide from causes related to pregnancy and childbirth, and nearly 4 million newborns die within 28 days of birth. In Uganda, 15 women die every single day from pregnancy and childbirth-related causes, 94 babies [...] Read more.

Each year, more than half a million women die worldwide from causes related to pregnancy and childbirth, and nearly 4 million newborns die within 28 days of birth. In Uganda, 15 women die every single day from pregnancy and childbirth-related causes, 94 babies are stillborn, and 81 newborn babies die. Cost-effective solutions for the continuum of care can be achieved through Village Health Teams to improve home care practices and health care-seeking behavior. This study aims at examining the implementation of the timed and targeted counseling (ttC) model, as well as improving maternal and newborn health care practices. We conducted a quantitative longitudinal study on pregnant mothers who were recruited on suspicion of the pregnancy and followed-up until six weeks post-delivery. The household register was the primary data source, which was collected through a secondary review of the ttC registers. All outcome and process variables were analyzed using descriptive statistics. The study enrolled 616 households from 64 villages across seven sub-counties in Hoima district with a 98.5% successful follow-up rate. Over the course of the implementation period of ttC, there was an increase of 29.6% in timely 1st antenatal care, 28.7% in essential newborn care, 25.5% in exclusive breastfeeding, and 17.5% in quality of antenatal care. All these improvements were statistically significant. The findings from this study show that the application of the ttC model through Village Health Teams has great potential to improve the quality of antenatal and newborn care and the health-seeking practices of pregnant and breastfeeding mothers in rural communities. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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25 pages, 474 KiB

Open AccessArticle

Paving the Way for Outdoor Play: Examining Socio-Environmental Barriers to Community-Based Outdoor Play

by Janet Loebach, Marcos Sanches, Julia Jaffe and Tara Elton-Marshall

Int. J. Environ. Res. Public Health 2021, 18(7), 3617; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073617 - 31 Mar 2021

Cited by 12 | Viewed by 5807

Abstract

Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed [...] Read more.

Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

22 pages, 6916 KiB

Open AccessFeature PaperArticle

How Youth of Color Create Communities of Hope: Connecting Advocacy, Activity, and Neighborhood Change

by Anna J. Kim, Jasmine Jones-Bynes, Nisha Botchwey and Terry L. Conway

Int. J. Environ. Res. Public Health 2021, 18(6), 3133; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063133 - 18 Mar 2021

Cited by 3 | Viewed by 2233

Abstract

The primary aim of this paper was to assess the association of after-school club characteristics with changes in physical activity, nutrition, and attitudes in students of color after participating in the “YEAH!” Advocacy-based Physical Activity Program. We examine the strengths of school-based vs. [...] Read more.

The primary aim of this paper was to assess the association of after-school club characteristics with changes in physical activity, nutrition, and attitudes in students of color after participating in the “YEAH!” Advocacy-based Physical Activity Program. We examine the strengths of school-based vs. non-school based programs in promoting feelings of self-efficacy and empowerment among students learning to become more physically active—and importantly, also test the strength of how programs that are more connected (to community-based partners) may contribute to students’ optimism around policy and public health as it directly affects them. This study examined differences in the youth advocacy training impact across four after-school club types: school-based with community partnerships, school-based without partnerships, non-school-based with community partners, and non-school-based clubs without partnerships. We measured improvements in youth’s “optimism for change”, “assertiveness” and “decision-making” as related to after school activities and found that non-school-based programs with community partners showed highest positive impact. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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15 pages, 1479 KiB

Open AccessArticle

Mothers’ Parenting Stress and Neighborhood Characteristics in Early Childhood (Ages 0–4)

by Eun Jung Kim, Min Jung Cho and Mi Jeong Kim

Int. J. Environ. Res. Public Health 2021, 18(5), 2648; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052648 - 05 Mar 2021

Cited by 3 | Viewed by 2239

Abstract

Neighborhood characteristics are important when raising children. Traditional approaches to parental stress research have focused on the impacts of daily hassles and how individual factors, such as children’s temperament, family resources, and social support from friends and family reduce or exacerbate parental stress. [...] Read more.

Neighborhood characteristics are important when raising children. Traditional approaches to parental stress research have focused on the impacts of daily hassles and how individual factors, such as children’s temperament, family resources, and social support from friends and family reduce or exacerbate parental stress. There have been few studies on neighborhood characteristics and parental stress, and even fewer studies have examined the association longitudinally. The goal of the present study was to explore the association between mothers’ parental stress and neighborhood characteristics longitudinally across early childhood (ages 0–4). Using the 2008–2012 Panel Study on Korean Children, we followed 1536 mothers. The results showed that mothers’ parenting stress was highest when children were aged two to three, and neighborhood characteristics had significant associations with parenting stress. The study indicated that mothers who reported that their neighborhoods had sufficient childcare facilities, were convenient to access public recreational and cultural facilities, and those who reported that their neighborhoods were good places to raise children, exhibited significantly lower levels of parenting stress. Further, the effects of neighborhoods on mothers’ parenting stress were greatest when children were aged one and four. Hence, such findings should be incorporated when designing and developing communities. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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20 pages, 13298 KiB

Open AccessArticle

Neighborhood-Level Lead Paint Hazard for Children under 6: A Tool for Proactive and Equitable Intervention

by Mikyung Baek, Michael B. Outrich, Kierra S. Barnett and Jason Reece

Int. J. Environ. Res. Public Health 2021, 18(5), 2471; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052471 - 03 Mar 2021

Cited by 5 | Viewed by 3661

Abstract

Lead is well known for its adverse health effects on children, particularly when exposure occurs at earlier ages. The primary source of lead hazards among young children is paint used in buildings built before 1978. Despite being 100% preventable, some children remain exposed [...] Read more.

Lead is well known for its adverse health effects on children, particularly when exposure occurs at earlier ages. The primary source of lead hazards among young children is paint used in buildings built before 1978. Despite being 100% preventable, some children remain exposed and state and local policies often remain reactive. This study presents a methodology for planners and public health practitioners to proactively address lead risks among young children. Using geospatial analyses, this study examines neighborhood level measurement of lead paint hazard in homes and childcare facilities and the concentration of children aged 0–5. Results highlight areas of potential lead paint hazard hotspots within a county in the Midwestern state studied, which coincides with higher concentration of non-white children. This places lead paint hazard in the context of social determinants of health, where existing disparity in distribution of social and economic resources reinforces health inequity. In addition to being proactive, lead poisoning intervention efforts need to be multi-dimensional and coordinated among multiple parties involved. Identifying children in higher lead paint hazard areas, screening and treating them, and repairing their homes and childcare facilities will require close collaboration of healthcare professionals, local housing and planning authorities, and community members. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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17 pages, 1848 KiB

Open AccessArticle

Housing and Community Environments vs. Independent Mobility: Roles in Promoting Children’s Independent Travel and Unsupervised Outdoor Play

by Lingyi Qiu and Xuemei Zhu

Int. J. Environ. Res. Public Health 2021, 18(4), 2132; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18042132 - 22 Feb 2021

Cited by 7 | Viewed by 2535

Abstract

Children’s independent mobility (CIM) has declined dramatically in recent decades despite its benefits in facilitating childhood development, promoting physical activity, and combating the obesity epidemic. This US-based study examines the impacts of housing and neighborhood environments on two modes of CIM—home-based independent travel [...] Read more.

Children’s independent mobility (CIM) has declined dramatically in recent decades despite its benefits in facilitating childhood development, promoting physical activity, and combating the obesity epidemic. This US-based study examines the impacts of housing and neighborhood environments on two modes of CIM—home-based independent travel to non-school destinations and unsupervised outdoor play—while considering personal and social factors. A bilingual parent/guardian survey was distributed to public elementary schools in Austin, Texas, asking about children’s travel and play, housing and neighborhood environments, and personal and social factors. A Google Street View audit was conducted to capture additional housing-related information. Logistic regressions were used to predict CIM. For second to fifth graders (N = 525), less than two-thirds of the parents would allow children’s independent travel to non-school destinations (62%) and unsupervised outdoor play (57.9%), with the majority limited to a short distance (five-minute walk) and a few destinations (e.g., friend’s/relative’s home). Stranger danger was a negative predictor and the presence of friend’s/relative’s home was a positive predictor for both modes of CIM. Quality of neighborhood environment was another positive correlate for independent travel to non-school destinations. Significant personal and social factors were also identified. Study findings demonstrated the impacts of physical environments on CIM and the potential of using relevant interventions to promote children’s health and development. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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14 pages, 761 KiB

Open AccessArticle

Healthy Places for Children: The Critical Role of Engagement, Common Vision, and Collaboration

by Mildred E. Warner and Xue Zhang

Int. J. Environ. Res. Public Health 2020, 17(24), 9277; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249277 - 11 Dec 2020

Cited by 16 | Viewed by 3524

Abstract

Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children [...] Read more.

Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children in their community plans. Those that do, provide more services and have more child-friendly zoning codes. We use a human ecological framework to build structural equation models of child-friendly zoning and services. We find communities with more engagement of families with children and youth and a common vision across generational, race, and ethnic lines report higher levels of child-friendly zoning and services. Collaboration between health providers and schools builds trust and leads to more services. However, child-friendly zoning is lower in communities with higher child poverty, and in suburbs and rural areas. Our results support a dynamic human ecological model where the processes of collaboration, inclusion, and engagement are key to creating healthy places for children. These processes may be especially important in addressing the unique challenges of suburban and rural communities. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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18 pages, 2116 KiB

Open AccessArticle

Integrating the Built and Social Environment into Health Assessments for Maternal and Child Health: Creating a Planning-Friendly Index

by Xi Wang, Jennifer Whittaker, Katherine Kellom, Stephanie Garcia, Deanna Marshall, Tara Dechert and Meredith Matone

Int. J. Environ. Res. Public Health 2020, 17(24), 9224; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249224 - 10 Dec 2020

Cited by 4 | Viewed by 2420

Abstract

Environmental and community context earliest in the life course have a profound effect on life-long health outcomes. Yet, standard needs assessments for maternal and child health (MCH) programs often overlook the full range of influences affecting health in-utero and early childhood. To address [...] Read more.

Environmental and community context earliest in the life course have a profound effect on life-long health outcomes. Yet, standard needs assessments for maternal and child health (MCH) programs often overlook the full range of influences affecting health in-utero and early childhood. To address this, we developed a methodology for assessing community risk in MCH based on six domains integrating 66 indicators across community, environment, socioeconomic indicators, and MCH outcomes. We pilot this methodology in Pennsylvania, and share examples of how local governments, planners, and public health officials across the geographic spectrum can integrate this data into community planning for improved maternal and child health. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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Review

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17 pages, 1839 KiB

Open AccessReview

More Than Shelter: Housing for Urban Maternal and Infant Health

by Jason Reece

Int. J. Environ. Res. Public Health 2021, 18(7), 3331; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073331 - 24 Mar 2021

Cited by 10 | Viewed by 4478

Abstract

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is [...] Read more.

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors. Full article

(This article belongs to the Special Issue Child-friendly Planning and Public Health)

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