Suchergebnisse

This case example illustrates different aspects of ethnographic methods of inquiry using my dissertation fieldwork experience in a poverty-impacted Kurdish migrant community in Istanbul, Turkey. First, a background to the study is provided. Second, four main characteristics of ethnographic inquiry are described with examples from my research study. Finally, two main data collection methods, namely, in-depth interviews and participant observations, are discussed and examples of the process by which these methods were developed and used in the context of my study are provided. Overall, this case study exemplifies the importance of preparing thoroughly for fieldwork while being ready to be flexible and adaptable as a field researcher.

Child labor is a serious issue in Turkey. This article provides a review of the current literature on risk factors associated with child labor in Turkey. Emphasizing their multilayered nature, the article examines risk factors contributing to child labor in Turkey by clustering them under individual, family, and structural factors. Recommendations for future research, policy, and practice are also discussed.

Regular family meal times have been associated with enhanced family cohesion and positive developmental outcomes for children–youth, especially in White and/or middle-class families. Less is known about the meal time experiences of low-income African American families. Guided by a family resilience perspective, this study examines meal times among a sample of low-income African American caregivers of preschoolers in an inner-city neighborhood. We conducted in-depth qualitative interviews and a photo elicitation interview with 11 low-income African American caregivers about their family meal time experiences. We found that caregivers valued family meal times and acknowledged their benefits for family life. However, competing demands such as family schedules, household configurations, chores, time pressures, fast food restaurants, and low-wage work affected the schedule and structure of meal times. This study adds to discussions of family meal times among low-income African American families and provides suggestions for enhancing mealtimes through culturally and developmentally appropriate interventions.

Abstract
Little research examines how families respond to the neighborhood food environment and family poverty barriers to children's nutritional health. Informed by a family strengths perspective that emphasizes agency, this exploratory study used qualitative data from twelve low-income African American female caregivers to explore strategies that women used to promote the nutritional health of their preschool-age children. We identified multiple restrictive and promotional strategies that caregivers utilized in the face of limited family resources and the poor quality of the neighborhood food environment. Monitoring was used as the key restrictive strategy to counter children's unhealthy eating practices. Six promotional strategies, which included selective food availability, cooking techniques, creative meal preparation and presentation, positive role-modeling, teaching and instruction, and media reinforcement, were used to enhance healthy nutritional patterns. These findings fill a substantive gap in our understanding of health-promoting practices in low-income African American households, and provide direction for family, neighborhood, and institutional efforts to promote healthy child nutrition.

The African region remains the world's most affected region in the HIV epidemic. A related consequence of HIV/AIDS in sub-Saharan Africa (SSA), including in Uganda, is the high prevalence of children and adolescents who have lost one or both parents to this virus or who have been perinatally infected. Guided by the Practical, Robust Implementation and Sustainability (PRISM) framework, this paper describes the strategies by which we have engaged community and government partners in research using three NIH-funded randomized clinical trials testing an evidence-based combination intervention aimed at improving health and mental health outcomes among children and adolescents impacted by HIV/AIDS in Uganda. We specifically lay out four strategies that have been used to facilitate stakeholder engagement, namely consultative meetings, stakeholder accountability meetings, training of key players (task-shifting), and policymaker engagement. We emphasize that community collaborations and partnerships are especially critical when implementing combination interventions that require a high level of communication and coordination among multiple implementation partners. We underline that building and sustaining long-term relationships and communication with the stakeholders can allow the researchers to successfully design rigorous studies that are responsive to local needs and can make a difference especially in low-resource settings. Finally, we highlight that the process of engagement and collaboration can be guided by conceptual frameworks.

A lack or low level of social capital is associated with negative outcomes for communities impacted by poverty. However, less is known about how different types of social capital operate on the ground in poverty–impacted urban neighborhoods. This article explores the ways in which bonding, bridging, and linking capital manifest among residents of two poverty–impacted neighborhoods in New York City. Findings of the study reveal that urban neighborhood characteristics, more than individual–level factors, compromise the ability to develop and utilize the leveraging role of bridging and linking capital. Lack of safety resulted in limited trust, and involvement in community life limit bonding capital. Opportunities for bridging are restricted by the socioeconomically homogenous and spatially segregated nature of the communities. Linking capital is undermined by the lack of resources in the neighborhoods. These structural barriers prevent communities from breaking the cycle of poverty and should be explicitly targeted when developing interventions focused on building social capital.

North-to-south migration has been a persistent trend in Ghana. Yet the migrating population has recently shifted to become predominantly female and younger, with a significant increase in rural adolescent girls seeking employment in urban and peri-urban areas. For adolescents without strong networks of social and financial support, this practice can jeopardize their physical and mental health, putting them at risk of sexual victimization and economic exploitation. Building upon the work of cumulative risk and ecological systems theorists, this article examines the case of female adolescent load bearers (Kayayei) in Ghana, highlighting the need to develop and evaluate multi-component prevention efforts.

AbstractIntroductionOptimal antiretroviral therapy (ART) adherence is crucial for improved patient outcomes; however, ART adherence among adolescents living with HIV (ALHIV) is low. Also, the performance of various adherence measures among ALHIV is under contention. We monitored ART adherence and compared Self‐report (SR) and Wisepill electronic monitoring (EM) performance in measuring ART adherence and predicting HIV viral suppression among ALHIV.MethodsBetween January 2014 and December 2015, we recruited 702 ALHIV aged 10–16 years into our cluster‐randomized controlled trial (2012–2018) in 39 clinics in Uganda. The intervention included a long‐term savings child development account, four micro‐enterprise workshops and 12 mentorship sessions. Using the entire sample, we performed multilevel logistic regression to predict monthly ART adherence trends for the first year of follow‐up. Since it is possible that the intervention had different effects on SR and EM adherence, we used participants in the control arm only to compare adherence using SR and EM and to calculate their sensitivity and specificity in predicting viral suppression.ResultsThere was a significant decline in adherence for each month throughout the entire follow‐up period regardless of the group assigned. Good ART adherence was measured at 79.2% (75.2–82.6%) and 97.0% (95.4–98.1%) using EM and SR, respectively. Overall, 64.3% (60.6–67.9%) had suppressed viral loads. The specificities for EM and SR in predicting viral non‐suppression were 80.4% (73.6–85.7%) and 96.7% (93.3–98.4%), while the sensitivities were 22.9% (15.0–33.3%) and 1.8% (0.4–6.9%), respectively. The area under the curve was low for both EM and SR, at 53.6% (45.7–61.5%) and 56.2% (53.2–59.3%), respectively. There was high agreement (78%) between SR and EM in monitoring adherence.ConclusionsOur findings highlighted the need for strategies for sustained optimal adherence. SR and EM measure adherence with a considerable agreement; however, neither is an accurate predictor of virological outcome. There is still a need for an acceptable, feasible and affordable method that predicts viral suppression among ALHIV.