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从生命历程视角看妇幼健康中的保护因素。

Protective Factors Using the Life Course Perspective in Maternal and Child Health.

作者信息

Salinas-Miranda Abraham A, King Lindsey M, Salihu Hamisu M, Wilson Roneé E, Nash Susan, Collins Sarah L, Berry Estrellita Lo, Austin Deborah, Scarborough Kenneth, Best Evangeline, Cox Lillian, King Georgette, Hepburn Carrie, Burpee Conchita, Briscoe Richard, Baldwin Julie

机构信息

University of South Florida.

University of Florida.

出版信息

Engage. 2020;1(3):69-86. Epub 2020 Dec 18.

Abstract

The life course perspective (LCP), a valuable theoretical framework for investigating racial disparities in birth outcomes, examines the cumulative exposure of risk and protective factors throughout the life span. Although risk and protective exposures are equally vital to health, most studies have focused solely on the risk factor exposures faced by vulnerable populations. In clear contrast to the traditional public health approach, which emphasizes a deficit model, strengths-based approaches focus on protective factors and fostering resilience. These approaches view communities as valuable assets that have the capacity to fully engage themselves and their residents to achieve optimal health. Participatory action research methods are well suited to apply a strengths-based approach to understand health disparities. Our study aimed to explore maternal and child health protective factors from community residents' perspective. A group of researchers, including active members in the community with a long history of grassroots development work, conducted ten community-based participatory focus groups with community residents in Tampa, FL, using the LCP framework. A total of 78 residents participated in ten focus groups. Perceived protective factors during pregnancy included self-esteem, spirituality, pregnancy support, good nutrition, prenatal care, and community resources. Protective factors for non-pregnant women were self-esteem, spirituality, social support, health literacy, community support and community resources, and societal factors. For children and adolescents, relevant protective factors were self-esteem, positive role models, nutrition and physical activity, and community support. The identified factors are community assets or strengths that mitigate or eliminate maternal and child health risks in families and communities residing in low-income neighborhoods, which must be considered in developing effective maternal and child health interventions.

摘要

生命历程视角(LCP)是研究出生结果种族差异的一个有价值的理论框架,它考察了整个生命跨度中风险因素和保护因素的累积暴露情况。尽管风险暴露和保护因素对健康同样重要,但大多数研究仅关注弱势群体所面临的风险因素暴露。与强调缺陷模型的传统公共卫生方法形成鲜明对比的是,基于优势的方法侧重于保护因素并培养复原力。这些方法将社区视为有价值的资产,有能力充分调动自身及其居民以实现最佳健康状态。参与式行动研究方法非常适合应用基于优势的方法来理解健康差异。我们的研究旨在从社区居民的角度探索母婴健康保护因素。一组研究人员,包括在社区发展工作方面有着长期基层工作经验的活跃成员,在佛罗里达州坦帕市使用LCP框架与社区居民进行了十次基于社区的参与式焦点小组讨论。共有78名居民参加了这十次焦点小组讨论。孕期被感知到的保护因素包括自尊、精神信仰、孕期支持、良好营养、产前护理和社区资源。非孕期女性的保护因素有自尊、精神信仰、社会支持、健康素养、社区支持和社区资源以及社会因素。对于儿童和青少年,相关的保护因素是自尊、积极的榜样、营养和体育活动以及社区支持。所确定的这些因素是社区资产或优势,可减轻或消除低收入社区家庭和社区中的母婴健康风险,在制定有效的母婴健康干预措施时必须予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c69/8054993/7476e613ab48/nihms-1663154-f0002.jpg

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本文引用的文献

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Racism and Health: Evidence and Needed Research.种族主义与健康:证据与研究需求。
Annu Rev Public Health. 2019 Apr 1;40:105-125. doi: 10.1146/annurev-publhealth-040218-043750. Epub 2019 Feb 2.
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Usability of Low-Cost Android Data Collection System for Community-Based Participatory Research.
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