GHD

ABSTRACT Little is known about the social context behind women's experiences concerning booking and antenatal care. In this study, women's narratives revealed that reasons for booking late are varied and sometimes complex. Personal non-acceptance of pregnancy, demanding social circumstances and supply-side circumstances such as administrative delays and inefficient communications are contributing factors. Some women booking late found that, once booked, little effort was made to actively retain contact. Other women reported lack of continuity of carer, language and communication issues as well as judgmental attitudes. Overall trust of the service was influenced by hospital reputation, previous experiences and staff behaviours. Disappointment was resolved by seeking care elsewhere in the subsequent pregnancy. It was concluded that maternity services should use late booking as a signal for tailored attention. Services need to be flexible and engaging and alternative communication strategies such as text messaging and use of email employed to inform women about timely booking.

Health services research practices in the context of ethnic and cultural diversity are under scrutiny. One issue that needs to be considered is that of inclusion in, and exclusion from, research studies on the basis of language ability. We explore current reporting practice concerning recruitment of participants in health services research using examples from one 'high impact' journal and suggest ways in which future reporting can be strengthened. Retrospective review of 207 'original research pieces' published in the BMJ. articles published in 2003 and 2004 reporting research entailing direct communication between a researcher and health service users. A data extraction checklist was applied concerning the reporting of language-related decisions in recruitment. Eighty-four percent of the research articles did not engage with language issues at all. For most papers it was impossible to ascertain whether research was carried out in a monolingual population or whether ...

ABSTRACT Little is known about the social context behind women's experiences concerning booking and antenatal care. In this study, women's narratives revealed that reasons for booking late are varied and sometimes complex. Personal non-acceptance of pregnancy, demanding social circumstances and supply-side circumstances such as administrative delays and inefficient communications are contributing factors. Some women booking late found that, once booked, little effort was made to actively retain contact. Other women reported lack of continuity of carer, language and communication issues as well as judgmental attitudes. Overall trust of the service was influenced by hospital reputation, previous experiences and staff behaviours. Disappointment was resolved by seeking care elsewhere in the subsequent pregnancy. It was concluded that maternity services should use late booking as a signal for tailored attention. Services need to be flexible and engaging and alternative communication strategies such as text messaging and use of email employed to inform women about timely booking.

Health services research practices in the context of ethnic and cultural diversity are under scrutiny. One issue that needs to be considered is that of inclusion in, and exclusion from, research studies on the basis of language ability. We explore current reporting practice concerning recruitment of participants in health services research using examples from one 'high impact' journal and suggest ways in which future reporting can be strengthened. Retrospective review of 207 'original research pieces' published in the BMJ. articles published in 2003 and 2004 reporting research entailing direct communication between a researcher and health service users. A data extraction checklist was applied concerning the reporting of language-related decisions in recruitment. Eighty-four percent of the research articles did not engage with language issues at all. For most papers it was impossible to ascertain whether research was carried out in a monolingual population or whether researchers had effectively excluded non-primary language speakers in their recruitment procedures. Over half (n=34) of the papers that mentioned language did so in relation to exclusion criteria, usually without further comment. Reporting practice on language-related decisions in recruitment and on the exclusion of research participants on grounds of language ability needs to be improved. A checklist for authors, reviewers or editors is offered with the aim of encouraging fuller reporting on the language composition of source and sample populations, and greater consideration of any implications that exclusion/inclusion on the grounds of language may have for studies and their findings.

Art interventions may provide a cost-effective approach to improving mental well-being. Most evaluations concentrate on intervention characteristics and little is known about other factors which might contribute to successful outcomes. This pre-and-post intervention mixed-methods study explored influences on differential changes in measured well-being among participants of an Arts on Referral (AoR) scheme in the UK. Measured well-being scores of 44 volunteers and findings from six semi-structured interviews were triangulated. Mean well-being scores improved by 8.0 (95% CI 4.8-11.3, P < 0.0001); the number of sessions attended and baseline scores were positively associated with outcome score. Participants from Black and Minority Ethnic (BME) groups and females appeared to show greater improvement in well-being scores than White British or male participants. Qualitative interviews supported and further explained these findings and suggested differential impacts of AoR may, in part, be explained by the importance of sharing experiences, reduced social isolation and external stressors. This study supports the use of AoR interventions for improving well-being among those facing short- and long-term mental health challenges. However, given the reduced sample size and the pre-post design results should be interpreted with caution and potential differences between ethnic groups and genders should be further explored.

This study explored women’s experiences of being screened for intimate partner violence and receiving an intervention during perinatal home visits in urban and rural settings in the USA. Twenty-six women were recruited from the DOVE (Domestic Violence Enhanced Home Visit) intervention trial to participate in a nested qualitative interpretive study. Women valued the opportunity to discuss their intimate partner violence experiences and access support. Disclosure was a staged process and home visitor communication style and the development of a trusting relationship were influencing factors. Safety planning was an important feature of the DOVE intervention, whether the abuse was past or ongoing. Women highlighted the need for post-abuse support services. Perinatal home visitors require training in intimate partner violence that supports the development of good communication skills and provides opportunities for experiential learning and feedback with regards to asking about and responding to intimate partner violence. Reinforcement training activities are necessary in order to enhance home visitor’s confidence and comfort, and sustain practice. Rigorous protocols are needed to ensure the safety of home visitors and women.

Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men participated in a Health and Relationship Survey in a U.K. sexual health service and 19 in an interview. Quantitative and qualitative data were analyzed separately and integrated at the level of interpretation and reporting. There were inconsistencies in perceptions and reports of abuse. Men were supportive of selective enquiry for domestic violence and abuse by practitioners (62.6%; 95% confidence interval = 58.1% to 66.7%) while being mindful of contextual factors.