The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model

Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.

Naming my world: Finding my voice

This is a personal account of a sociological career over four decades, influenced by developments in Irish society and sociology. I focus on the growth of a feminist sociology, the stigmatisation of unmarried mothers, concealed stories and the changing treatment of ‘voice’ in sociological research.

Cardiovascular disease in people born to unmarried mothers in two historical periods: The Helsinki Birth Cohort Study 1934–1944

Aims:Socio-economic conditions in early life are important contributors to cardiovascular disease – the leading cause of mortality globally – in later life. We studied coronary heart disease (CHD) and stroke in adulthood among people born out of wedlock in two historical periods: before and during World War II in Finland. Methods: We compared offspring born out of wedlock before (1934–1939) and during (1940–1944) World War II with the offspring of married mothers in the Helsinki Birth Cohort Study. The war affected the position of unmarried mothers in society. We followed the study subjects from 1971 to 2014 and identified deaths and hospital admissions from CHD and stroke. Data were analysed using a Cox regression, adjusting for other childhood and adulthood socio-economic circumstances. Results: The rate of out-of-wedlock births was 240/4052 (5.9%) before World War II and 397/9197 (4.3%) during World War II. Among those born before World War II, out-of-wedlock birth was associated with an increased risk of stroke (hazard ratio (HR)=1.44; 95% confidence interval (CI) 1.00–2.07) and CHD (HR=1.37; 95% CI 1.02–1.86). Among those born out of wedlock during World War II, the risks of stroke (HR=0.89; 95% CI 0.58–1.36) and CHD (HR=0.70; 95% CI 0.48=1.03) were similar to those observed for the offspring of married mothers. The p-values for interaction of unmarried×World War II were ( p=0.015) for stroke and ( p=0.003) for CHD. Conclusions: In a society in which marriage is normative, being born out of wedlock is an important predictor of lifelong health disadvantage. However, this may change rapidly when societal circumstances change, such as during a war.

Parents’ Sleep Across Weekdays and Weekends: The Influence of Work, Housework, and Childcare Time

Children increase time demands with important consequences for sleep. Here, we test whether parents’ paid and unpaid time demands and the presence of young children equally reduce mothers’ and fathers’ sleep, comparing the married/cohabiting to unmarried. Applying data from the American Time Use Survey (ATUS, 2003–2016), we find married/cohabiting mothers report less sleep when young children or multiple children are present; they are employed; their spouses are employed; and they spend more time in housework and childcare. By contrast, unmarried mothers report less sleep when children are present because of their larger domestic loads. For married/cohabiting fathers, the presence of multiple children is associated with less sleep but doing more housework results in more sleep. Finally, unmarried fathers’ employment time explains the association of children on their sleep. Parents report a sleep deficit relative to the childless but the reasons vary by gender and the co-presence of a partner.