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Implementation of a Family Planning Clinic-Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives

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PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2017年第2期49卷 85-93页

作者： Miller, Elizabeth McCauley, Heather L. Decker, Michele R. Levenson, Rebecca Zelazny, Sarah Jones, Kelley A. Anderson, Heather Silverman, Jay G. Univ Pittsburgh Sch Med Childrens Hosp Pittsburgh Div Adolescent & Young Adult Med Pittsburgh PA 15260 USA Univ Pittsburgh Sch Med Dept Pediat Pediat Pittsburgh PA 15260 USA Michigan State Univ Human Dev & Family Studies E Lansing MI 48824 USA Univ Pittsburgh Sch Med Dept Pediat Div Adolescent & Young Adult Med Pittsburgh PA 15260 USA Johns Hopkins Univ Dept Populat Family & Reprod Hlth Baltimore MD USA Johns Hopkins Univ Bloomberg Sch Publ Hlth Ctr Publ Hlth & Human Rights Womens Hlth & Rights Program Baltimore MD USA Futures Violence San Francisco CA USA Univ Calif San Diego Ctr Gender Equ & Hlth Res La Jolla CA 92093 USA Univ Calif San Diego Med & Global Publ Hlth La Jolla CA 92093 USA

CONTEXT: Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS: In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to off er a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS: Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to off er the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS: A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.

关键词： INTIMATE partner violence -- Prevention ABUSED women CONTROL (Psychology) CONSENSUS (Social sciences) COUNSELING HEALTH education SEXUAL health INTERVIEWING RESEARCH methodology RESEARCH REPRODUCTIVE health QUALITATIVE research HARM reduction (Human behavior) FAMILY planning medical coding

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Believing in Expertise: How Authors' Credentials and Language Use Influence the Credibility of Online Health Information

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HEALTH COMMUNICATION 2017年第7期32卷 828-836页

作者： Thon, Franziska M. Jucks, Regina Univ Munster Inst Psychol Educ Fliednerstr 21 D-48149 Munster Germany

Today, many people use the Internet to seek health advice. This study examines how an author's expertise is established and how this affects the credibility of his or her online health information. In a 2 (authors' credentials: medical vs. nonmedical)x2 (authors' language use: technical vs. every day) within-subjects design, 127 study participants, or seekers, judged authors' expertise, benevolence, and integrity as well as the credibility of their medical statements. In addition, we assessed seekers' awareness of their own knowledge and behavior. Results revealed that users consciously rewarded authors' credentials and subconsciously punished technical language. Seekers were keenly aware of authors' credentials and perceived authors with medical credentials to have a higher level of expertise and their information to be more credible. Technical language use negatively affected authors' integrity and the credibility of their health information, despite seekers being unaware of it. Practical implications for health communication and implications for future research are outlined.

关键词： COMMUNICATION in medicine WEBSITES TRUTHFULNESS & falsehood COLLEGE students EXPERIMENTAL design LANGUAGE & languages MEDICINE information services PROBABILITY theory QUESTIONNAIRES TRUST WORLD Wide Web HEALTH literacy HEALTH information services medical coding

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An Examination of Family, Healthcare Professionals, and Peer Advice on Physical Activity Behaviors among Adolescents at High Risk for Type 2 Diabetes

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HEALTH COMMUNICATION 2017年第7期32卷 857-863页

作者： Amuta, Ann O. Jacobs, Wura Barry, Adam E. Texas Womans Univ Dept Hlth Studies Denton TX 76204 USA Texas A&M Univ Dept Hlth & Kinesiol College Stn TX 77843 USA Calif State Univ Fullerton Dept Hlth Sci Fullerton CA 92634 USA

Studies have shown that many college students do not meet the recommended daily physical activity (PA) levels, and about 22% of these students are overweight. Given that engaging in PA is a protective behavior against many chronic conditions, it is imperative to understand what sources of information/advice to engage in PA is most influential. Hence, the purpose of this study was to examine the relative impact of different sources of advice regarding exercise and PA on actual PA engagement among obese/overweight adolescents. Using data from 319 overweight/obese college students, multivariate regression analyses were conducted to examine which source of advice (from parents, peers, or healthcare provider) to engage in PA was associated with PA behavior among these adolescents. Influence of type 2 diabetes (T2D) family history on PA behavior was also examined. Moderate and vigorous PA behavior was more likely among obese/overweight adolescents who received advice to exercise or engage in PA from their peers (B=200.85, =0.193, p=0.001;B=121.19, =0.145, p=0.014). Overweight/obese adolescents with a T2D family history were more likely to walk compared with those without a T2D family history ((2)=12.97, p=0.000). Findings suggest that although healthcare professionals advise obese/overweight adolescents, those who received advice regarding PA behavior from their peers were more likely to heed the advice and exercise/engage in PA. In essence, intervention efforts should focus on employing peer ambassadors to counsel other adolescents on the importance of PA.

关键词： ADOLESCENT psychology PEER relations PHYSICAL activity NON-insulin-dependent diabetes risk factors MULTIPLE regression analysis COLLEGE students BLACKS CHI-squared test FAMILIES HISPANIC Americans MEDICINE information services PHYSICIANS SURVEYS WHITES AFFINITY groups BODY mass index FAMILY medical history DATA analysis software HEALTH information services medical coding

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Spatial Navigation: Retrosplenial Cortex Encodes the Spatial Structure of Complex Routes

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CURRENT BIOLOGY 2017年第13期27卷 R649-R651页

作者： Clark, Benjamin J. Univ New Mexico Dept Psychol MSC03 22201 Univ New Mexico Albuquerque NM 87131 USA

A new study in which recordings were made from the retrosplenial cortex while rats navigated through a complex environment has revealed populations of cells that encode route-segments as well as the relative position ... 详细信息

关键词： CELL populations medical coding RATS EXONS (Genetics) NEURONS

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Making a Visual Impression (or Not): Current Design Practices of Nutritional Websites

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HEALTH COMMUNICATION 2017年第4期32卷 470-482页

作者： Lazard, Allison J. Dudo, Anthony Dennis, Tessa Ewald, Mary Grace Love, Brad Univ N Carolina Sch Media & Journalism Chapel Hill NC USA Univ Texas Austin Stan Richards Sch Advertising & Publ Relat Austin TX 78712 USA

Understanding the influence of visual design, as the access point for online health communication, is key as Americans are increasingly sickened by an obesity epidemic. Nutritional websites that deliver critical health information should be considered as a potential strategy to fight against the grave consequences of obesity, as research indicates that consumers are consistently turning to the Internet as a resource for health information. Focusing on nutritional websites, this study analyzes the use of visual design principles that are known to greatly influence first impressions and appeal of the information from the user's perspective. The results suggest there are opportunities for improvement to the online communication of nutritional information to increase the likelihood of users' favorable first impressions, the critical first steps for nutritional information delivery goals.

关键词： PREVENTION of obesity COLOR CONTENT analysis (Communication) HEALTH promotion WEB development MEDICINE information services NUTRITION USER interfaces (Computer systems) SOCIAL context HEALTH information services medical coding

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Examining Sibling Communication About Problematic Drinking: An Application of Inconsistent Nurturing as Control Theory

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JOURNAL OF FAMILY COMMUNICATION 2017年第1期17卷 65-87页

作者： Glowacki, Elizabeth M. Univ Texas Austin Dept Commun Studies 2504A Whitis Ave A1105CMA 7-112 Austin TX 78712 USA Univ Texas Austin Ctr Hlth Commun 2504A Whitis Ave A1105CMA 7-112 Austin TX 78712 USA

This study applies inconsistent nurturing as control (INC) theory to examine how siblings describe communicating about problematic drinking. Thirty-five college students reported on how they and a sibling discuss drinking that is perceived as problematic and described behaviors related to the problematic drinking. Interviews were transcribed and coded in two separate rounds of coding;the first round identified categories related to INC theory (reinforcement, punishment, and labeling). Reinforcement often took the form of avoiding the topic of drinking and using drinking as a means for bonding. Punishment primarily took the form of confrontation. The second round identified such themes as frustration at the inability to stop a sibling's drinking, a tendency to overlook the severity of the drinking, and a combination of wanting to discuss alcohol openly, but also wanting to avoid discussions about negative consequences. There were five primary descriptions of power dynamics: equal and open with one another (friend-like relationship), one sibling in control (parent-like relationship), power as context-based, power changing over the course of the relationship due to a significant event (i.e., parents' divorce), and power as a personality trait.

关键词： CONTROL (Psychology) ALCOHOLISM BROTHERS & sisters COLLEGE students COMMUNICATION INTERVIEWING POWER (Social sciences) PSYCHOLOGY REINFORCEMENT (Psychology) THEORY medical coding

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Abortion Stigma Among Low-Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment

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PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2017年第1期49卷 29-36页

作者： Gelman, Amanda Rosenfeld, Elian A. Nikolajski, Cara Freedman, Lori R. Steinberg, Julia R. Borrero, Sonya Univ Colorado Internal Med Aurora CO USA VA Pittsburgh Healthcare Syst Pittsburgh PA USA Univ Pittsburgh Ctr Res Hlth Care Sch Med Dept Gen Internal Med Pittsburgh PA 15260 USA Univ Calif San Francisco Dept Obstet Gynecol & Reprod Sci San Francisco CA USA Univ Maryland Dept Family Sci Sch Publ Hlth College Pk MD 20742 USA Univ Pittsburgh Med & Clin & Translat Sci Sch Med Pittsburgh PA 15260 USA

CONTEXTAbortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. METHODSA qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them. RESULTSWomen commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. CONCLUSIONSWomen's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences.

关键词： ABORTION & psychology INTERVIEWING RESEARCH methodology PREGNANCY FINANCING of research STIGMA (Social psychology) QUALITATIVE research SOCIOECONOMIC factors THEMATIC analysis DATA analysis software medical coding DESCRIPTIVE statistics

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Exploring Family Support for Older Chinese Singaporean Women in a Confucian Society

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HEALTH COMMUNICATION 2017年第5期32卷 603-611页

作者： Chang, Leanne Basnyat, Iccha Natl Univ Singapore Dept Commun & New Media Blk AS603-4111 Comp Dr Singapore 117416 Singapore

This study investigated the functions of family support in older Chinese Singaporean women's daily health management in a Confucian cultural context, wherein family solidarity and women's caregiving responsibilities are emphasized. Thirty-eight interviews were conducted with ethnic Chinese women above the age of 60 in Singapore. Our thematic analysis showed that older women played dual roles as support providers and recipients in the family. Their caregiver identity and intent to preserve tradition resulted in a downward transmission of informational and physical support and their hesitance to accept resources provided by younger family members. The asymmetrical flow of family support generated mixed impacts on the women's daily health management. In their transition between tradition and modernity, older women fulfilled their family responsibilities but did not require their children to do so. Our findings suggested an integration of familial and institutional resources to meet older women's support needs and help them enhance their health behavior.

关键词： FAMILY relations WOMEN caregivers HEALTH behavior CHINESE ELDER care GRADUATE students INTERVIEWING RESEARCH methodology RELIGION RESEARCH -- Evaluation WOMEN PILOT projects SOCIAL support THEMATIC analysis medical coding FAMILIES ATTITUDES

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Perception of spiritual health: A qualitative content analysis in Iranian older adults

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EDUCATIONAL GERONTOLOGY 2017年第1期43卷 21-32页

作者： Zibad, Hosein Ajam Foroughan, Mahshid Shahboulaghi, Farahnaz Mohammadi Rafiey, Hassan Rassouli, Maryam Gonabad Univ Med Sci Fac Nursing & Midwifery Dept Nursing Social Dev & Hlth Promot Res Ctr Gonabad Iran Univ Social Welf & Rehabil Sci Iranian Res Ctr Aging Tehran Iran Univ Social Welf & Rehabil Sci Social Welf Management Res Ctr Tehran Iran Shahid Beheshti Univ Med Sci Sch Nursing & Midwifery Pediat Nursing Dept Tehran Iran

The present study was performed with the aim to explain older people's perceptions of spiritual health. It was conducted using the conventional content analysis method. Twelve individuals aged 60years or older with normal cognition participated in the study using purposive sampling. Data were collected by in-depth interviews. Data analysis performed using standard method of thematic *** average age of the study participants was 71.25 +/- 9.48. The data analysis resulted in three main categories of spiritual insight, spiritual function, and spiritual affection. The spiritual insight included cognition of God and belief in Him, understanding of the divine religions and belief in them, self-cognition, cognition of the creation, and belief in the hereafter. This category included the two subcategories of spiritual cognition and spiritual belief. Spiritual function represented the interactions that the older people experienced in relations with God, themselves, and others. This category consisted of the subcategories of relationship with God, relationship with others, and self-cultivation. The spiritual affection included loving God and other humans and consisted of the three subcategories of spiritual affections to God, others, and oneself. This study presents in-depth data on the concept of spiritual health from older people's viewpoints. These findings would help healthcare teams in designing appropriate interventions for older people's health promotion. Also, by using the results of this research, health researchers design more appropriate tools for measuring spiritual health based on older people's perception of the concept of spiritual health.

关键词： ATTITUDE testing CONTENT analysis (Communication) INTERPERSONAL relations INTERVIEWING SPIRITUALITY QUALITATIVE research THEMATIC analysis DATA analysis software medical coding DESCRIPTIVE statistics

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Food Insecurity in Singapore: The Communicative (Dis)Value of the Lived Experiences of the Poor

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HEALTH COMMUNICATION 2017年第8期32卷 954-962页

作者： Tan, Naomi Kaur-Gill, Satveer Dutta, Mohan J. Venkataraman, Nina Natl Univ Singapore Dept Commun & New Media Singapore Singapore Natl Univ Singapore Dept English Language & Literature Singapore Singapore

Food insecurity is a form of health disparity that results in adverse health outcomes, particularly among disenfranchised and vulnerable populations. Using the culture-centered approach, this article engages with issues of food insecurity, health, and poverty among the low-income community in Singapore. Through 30 in-depth interviews, the narratives of the food insecure are privileged in articulating their lived experiences of food insecurity and in co-constructing meanings of health informed by their sociocultural context, in a space that typically renders them invisible. Arguing that poverty is communicatively sustained through the erasure of subaltern voices from mainstream discourses and policy platforms, we ask the research question: What are the meanings of food insecurity in the everyday experiences of health among the poor in Singapore? Our findings demonstrate that the meanings of health among the food insecure are constituted in culture and materiality, structurally constrained, and ultimately complexify their negotiations of health and health decision making.

关键词： FOOD security COMMUNICATION in medicine EXPERIENCE HEALTH of poor people NUTRITION HEALTH disparities FOOD & culture medical decision making GROUNDED theory INTERVIEWING CULTURAL values medical coding FIELD notes (Science) PATIENT decision making

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