The examination of both parents' and nurses' expectations and attitudes towards parental participation in the care of ill children in a community hospital, non-specialty setting was undertaken in this exploratory, qualitative research study within Australia. First, in this triangulated research study, 14 in-depth interviews with parents were carried out about their participation in the care of their ill children. Content analysis revealed that the four main themes were to do with parental factors including control, expectations, support and emotion; communication; the importance of being with your child; and the fact that mothers do the mothering and nurses do the nursing. Two focus group sessions were held with paediatric nursing staff. Content analysis confirmed real communication problems between nurses and parents. Implications that arose for nursing practice were for in-service workshops to improve communication between nurses and families as well as workshops to prepare students of university nursing programmes offering paediatric electives.

The Health Belief Model (HBM) was reviewed with the aim of modifying it so that it reflected a health promotion stance for young families. Since this model's inception, health professionals like nurses have been involved in using the HBM to guide their practice. It is argued that to assist families, nurses now need a model that is focused on "health." In support of this approach, reorienting the HBM and basing it on "positive" health definitions associated with health promotion, by modifying it through adding the constructs "perceived behavioral control" (representing health locus of control) and "behavioral intention" from Ajzen will provide nurses with a more appropriate and useful model for interacting with families and their preschool children. A summary of positive and negative aspects of the modification of the HBM is presented, followed by a strategy for the process of validating the revised HBM for young families.

Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

This qualitative, descriptive study first explored parents' concept of health and then examined the health practices they undertook for their preschool-aged children. The purposive sample of 11 parent couples and 3 single parents (14 parent sets in total) with preschool-aged children attending long daycare and preschool/kindergarten centers was equally distributed between parents from two different socioeconomic groups in two suburbs of western Sydney, Australia. Consenting parents were interviewed and transcripts were analyzed concurrently in accordance with a grounded theory approach (Glaser Strauss, 1967). Results revealed the presence of three themes, and practice implications for community nurses stem from them. These themes were Educating About Family Health, The Dynamic, Multidimensional Nature of Teaching Child Health Behavior, and The Intergenerational Theme. There was only minimal support for health-related socioeconomic differences. The study also found that most families with preschool-aged children were engaged in illness prevention rather than health promotion. Unlike those families focused on illness prevention, families focused on a health promotion mode were more sophisticated in their educational strategies and used more educational strategies associated with developing their child's health behaviors. This research validated the importance of the intergenerational transmission of values, particularly by mothers. The health behaviors that mothers considered important, and that they reinforced with their children, were transmitted equally to their daughters and sons.

By modifying the Health Belief Model (HBM) nurses can provide health promotion guidance for families through the revised HBM for young families. The constructs 'perceived behavioral control' and 'behavioral intention' from Ajzen's Theory of Planned Behavior were added to the HBM to provide a health orientation. An initial qualitative study informed the second quantitative study through thematic data obtained by interviewing parents about family health. The second comparative study of low and high socioeconomic status families of preschool-aged children living in western Sydney, Australia, measured family health through the Parental Health Behavior Questionnaire (PHBQ). After a small pilot study, the researcher distributed 150 questionnaires to center directors from preschools, kindergartens and long day care, who then handed out questionnaires to interested parents. Data collection occurred in 1998 with consenting parents returning the questionnaires for collection by the researchers. A convenience sample of 103 was obtained with a 69% return rate. Analysis was undertaken through MANCOVA. Justification for validity occurred through logical analysis and hypothesis testing, based on the literature, while reliability was acknowledged by undertaking Cronbach coefficient alphas on small variable clusters. Results support the constructs 'perceived behavioral control' and 'behavioral intention' in the revised model, suggesting that for families of different socioeconomic background, differences emerge in terms of their perceived control over their child's health and the initiation of health behaviors for their child. Recommendations for further research are for refinement of the PHBQ, new research with different families, and further testing of all the model constructs.