Objective-To understand perceptions, beliefs, and experiences about breastfeeding in Marshallese mothers residing in Northwest Arkansas.Design-A qualitative, exploratory study using a brief survey and focus groups. Marshallese women, 18 years or older who have a child under seven years of age were included in the study. A total of 31 participants were interviewed in five focus groups. In addition, four native Marshallese community health workers who work with Marshallese mothers participated in a sixth focus group. Setting-Community-based organization in Northwest Arkansas.Results-The majority of mothers viewed breast milk as superior to formula, but had concerns about adequate milk supply and the nutritional value of their milk. The primary barriers to exclusive breastfeeding in the United States included public shaming -both verbal and non-verbal, perceived milk production and quality, and maternal employment. Participants report that these barriers are not experienced in the Marshall Islands and are encountered after moving to the United States. Breastfeeding mothers rely heavily on familial support, especially the eldest female, who may not reside in the United States. Institutions, including the Women, Infants, and Children (WIC) program influence is strong and may negatively affect breastfeeding.Conclusions-Despite the belief that breast milk is the healthiest option, breastfeeding among Marshallese mothers is challenged by numerous barriers they encounter as they assimilate to US cultural norms. The barriers and challenges, along with the strong desire to assimilate to US culture, impact Marshallese mothers' perceptions, beliefs, and experiences with breastfeeding.
Background Utilizing standardized patients (SPs) as a strategy to potentially improve beginning level nursing students’ confidence, satisfaction, and communication after simulated clinical cases is an innovative approach in nursing education. Aim The aim of this study was to examine to what extent an SP affected first semester nursing students’ self-confidence, satisfaction, and communication using a simulated clinical case. Methods First semester undergraduate students in a bachelors of nursing program at a large university in the South-Central region of the United States ( N = 100), were randomly assigned to one of the two groups. Each group was assigned the same case using either an SP or high-fidelity manikin. Students completed postsurveys immediately following completion of the simulation. Student’s self-confidence, satisfaction, and communication were measured using the National League for Nursing Student Satisfaction and Self-Confidence in Learning for Nursing Education Research and an SP/Faculty Communication Checklist. Results An independent sample t test comparing the two student groups on each of the outcome variables was conducted for each of the research questions. Students who completed the simulation with an SP, reported greater satisfaction, and improved communication. Student reflective comments were significantly more positive in the SP group. There was no statistical difference between the two groups in self-confidence. Conclusion Further research is needed to determine whether the use of SPs versus high-fidelity manikins in simulated cases results in increased self-confidence in beginning level nursing students. Student satisfaction and communication are key components for nursing student success. The impact of SPs and the effect on student outcomes could have long-term benefits for undergraduate nursing programs.
Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.
Introduction:Obesity affects more than 40 million children globally. Efforts to promote proper nutrition in an attempt to reduce childhood obesity should consider maternal beliefs and cultural customs around food. Little is known regarding child feeding, including weaning practices and foods consumed in the first years of life among Marshallese children, a sub-group of Pacific Islanders, residing in the United States.Methods:This study aims to explore the influences on introduction of complementary foods among Marshallese mothers and caregivers residing in the United States, to serve as the basis for promotion of improved nutrition. Focus groups and demographic surveys were conducted with Marshallese mothers and caregivers (N = 27) to explore child-feeding beliefs, perceptions, and practices.Results:All mothers reported breastfeeding their infants, and 80% reported using some type of milk supplementation. There was a difference in mother and caregiver responses regarding which first foods to introduce and average age of introduction.Discussion:Analysis revealed three themes identified as being influential for child-feeding practices: Marshallese breastfeeding customs, introduction of solid foods, and Marshallese family feeding customs.
ObjectiveThe present study aimed to examine the key influences on infant and child feeding practices among a Marshallese community at each social ecological level. It is the first study to examine the key influences on infant and child feeding practices with Marshallese immigrant women in the USA and helps fill a gap in the previous literature that has included other immigrant women.DesignCommunity-based participatory research design with twenty-seven participants taking part in four qualitative focus groups.SettingThe study took place within the Marshallese community in Arkansas, USA.ParticipantsParticipants included Marshallese women with children aged 1–3 years and/or caregivers. Caregivers were defined as someone other than the parent who cares for children. Caregivers were often older women in the Marshallese community.ResultsThere were five primary themes within multiple levels of the Social Ecological Model. At the intrapersonal level, mothers’ and caregivers’ autonomy emerged. At the interpersonal level, child-led and familial influences emerged. At the organizational level, health-care provider influences emerged; and at the policy level, the Special Supplemental Nutrition Program for Women, Infants, and Children emerged as the most salient influence.ConclusionsMarshallese immigrant women’s infant and child feeding practices are influenced at intrapersonal, interpersonal, organizational and policy levels. Understanding these multidimensional influences is necessary to inform the creation of culturally tailored interventions to reduce health disparities within the Marshallese community.
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