Family Science
Permanent URI for this communityhttp://hdl.handle.net/1903/2239
Formerly known as the Department of Family Studies.
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Item The context of violent disagreements between parents: a qualitative analysis from parents’ reports(Springer Nature, 2014-12-24) Bair-Merritt, Megan H; Mandal, Mahua; Epstein, Norman B; Werlinich, Carol A; Kerrigan, DeannaIntimate partner violence (IPV) is a prevalent public health problem that affects millions of families. Much of what is known about IPV comes from quantitative studies that often "count" acts of IPV without exploring in depth the circumstances surrounding the violence, thereby leaving critical questions unanswered; existing qualitative studies tend to focus solely on women’s perspectives. There is a dearth of dyadic qualitative research exploring the context of IPV in families with children, thus hindering the development of effective interventions for families experiencing IPV. Seven heterosexual couples were recruited from a University-based family therapy clinic to participate in qualitative interviews. Couples were eligible if they had experienced severe verbal or any physical aggression during the past 4 months; had ≥ one child living in the household; were English-speaking; and were ≥ 18. Each individual was interviewed separately. Key topics explored included specific types of violence used by men and women; primary triggers and the context surrounding aggressive disagreements; degree to which the child(ren) were exposed; and perceived consequences for adults and children. All couples listed household responsibilities and parenting as key IPV triggers. Couples with infants reported that parenting disagreements were particularly heated, with women using aggression due to frustration about their partners’ lack of support. Couples also described substance use, wanting to be heard, and prior violence histories as triggers or as the background context for IPV episodes. Children were present during IPV and often intervened in conflicts involving severe violence. Parents’ perceptions of the effects of IPV on their children ranged from minimal to major emotional distress, with men describing more significant impact than women. When describing acute triggers, parents most commonly mentioned that arguments were instigated by concerns about the division of household labor and parenting, a finding that may have significant implications for intervention development; this was particularly notable for parents of infants. Our findings emphasize the need for innovative programs that help parents cope with the stresses of raising a family as well as programs that directly address the consequences of IPV for children.Item Predictors of maternal health services utilization by poor, rural women: a comparative study in Indian States of Gujarat and Tamil Nadu(Springer Nature, 2015-07-31) Vora, Kranti Suresh; Koblinsky, Sally A.; Koblinsky, Marge A.India leads all nations in numbers of maternal deaths, with poor, rural women contributing disproportionately to the high maternal mortality ratio. In 2005, India launched the world’s largest conditional cash transfer scheme, Janani Suraksha Yojana (JSY), to increase poor women’s access to institutional delivery, anticipating that facility-based birthing would decrease deaths. Indian states have taken different approaches to implementing JSY. Tamil Nadu adopted JSY with a reorganization of its public health system, and Gujarat augmented JSY with the state-funded Chiranjeevi Yojana (CY) scheme, contracting with private physicians for delivery services. Given scarce evidence of the outcomes of these approaches, especially in states with more optimal health indicators, this cross-sectional study examined the role of JSY/CY and other healthcare system and social factors in predicting poor, rural women’s use of maternal health services in Gujarat and Tamil Nadu. Using the District Level Household Survey (DLHS)-3, the sample included 1584 Gujarati and 601 Tamil rural women in the lowest two wealth quintiles. Multivariate logistic regression analyses examined associations between JSY/CY and other salient health system, socio-demographic, and obstetric factors with three outcomes: adequate antenatal care, institutional delivery, and Cesarean-section. Tamil women reported greater use of maternal healthcare services than Gujarati women. JSY/CY participation predicted institutional delivery in Gujarat (AOR = 3.9), but JSY assistance failed to predict institutional delivery in Tamil Nadu, where mothers received some cash for home births under another scheme. JSY/CY assistance failed to predict adequate antenatal care, which was not incentivized. All-weather road access predicted institutional delivery in both Tamil Nadu (AOR = 3.4) and Gujarat (AOR = 1.4). Women’s education predicted institutional delivery and Cesarean-section in Tamil Nadu, while husbands’ education predicted institutional delivery in Gujarat. Overall, assistance from health financing schemes, good road access to health facilities, and socio-demographic and obstetric factors were associated with differential use of maternity health services by poor, rural women in the two states. Policymakers and practitioners should promote financing schemes to increase access, including consideration of incentives for antenatal care, and address health system and social factors in designing state-level interventions to promote safe motherhood.Item VICTIM DEPRESSION, POSITIVE PARTNER BEHAVIOR, AND TYPE OF PARTNER AGGRESSION AS DETERMINANTS OF WOMEN’S STEPS TOWARD LEAVING AN ABUSIVE RELATIONSHIP(2019) Thomas, Jannel; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated factors associated with the degree to which victims of partner violence take steps toward leaving the relationship. It was a secondary analysis of clinic data from pre-therapy couple assessments of demographic characteristics; physical, psychological, and sexual partner aggression; victim depression; perpetrator positive partner behavior; and steps the victim took toward leaving. Females’ income and education were not associated with steps toward leaving. Physical, psychological, and sexual aggression were all associated with steps toward leaving. Greater depression was associated with more steps toward leaving and more positive partner behavior was associated with fewer steps toward leaving. Neither depression nor positive partner behavior moderated the association between physical or psychological aggression and steps toward leaving. The association between sexual aggression and steps toward leaving was positive when positive partner behavior was higher, but non-significant when positive partner behavior was lower. Clinical implications and suggestions for future research are discussed.Item RACE AND IMMIGRATION STATUS AS MODERATORS OF THE RELATIONSHIP BETWEEN FAMILY ACCEPTANCE/FAMILY REJECTION AND DEPRESSIVE SYMPTOMS FOR LGBTQ+ YOUTH(2019) Levin, Emma R; Leslie, Leigh; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research consistently demonstrates that LGBTQ+ youth, when compared to non-LGBTQ+ youth, are at significantly greater risk for depression, anxiety, substance use, and suicidality as a result of stressors related to belonging to a minority group (Russell & Fish, 2016). Family acceptance is an important protective factor against these negative mental health outcomes, and family rejection has been demonstrated as an important risk factor. Research on LGBTQ+ youth has been criticized for regarding all LGBTQ+ youth as the same and not accounting for the intersection and interaction with other identities such as race or immigrant status. The research questions posed by this study are 1) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family acceptance and depressive symptoms?, and 2) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family rejection and depressive symptoms? Results of the present study show that race significantly moderated the relationship between family acceptance and depression for LGBTQ+ youth, but did not moderate the relationship between family rejection and depression. Immigrant status moderated neither relationship. Three-way interactions with race and immigrant status moderated both the association among family acceptance, family rejection, and depression. Clinical implications and implications for future research are discussed.Item Characterizing Trends in Human Papillomavirus Vaccine Discourse on Reddit (2007-2015): An Observational Study(JMIR Publications, 2019) Yama, Yuki; Hu, Dian; Jamison, Amelia; Quinn, Sandra Crouse; Broniatowski, David A.Background: Despite the introduction of the human papillomavirus (HPV) vaccination as a preventive measure in 2006 for cervical and other cancers, uptake rates remain suboptimal, resulting in preventable cancer mortality. Social media, widely used for information seeking, can influence users’ knowledge and attitudes regarding HPV vaccination. Little is known regarding attitudes related to HPV vaccination on Reddit (a popular news aggregation site and online community), particularly related to cancer risk and sexual activity. Examining HPV vaccine–related messages on Reddit may provide insight into how HPV discussions are characterized on forums online and influence decision making related to vaccination. Objective: We observed how the HPV vaccine is characterized on Reddit over time and by user gender. Specifically, this study aimed to determine (1) if Reddit messages are more related to cancer risks or sexual behavior and (2) what other HPV vaccine–related discussion topics appear on Reddit. Methods: We gathered all public Reddit comments from January 2007 to September 2015. We manually annotated 400 messages to generate keywords and identify salient themes. We then measured the similarity between each comment and lists of keywords associated with sexual behavior and cancer risk using Latent Semantic Analysis (LSA). Next, we used Latent Dirichlet Allocation (LDA) to characterize remaining topics within the Reddit data. Results: We analyzed 22,729 messages containing the strings hpv or human papillomavirus and vaccin. LSA findings show that HPV vaccine discussions are significantly more related to cancer compared with sexual behavior from 2008 to 2015 (P<.001). We did not find a significant difference between genders in discussions of cancer and sexual activity (P>.05). LDA analyses demonstrated that although topics related to cancer risk and sexual activity were both frequently discussed (16.1% and 14.5% of word tokens, respectively), the majority of online discussions featured other topics. The most frequently discussed topic was politics associated with the vaccine (17.2%). Other topics included HPV disease and/or immunity (13.5%), the HPV vaccine schedule (11.5%), HPV vaccine side effects (9.7%), hyperlinks to outside sources (9.1%), and the risks and benefit of HPV vaccination (8.5%). Conclusions: Reddit discourse on HPV vaccine encompasses a broad range of topics among men and women, with HPV political debates and cancer risk making up the plurality of the discussion. Our findings demonstrated that women and men both discussed HPV, highlighting that Reddit users do not perceive HPV as an issue that only pertains to women. Given the increasing use of social media as a source of health information, these results can inform the development of targeted online health communication strategies to promote HPV vaccination to young adult users of Reddit. Analyzing online discussions on Reddit can inform health communication efforts by identifying relevant, important HPV-related topics among online communities.Item Clerical Conduct Related to the Perpetuation of Child Sexual Abuse in Pennsylvania Catholic Dioceses: A Developing Framework(2019) Britto, Crystel; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Throughout his papacy, Pope Francis reiterated that clericalism played a major role in the global Catholic sexual abuse crisis. Research has not been able to back this claim due to lack of data on cultural and structural elements that have contributed to the various crises. The present study aims to fill this gap in research by examining narratives regarding clerical sexual abuse and seeks to explore themes contributing to a framework of abuse. Qualitative data analysis was conducted by examining the 40th Statewide Investigating Grand Jury Report of Pennsylvania, focusing on correspondence between various actors regarding 12 priests in Pennsylvania and their involvement in child sexual abuse. Using grounded theory with elements of narrative analysis, the study seeks to explore themes of belief, behavior and emotion of clergy between 1930-2016. The results provide insight into the nature of the Catholic Church’s involvement in the perpetuation of child sexual abuse.Item FAMILY-CENTERED PEDIATRIC CARE: PREDICTORS OF ACCESS AND ASSOCIATIONS WITH CHILD WELL-BEING(2019) Fife, Julie Marie; Lewin, Amy B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Despite widespread recognition that family-centered care (FCC) is a critical component of quality pediatric health care, not all children receive FCC. This study builds on previous work by: (1) examining the extent to which socioeconomic resources are associated with the receipt of FCC after implementation of the Affordable Care Act, (2) exploring whether healthcare workforce shortages interfere with the delivery of FCC, and (3) extending previous research on the role of FCC in child well-being by measuring well-being across multiple domains and including children without special health care needs. Using data from the 2016 National Survey of Children’s Health (n=50,212), this study found a graded relationship between the odds of receiving FCC and multiple indicators of family-level socioeconomic resources, indicating that socioeconomic resources, beyond health insurance, are important factors in accessing quality pediatric health care. Healthcare workforce shortages may also play a role in the availability of FCC. Results from this study found consistent and significant associations between FCC and positive child well-being among healthy and typically developing children, and these associations were found across all domains of development. Findings indicated that FCC is particularly beneficial for young children (0-5 years), and children in households with low to moderate socioeconomic resources, making it a potentially meaningful tool to help reduce health disparities for children from households with more limited socioeconomic resources. Future research, and policies and practices aimed at increasing the delivery of FCC should include and emphasize the experiences of Hispanic families and families with limited socioecnomic resources.Item Trangender-Inclusive Health Care Services Among College Health Centers in the United States(2019) Messman, Jenna Beckwith; Leslie, Leigh A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research demonstrates that transgender people face significant health disparities compared to their cisgender peers, experience harassment and mistreatment in health care settings, and that many health care facilities are ill-equipped to competently treat them. While there has been some evaluation of trans-inclusive services provided in large health care facilities, there has been no formal assessment of the competencies of college health care facilities to meet the needs of transgender students. A 43-item survey tool operationalizing the American College Health Association’s (ACHA) Guidelines for Trans-Inclusive College Health Programs was developed and sent to representatives of ACHA’s membership (n=1,005). The degree to which college health centers are meeting these 32 recommended guidelines was assessed. The data show that college health centers are overwhelming providing some degree of trans-inclusive health care and that the provision of such services varies greatly based on six institutional characteristics: control of institution (public vs. private); religious affiliation (yes vs. no); transgender-inclusive laws and policies by state (low inclusion vs. high inclusion); size of institution (<1000, 1000-4999, 5000-9999, 10000-19999, 20000+); locale (city, suburban, town, rural); and region (Northeast, Midwest, South, West). These findings are notable in that many college health centers are providing more trans-inclusive care than most large health care facilities and are positioned to be leaders in trans-inclusive health care. Despite the provision of such services on college campuses, transgender students still face significant health disparities compared to their cisgender peers and more research is needed to better understand what colleges and communities can do to improve their health outcomes.Item THE MEDIATING ROLE OF PARENTING BEHAVIOR IN THE ASSOCIATION BETWEEN PARENTAL AND CHILD PSYCHOLOGICAL FUNCTIONING(2019) Gheorghiu, Stefania; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The aim of the present study was to broaden the investigation of the intergenerational association of psychological functioning by examining the role of parenting behavior (harsh parenting and parental acceptance) as a mediating factor in the association between maternal and youth psychological functioning (i.e., severity of anxiety and depression symptoms). Measures of psychological distress, harsh parenting, and parental acceptance were administered to a community sample of 309 Latino youth (ages 9-15) and their mothers. Results from a path analysis, controlling for monthly family income, mother’s age at baseline assessment, and the number of children in the household, showed support for the mediating role of parental acceptance but not harsh parenting in the association between parent and youth psychological functioning. However, harsh parenting had an indirect association with child psychological distress, mediated by lower child perceptions of parental acceptance. Implications for future research and clinical practice are discussed.Item THE PHYSICAL AND MENTAL HEALTH EFFECTS OF ADULT CHILDREN ON FATHERS: A LONGITUDINAL STRUCTURAL EQUATION ANALYSIS(2019) Blick, Ryan; Anderson, Elaine; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Men are entering the later stages of life at an unprecedented rate. As fathers and their children age, a gradual transition in the hierarchy of their relationship occurs, eventually resulting in fathers being recipients, rather than providers, of care. Unfortunately, little is known about the effect that adult children (children ages 19 years old and above) have on fathers’ physical and mental health in the middle-to-late stages of life. Using a sample of 588 fathers who were between the ages of 50- and 80-years-old and who had at least one adult child, a series of structural equation models using a cross-lagged panel design were conducted to increase our understanding of 1) the nature of the associations among fathers’ physical health, mental health, relationship quality with their spouse, and relationship quality with their adult children over time in middle-to-late adulthood, and 2) how these associations change as fathers age in middle-to-late adulthood. The findings indicate that fathers’ mental health is strongly correlated with their physical health, marital relationship quality, and relationship quality with their focal child across all age groups of fathers between 57- and 80-years-old. However, a transition seems to occur for fathers between 63- and 68-years-old that increases the within-time salience of fathers’ relationship quality with their focal child. In spite of the strong bivariate correlations, the structural equation models revealed high levels of within-trait stability and a lack of cross-trait predictive power among each of these aspects of fathers’ lives across age groups. The lone exception to this was in the emergence of a significant effect from father’s mental health between the ages of 69- and 74-years-old to their father-child relationship quality six years later, suggesting the possibility of a final transition in father-child relationship dynamics late in fathers’ lives.