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This longitudinal descriptive study compared the adjustment to new parenthood in two groups of first-time mothers and fathers. Participants included 106 married couples, 58 (55%) who attended prenatal childbirth education classes and 48 (45%) who did not. The study variables included prenatal, intrapartal, and new parent experiences. All mothers and fathers completed questionnaires during the last trimester of pregnancy and one month after delivery of a healthy newborn. Fathers were present during labor and birth regardless of prenatal class attendance. The groups differed in maternal age and in maternal andpaternal education levels, but did not direr in measures ofprenatal attachment, paternal childbirth involvement, childbirth satisfaction, parenting sense of competence, and ease of transition to parenthood. The results suggest the need for further study of the influence of prenatal classes on becoming a new parent, and of the effects of the father S presence during childbirth on birth and new parent experiences. (BIRTH 22:1, March 1995)Adjustment to parenthood is a time of stress for firsttime parents, and attendance at prenatal childbirth education classes is believed to prepare them for this transition. It has been estimated, however, that approximately 50 percent of expectant couples do not attend prenatal classes, and those from lower socioeconomic groups are less likely to attend than middle-and upperincome couples (1-6). Despite the importance attached to prenatal classes, few studies have compared attenders with nonattenders to examine the psychosocial variables related to prenatal, intrapartal, and new parent factors reported to affect adjustment (3). Couples choose to attend childbirth education classes for many reasons (24,7), and although some explanations relate

A paucity of prenatal data is available concerning prenatal experiences of primigravid women compared with those of multigravid women. Therefore, the objectives of this study were twofold: to compare prenatal personal (demographic and other descriptive elements, including self-esteem) and psychosocial variables (maternal-fetal attachment, marital satisfaction) and to describe perceived pregnancy experiences for both primigravid and multigravid women. Both quantitative and qualitative data were collected using a descriptive mixed-methods design. The data were part of a larger, longitudinal study focused on adjustment to parenthood in military and civilian couples. Married pregnant women who resided on the east and west coasts of the United States were recruited from prenatal care facilities. Participants included 50 pregnant primigravid and 50 multigravid married women recruited during the last trimester of a healthy, uncomplicated pregnancy. The main outcome measures included personal and psychosocial variables (demographics, self-esteem, maternal-fetal attachment, marital satisfaction) and perceived pregnancy experiences. Multigravid women had significantly lower levels of maternal-fetal attachment (p < .00) and marital satisfaction (p < .00) than did primigravid women during their third trimester of pregnancy. The pregnant women's responses clearly reveal that unique and distinct differences exist between the needs of primigravid women and those of multigravid women. Innovative prenatal educational interventions tailored to meet the distinct needs of primigravid and multigravid women are suggested.

The purpose of this project was to evaluate the efficacy of group diabetes care for an underserved population using a patient-centered approach with the inclusion of interactive diabetes self-management education. In place of the traditional office visit, patients attended three group visits. Improvements in diabetes knowledge and patient-perceived self-efficacy resulted.

Pediatric obesity has risen dramatically in the United States during the last two decades; it is a significant child health problem that is preventable and largely under-diagnosed and under-treated. It is essential to discuss prevention of obesity with parents at every well-child visit; treatment should be initiated when patterns of weight gain exceed established percentiles for increasing height for age and gender.

Evaluation research and outcomes measurement in the arena of behavioral health services for children must be adapted for the community agency setting. Through evaluation research, it is possible to address service goals as well as more traditional academic research goals. This article examines a variety of activities that have been implemented to evaluate children’s behavioral and educational services in a Northern California non-profit community agency. It is noted that there are multiple formats for collecting information from and providing comments to children’s parents, their clinicians, and program administration staff, all of which can be used to effectively address service-focused evaluation research goals. Challenges to doing scientifically rigorous research in a community setting require additional considerations regarding organizational culture and structure. Based on the experiences of the authors and the experiences of others, the article describes general principles that can guide evaluation research and outcomes measurement with children and their families in the community health agency setting.

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L earning teams were developed to promote active learning among students in distance education. This is a teaching-learning strategy that was adapted from collaborative and team-based learning concepts. In an online environment, promoting active learning is a challenge as students, often in large class sizes, work independently rather than meeting regularly in a traditional classroom. Collaborative learning enhances motivation to learn, knowledge retention, and understanding of content in a variety of classroom settings. 1-4 Learning teams were implemented to promote active learning, increase student engagement and collaboration, and efficiently manage large class sizes. The purpose of this column is to describe the use of learning teams as a teaching-learning strategy in distance education graduate nursing courses. Learning Team Instructional MethodThe learning team instructional method described here included 3 steps: preterm learning team formation, mastery of course objectives as learning teams, and evaluation of the experience. 4 Course announcements were posted prior to the beginning of the term to describe the concepts and advantages of collaborative learning, with ways the courses would use learning teams to enhance learning and maximize connection to peers. Course requirements included the following: all course assignments would be completed by learning teams, learning teams would consist of 3 students, and requests for specific learning team partners could be made in advance of the new term. If students did not request learning team partners, faculty assigned students to a team.At the start of the term, all students reviewed the course learning team policy that outlined faculty expectations and student responsibilities. Faculty expectations included that each learning team partner would participate fully in course work through group discussions about course content and by equal contribution to completing assignments. Student responsibilities included planning for course due dates, synthesizing course content through required reading and written assignments, and exchanging constructive feedback with learning team partners. A written collaboration statement on each submitted assignment indicated that all students contributed equally to and agreed with the final submitted assignment.At the end of each course, students were invited to evaluate their learning team experience. Students were asked to write a reflection about advantages and disadvantages of participating in learning teams to complete course assignments. Student reflections provided narrative data that were used to evaluate learning teams as a teaching-learning strategy. In addition to written student reflections, 5 faculty were interviewed to provide their perceptions of advantages and disadvantages of teaching in courses using learning teams. Faculty narrative data were also used to evaluate the teachinglearning strategy.Institutional review board approval was provided by the university to use the anonymous written student reflections and obta...