Understanding the impacts of child marriage on the health and well-being of adolescent girls and young women residing in urban areas in Egypt

Background Egypt has made progress in delaying age at marriage, but child marriage continues to be practiced in many places across the country. This study investigates the impacts of child marriage on the health and wellbeing of girls residing in urban Egypt using a multi-method approach. Methods The quantitative component leveraged data from the 2014 Egypt Demographic and Health Survey and focused on (1) reproductive health, (2) maternal health and (3) social outcomes among a subsample of ever-married urban women ages 20–24 (N = 1041). Simple and multivariable logistic regressions were used to estimate prevalence odds ratios and 95% confidence intervals for associations between child marriage and the three sets of outcomes. The qualitative component drew from 11 focus groups, 23 in-depth interviews, and 13 key informant interviews conducted in three urban sites in Egypt. The data was thematically analyzed using a combination of inductive and deductive coding. Results The prevalence of marriage under age 18 was 13.22%. Child marriage was significantly associated with ever use of contraception (Adjusted Odds Ratio (AOR) 2.95 95% CI 1.67–5.19), multiple births (AOR 12.93 95% CI 5.45–30.72), rapid repeat childbirth (AOR 2.20 95% CI 1.34–3.63), and pregnancy termination (AOR 1.89 95% CI 1.11–3.23). Many of these associations disappeared after adjusting for marriage duration. Girls married under age 18 had larger spousal age gaps (AOR 2.06; 95% CI 1.24–3.41) and higher odds of FGM (AOR 2.14; 95% CI 1.11–4.13). They were significantly more likely to report receiving no ANC care (AOR 0.39; 95% CI 0.19–0.80), and less likely to deliver through C-section (AOR: 0.53; 95% CI 0.34–0.83). Consequences emerging from the qualitative data centered around five themes: (1) Access to and use of sexual and reproductive health services; (2) exposure to FGM; (3) marriage and birth registration; (4) marital relations; and (5) relationship with in-laws. Conclusion Findings provide important insights into the practice of child marriage in urban areas in Egypt and illustrate a range of adverse consequences associated with the practice.

Veteran families with complex needs: a qualitative study of the veterans’ support system

Background Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system. Methods The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. Results Both service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. Conclusion The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

Super-Spreaders or Victims of Circumstance? Childhood in Canadian Media Reporting of the COVID-19 Pandemic: A Critical Content Analysis

This qualitative research study, a critical content analysis, explores Canadian media reporting of childhood in Canada during the COVID-19 global pandemic. Popular media plays an important role in representing and perpetuating the dominant social discourse in highly literate societies. In Canadian media, the effects of the pandemic on children and adolescents’ health and wellbeing are overshadowed by discussions of the potential risk they pose to adults. The results of this empirical research highlight how young people in Canada have been uniquely impacted by the COVID-19 global pandemic. Two dominant narratives emerged from the data: children were presented “as a risk” to vulnerable persons and older adults and “at risk” of adverse health outcomes from contracting COVID-19 and from pandemic lockdown restrictions. This reflects how childhood was constructed in Canadian society during the pandemic, particularly how children’s experiences are described in relation to adults. Throughout the pandemic, media reports emphasized the role of young people’s compliance with public health measures to prevent the spread of COVID-19 and save the lives of older persons.

The Secondary Harms of Parental Substance Use on Children’s Educational Outcomes: A Review

Parental substance use, that is alcohol and illicit drugs, can have a deleterious impact on child health and wellbeing. An area that can be affected by parental substance use is the educational outcomes of children. Current reviews of the literature in the field of parental substance use and children's educational outcomes have only identified a small number of studies, and most focus on children's educational attainment. To grasp the available literature, the method from Arksey and O’Malley (2005) was used to identify literature. Studies were included if they were empirical, after 1950, and focused on children’s school or educational outcomes. From this, 51 empirical studies were identified which examined the relationship between parental alcohol and illicit drug use on children’s educational outcomes. Five main themes emerged which included attainment, behavior and adjustment, attendance, school enjoyment and satisfaction, academic self-concept, along with other miscellaneous outcomes. This paper highlights the main findings of the studies, the gaps in the current literature, and the challenges presented. Recommendations are made for further research and interventions in the areas of parental substance use and child educational outcomes specifically, but also for broader areas of adversity and child wellbeing.

Public Perceptions of Local Parks and Recreation as an Essential Community Service During the COVID-19 Pandemic

Local residents are the primary stakeholder for municipal parks and recreation who have the potential to influence funding and policy through their participation, voting, and advocacy. Research has suggested that individuals are more likely to support parks and recreation and view them as essential when they perceive they provide benefits that address their own as well as broader community needs. This panel study investigated Pennsylvania residents and the extent they considered parks and recreation an essential community service during the COVID-19 pandemic. It further assessed the rationale for why parks and recreation were considered either essential or non-essential during this time period. A majority of respondents (54%) felt local parks and recreation were an essential service in their community during the pandemic based primarily on their perceived contributions to physical health, mental health and wellbeing, and the safe provision of recreation opportunities. Conversely, parks and recreation were considered non-essential when they had been closed, when individuals were unsure of what services were actually provided during the pandemic, or they were perceived as unsafe or unsanitary given the presence of COVID-19. Findings provide evidence of the contributions provided by local parks and recreation during the COVID-19 pandemic and suggest influenceable factors associated with perceptions of whether parks and recreation are an essential community service.

The helpfulness of web-based mental health and wellbeing forums for providing peer support for young people: A cross-sectional exploration (Preprint)

BACKGROUND Young people are increasingly going online to seek out web-based support for their mental health and wellbeing. Peer support forums are popular with this age group, with young individuals valuing the fact that they are available 24/7, providing a safe and anonymous space for exploration. Currently, little systematic evaluation of the helpfulness of such groups in providing support has been conducted. OBJECTIVE This study examines the helpfulness of the support offered within web-based peer support forums for young people. It specifically investigates the self-reported user-ratings of helpfulness reported through the completion of a developing experience measure. The ratings are used to consider the further development of the measure and to reflect upon the overall helpfulness of the forums as indicated by the reported scores. METHODS The study makes use of routinely collected practice-based outcome data from online mental health forums for young people. These forums are hosted by the UK based web-based therapy and support service, Kooth.com. A cross-sectional design has been employed to explore the outcomes that have been reported by those accessing the forums using a Peer Online Community Experience Measure (POCEM). To consider the helpfulness in general, a total of 23,443 completed POCEMs from the 2020 calendar year were used. A second dataset of 17,137 completed POCEMs from the same year was used to consider whether other indicators, such as the time of day of the post, had an impact upon the helpfulness rating. RESULTS Female users between the ages of 11 and 16 predominantly completed the POCEM. This is in keeping with the majority of those using the service. 74.6% of the scores on the POCEM indicated the individuals found the posts helpful, and there was some indication that males were more likely to report obtaining intrapersonal support, whilst females obtained interpersonal support. Further, the POCEM scores reflected the internal consistency of the measure and provided an insight into the way that young people made use of the peer support resource. For instance, posts were rated more helpful if individuals spent a longer time reading them, and the topics discussed changed throughout the day with more mental health issues being discussed later at night. CONCLUSIONS The results appear to demonstrate that overall, the young people involved in this study found web-based peer support helpful. They indicate that that peer support can provide an important strand of care within a supportive mental health ecosystem, particularly during time periods when in-person support is typically closed. However, caution is needed when interpreting the results of this study. Whilst such services are incredibly well used, they have received little research attention to date. As such, further investigation into what constitutes helpful and unhelpful peer support is needed.

Monitoring and Understanding Urban Transformation: A Mixed Method Approach

Cities must address many challenges including air quality, climate change and the health and wellbeing of communities. Public authorities and developers increasingly look to improve these through the implementation of interventions and innovations, such as low traffic neighbourhoods, deep housing retrofits and green infrastructure. Monitoring the impacts of interventions is essential to determine the success of such projects and to build evidence for broader urban transformation. In this paper we present a mixed-method cross-disciplinary approach that brings together cutting edge atmospheric and data science, measurements of activity in public spaces and novel methods to assess wellbeing-promoting behaviours. The Manchester Urban Observatory focuses on living areas that have a high density of inter-related systems, which require observation, understanding and intervention at multiple levels. This must be completed in line with urban planning goals as well as a clear and succinct data solution that allows robust scientific conclusions to be made and viewed in real time. Delivery of such a monitoring strategy is not trivial and is time, resource and expertise heavy. This paper discusses the methods employed by the Manchester Urban Observatory to monitor the effectiveness off interventions implemented within cities and effective communication strategies with local communities.

Barriers to initiating and maintaining participation in parkrun

Interventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43% who register never participate in a parkrun event. This research had two objectives; i) explore the demographics of people who register for parkrun in United Kingdom, Australia, Ireland, and don’t initiate or maintain participation ii) understand the barriers to participating in parkrun amongst these people. Mandatory data at parkrun registration provided demographic characteristics of parkrun registrants. A bespoke online survey distributed across the three countries captured the reasons for not participating or only participating once. Of 680,255 parkrun registrants between 2017 and 19, 293,542 (43%) did not participate in any parkrun events and 147,148 (22%) only participated in one parkrun event. Females, 16–34 years and physically inactive were more likely to not participate or not return to parkrun. Inconvenient start time was the most frequently reported barrier to participating, with females more likely than males to report the psychological barrier of feeling too unfit to participate. Co-creating strategies with and for people living with a chronic disease, women, young adults, and physically inactive people, could increase physical activity participation within parkrun.