Peter J. Lawson

ethnographic approaches to child care research a review of the literature

This article presents the findings from a review of ethnographic approaches to child care research. Ethnographic research has enhanced researcher and practitioner understandings of the child care environment by providing entry into the child care center as an important site not only of development and education, but also of social reproduction and enculturation. The extant research is summarized by identifying four dominant perspectives for viewing non-parental child care: (1) caregiver-centered, (2) mother-centered, (3) child-centered, and (4) societal. This article argues that studying the perspectives of caregivers, mothers, and children in isolation limits understandings of child care experience, since experience is shaped by continuous interactions among participants. We suggest that a more holistic ethnographic approach could enhance child care practice by increasing understanding of the relationships among caregivers, mothers, and children, and how these relationships influence children’s social and emotional development. The article concludes with a proposed agenda for ethnographic research on child care.

Intimate Partner Violence and Barriers to Cervical Cancer Screening: A Gynecologic Oncology Fellow Research Network Study.

Objectives The aims of the study were to examine barriers to cervical cancer screening among women who have experienced intimate partner violence (IPV) and accessed domestic violence shelters, to compare barriers among those up-to-date (UTD) and not UTD on screening, and to evaluate acceptability of human papillomavirus self-sampling. Materials and Methods This is a cross-sectional survey in which domestic violence shelters in Ohio were identified and women completed an anonymous survey assessing UTD screening status, barriers related to screening, history of IPV, intention to follow up on abnormal screening, and acceptability of self-sampling. Characteristics of UTD and not UTD women were compared using Mann-Whitney U tests. Results A total of 142 women from 11 shelters completed the survey. Twenty-three percent of women were not UTD. Women who were not UTD reported more access-related barriers (mean = 2.2 vs 1.8; p = .006). There was no difference in reported IPV-related barriers between women who were not UTD and those who are UTD (mean = 2.51 in not UTD vs 2.24 in UTD; p = .13). Regarding future screening, of the women who expressed a preference, more women not UTD preferred self-sampling than UTD women (32% vs 14%; p = .05). Conclusions In this study, access-related barriers were more commonly reported among women not UTD with screening. Addressing these barriers at domestic violence shelters may improve screening among not UTD women. Self-sampling may also be one feasible approach to support screening in this population.

Transitions, realignments, and focus shifts: possibilities for biopsychosocial care in the electronic health record era.

The healthcare system in the United States is currently evolving in response to a diverse range of inter-related economic and political pressures. In this article, we discuss three important macro-level transitions (volume to value, clinician-centric to patient-centered care, and individual to population) and their implications for the practice of medicine, health information technology (HIT), and clinical training. Specifically, challenges and opportunities for advancing the use of the biopsychosocial model in clinical practice and teaching in this new, electronic health record (EHR) era of medicine are highlighted. While much work needs to be done to leverage the potential of EHR/HIT systems, their potential to improve population health and patient experience while controlling the costs of care is great. As primary care clinicians and behavioral scientists navigating this changing healthcare landscape, we should continue to strive to deliver high-quality, patient-centered care. Insisting that future generations of EHR/HIT systems support a biopsychosocial approach is part of this mission.

Development of a Measure of Incremental Behavior Change Toward Smoking Cessation

Introduction A reliable measure capable of detecting progression towards smoking cessation would be valuable for evaluating and optimizing the effectiveness of low- to moderate-intensity cessation interventions, such as brief advice in the primary care setting. This article presents the development and evaluation of a brief self-report measure of Incremental Behavior Change toward Smoking cessation (IBC-S). Methods Sequential samples of 411 and 399 adult smokers completed items representing a spectrum of behavioral and cognitive changes antecedent to smoking cessation. The dimensionality, fit, range of difficulty, and reliability of items were evaluated using factor analysis and Rasch modeling. Results The final 15-item IBC-S measure met fit criteria and demonstrated acceptable reliability. Participants with a significant change in IBC-S score were over four times more likely to report cessation at 6-week follow-up (OR 4.37, 95% CI 1.83-10.42). Conclusion The IBC-S is brief, reliable and associated with self-report of smoking reduction and cessation. Implications This article presents the psychometric evaluation of a measure to assess a spectrum of behaviors and cognitions antecedent to smoking cessation. The findings indicate that the items show good measurement properties and good potential as a sensitive measure to evaluate interventions. This measure provides an alternative outcome for interventions that are designed to move individuals towards cessation attempts.