Introduction The Maternal Infant Health Outreach Worker (MIHOW) program is a home visiting program, utilizing peer mentors to improve maternal/child health outcomes in underserved communities. Findings are presented from a randomized clinical trial (RCT) testing the efficacy of the MIHOW model in a sample of Hispanic women in Tennessee. We hypothesized maternal and infant outcomes would be better in women assigned to MIHOW than women assigned to the minimal education intervention (MEI) group (receipt of educational materials). Methods Women entered the study during pregnancy (< 26 weeks gestation) and were followed through 6 months postpartum. A total of 188 women were enrolled and randomly assigned (MEI = 94; MIHOW = 94), with 178 women completing the study (MEI = 87; MIHOW = 91). Results Positive and statistically significant (p < 0.01) effects of MIHOW were observed on breastfeeding self-efficacy and exclusivity, levels of depressive symptoms and parenting stress, safe sleep practices, and infant stimulation in the home. No statistically significant differences were noted in number of prenatal visits. Discussion Results expand limited empiric evidence and provide strong support of the effectiveness of MIHOW on improving health outcomes in this sample of Hispanic mothers and their infants. MIHOW is a viable option for providing culturally sensitive services to immigrant and underserved families.

Findings are presented from focus group data collected during a larger study describing factors that inhibit, support, and sustain women's abilities to leave and stay out of abusive relationships. A subset (n = 24) of the larger study sample (N = 40) participated in one of four focus groups. Participants had left or were currently in abusive intimate relationships. Women reported diverse experiences and were in various stages of abusive relationships. Ages ranged from 21 to 51; 67% were Caucasian, and 20% African American. Most women (71%) had at least a high school education and were employed (60%), but 83% reported annual incomes less than $20,000. NVIVO software facilitated content analysis of transcriptions. After initial synthesis of data, 20 women participated in one of two confirmatory focus groups. Four primary themes emerged from the content analysis: (1) Living an Unnatural Experience included maladaptive physical and emotional responses to chronic violence; (2) The Experience of Telling included multiple intrapersonal, interpersonal, and societal barriers to disclosure; (3) The Experience of Leaving included descriptions of acute and long-term experiences and difficulties; and (4) Reducing Barriers included participant ideas on ways to reduce barriers to assistance. Recommendations are made to improve community interventions and programs that will facilitate the choices and enhance the successes of women who have experienced domestic violence.

This article identifies unmet needs and challenges of 37 families caring for children with special health care needs (CSHCN). Data were collected in focus groups. Data saturation occurred in the third group. Another group was conducted to ensure adequate inclusion of rural participants. Mean age of participants was 36 years. Most participants were women (92%), Caucasian (65%), high school graduates (89%), and employed, with 38% from rural communities. All families had health care insurance, primarily Medicaid (87%). An interdisciplinary team used NVIVO software to facilitate content analysis. Seven areas emerged: family support systems, early intervention/school systems, coordination of care, lack of knowledge, provider/family relationships, parent roles, and insurance systems. Caregivers noted the critical role of nurses but a lack of nurse presence in community care systems. This study adds to the multidimensional nature of caring for CSHCN and highlights the importance of considering how families interface with multiple community sectors.

Many of the studies regarding the effectiveness of the BFHI have been hampered by weak designs or methodologic limitations. Research conducted in the United States and employing experimental designs would help to more conclusively determine the effectiveness of the BFHI as an intervention to improve breastfeeding rates.

Depressive symptoms mediated the effects of childhood abuse, everyday stressors, and self-esteem and provided the linkage between these variables and at-risk parenting attitudes. Self-esteem decreased as everyday stressors increased but did not directly affect parenting attitudes. A relationship was not found between childhood abuse and low self-esteem. This study highlights the complexity of parenting and the need to identify other factors of at-risk parenting not accounted for in this study.