A stakeholder process evaluation of a social marketing walking intervention targeting children

One quarter of Australian children are overweight or obese (ABS, 2010), putting them at increased risk of physical and psychological health problems (Reilly et al., 2003). Overweight and obesity in childhood tends to persist into adulthood and is associated with premature death and morbidity (Reilly & Kelly, 2011). Increases in Australian children’s weight have coincided with declines in active transportation, such as walking, to school (Salmon et al., 2005). To address this problem, the Victorian Health Promotion Foundation (VicHealth), which is an independent statutory authority which advises government and contributes to promoting good health in Victoria (VicHealth, 2014), developed the Walk to School program. Walk to School aims to encourage primary school children in Victoria to walk to and from school more often. Walking to school is a low cost and effective means of reducing excess weight (Rosenberg et al., 2006) that can be easily integrated into daily routine (Brophy et al., 2011). The purpose of this paper is to present the results of the stakeholder process evaluation of Walk to School 2013, which forms part of a broader outcome evaluation that is currently in field. Although there is an emphasis on outcome evaluation of programs, process evaluation can be equally important in determining program success (Saunders et al., 2005). Further, process evaluation to assess program delivery and utilization is explicitly recommended by two social marketing frameworks (see Lefebvre et al., 1988; Walsh et al., 1993).

Students’ well-being and social connections

Description of Workshop/Poster Presentation This presentation will showcase CORE Connections – ‘Creating Opportunities for Resilience and Engagement’ – which is a whole-school approach to mental health promotion. While initially designed to prevent adolescent depression and substance abuse, current thinking suggests that competency enhancement (e.g., autonomy, competence, supportive networks) more widely improves students’ well-being, educational engagement, and learning outcomes. In the presentation, we will provide an overview of the CORE project, describe the CORE intervention, which is conceptualized as a dynamic and penetrating process of social practices, present some preliminary findings from the pilot phase of CORE, and conclude our presentation with an interactive section with the participants. This project will highlight a wellness focus that addresses social engagement within whole school cultures. Purpose of the Presentation Student mental and physical well-being has gained increasing attention. Our presentation will introduce the CORE project, which has a potential to decrease student depression, anxiety, and substance use, and to increase student self-esteem and learning outcomes. In this vein, our presentation will raise the public awareness of the salient role of social connection in student well-being. Specifically, a group of presenters will discuss the impact of social connection on students’ anxiety, mathematics achievement, and perceived racial discrimination. • We will present participants with an alternative way to conceptualize and approach mental health promotion within a school context. In contrast to prescribed programs that are commonly used in today’s schools, CORE is a whole-school approach that is flexibly integrated into all aspects of the classroom and school environment. Our aim is to illustrate the intervention principles of CORE while highlighting examples of mental health outcomes/transformation. • Underutilized in mental health promotion research, social network analysis provides critical information in understanding relationships between social cohesion (e.g., a student’s connectedness to others) and mental health outcomes. This session will showcase how focusing on and strengthening social connections in and out of school can contribute to student well-being, achievement, and mental health. Educational Objectives By the end of the presentation, participants will • obtain a general overview of the CORE program, • understand how psychological health and school performance relate to student well-being, • and understand how social connections in and out of school can contribute to student well-being. Interactive / Participatory Component We will invite audience members to discuss inhibitors and contributors to student well-being and the best ways for schools to help students feel safe, connected, and valued. Presentation Key Points • Overview of the CORE project • Theorization of social connection • Some empirical studies emerging from CORE • Presenter-audience interaction Evidence of Relevance and Utility to Participants Potential participants are adults with significant relationships with students, either as family members, community neighbors, educators, scholars, service providers, or policy makers. Our presentation will inspire these significant adults to construct a welcoming society to help improve student well-being.

Feasibility of an in-patient exercise intervention for children undergoing haematopoietic stem cell transplant

With improving survival rates following HSCT in children, QOL and management of short- and long-term effects need to be considered. Exercise may help mitigate fatigue and declines in fitness and strength. The aims of this study were to assess the feasibility of an inpatient exercise intervention for children undergoing HSCT and observe the changes in physical and psychological health. Fourteen patients were recruited, mean age 10 yr. A 6MWT, isometric upper and lower body strength, balance, fatigue, and QOL were assessed prior to Tx and six wk post-Tx. A supervised exercise program was offered five days per week during the inpatient period and feasibility assessed through uptake rate. The study had 100% program completion and 60% uptake rate of exercise sessions. The mean (±s.d.) weekly activity was 117.5 (±79.3) minutes. Younger children performed significantly more minutes of exercise than adolescents. At reassessment, strength and fatigue were stabilized while aerobic fitness and balance decreased. QOL revealed a non-statistical trend towards improvement. No exercise-related adverse events were reported. A supervised inpatient exercise program is safe and feasible, with potential physiological and psychosocial benefits.

The Nature, Origins, and Consequences of Finnish Shame-Proneness: A Grounded Theory Study

Although shame is a universal human emotion and is one of the most difficult emotions to overcome, its origins and nature as well as its effects on psychosocial functioning are not well understood or defined. While psychological and spiritual counselors are aware of the effects and consequences of shame for an individual s internal well-being and social life, shame is often still considered a taboo topic and is not given adequate attention. This study aims to explain the developmental process and effects of shame and shame-proneness for individuals and provide tools for practitioners to work more effectively with their clients who struggle with shame. This study presents the empirical foundation for a grounded theory that describes and explains the nature, origins, and consequences of shame-proneness. The study focused on Finnish participants childhood, adolescence and adulthood experiences and why they developed shame-proneness, what it meant for them as children and adolescents and what it meant for them as adults. The data collection phase of this study began in 2000. The participants were recruited through advertisements in local and country-wide newspapers and magazines. Altogether 325 people responded to the advertisements by sending an essay concerning their shame and guilt experiences. For the present study, 135 essays were selected and from those who sent an essay 19 were selected for in-depth interviews. In addition to essays and interviews, participants personal notebooks and childhood hospital and medical reports as well as their scores on the Internalized Shame Scale were analyzed. The development of shame-proneness and significant experiences and events during childhood and adolescence (e.g., health, parenting and parents behavior, humiliation, bullying, neglect, maltreatment and abuse) are discussed and the connections of shame-proneness to psychological concepts such as self-esteem, attachment, perfectionism, narcissism, submissiveness, pleasing others, heightened interpersonal subjectivity, and codependence are explained. Relationships and effects of shame-proneness on guilt, spirituality, temperament, coping strategies, defenses, personality formation and psychological health are also explicated. In addition, shame expressions and the development of shame triggers as well as internalized and externalized shame are clarified. These connections and developments are represented by the core category lack of gaining love, validation and protection as the authentic self. The conclusions drawn from the study include a categorization of shame-prone Finnish people according to their childhood and adolescent experiences and the characteristics of their shame-proneness and personality. Implications for psychological and spiritual counseling are also discussed. Key words: shame, internalized shame, external shame, shame development, shame triggers, guilt, self-esteem, attachment, narcissism, perfectionism, submissiveness, codependence, childhood neglect, childhood abuse, childhood maltreatment, emotional abuse, sexual abuse, spiritual abuse, psychological well-being

Very Low Birth Weight Infants as Young Adults : Focus on aspects of cognition, behavior and sleep

Major advances in the treatment of preterm infants have occurred during the last three decades. Survival rates have increased, and the first generations of preterm infants born at very low birth weight (VLBW; less than 1500 g) who profited from modern neonatal intensive care are now in young adulthood. The literature shows that VLBW children achieve on average lower scores on cognitive tests, even after exclusion of individuals with obvious neurosensory deficits. Evidence also exists for an increased risk in VLBW children for various neuropsychiatric disorders such as attention-deficit hyperactivity disorder (ADHD) and related behavioral symptoms. Up till now, studies extending into adulthood are sparse, and it remains to be seen whether these problems persist into adulthood. The aim of this thesis was to study ADHD-related symptoms and cognitive and executive functioning in young adults born at VLBW. In addition, we aimed to study sleep disturbances, known to adversely affect both cognition and attention. We hypothesized that preterm birth at VLBW interferes with early brain development in a way that alters the neuropsychological phenotype; this may manifest itself as ADHD symptoms and impaired cognitive abilities in young adulthood. In this cohort study from a geographically defined region, we studied 166 VLBW adults and 172 term-born controls born from 1978 through 1985. At ages 18 to 27 years, the study participants took part in a clinic study during which their physical and psychological health was assessed in detail. Three years later, 213 of these individuals participated in a follow-up. The current study is part of a larger research project (The Helsinki Study of Very Low Birth Weight Adults), and the measurements of interest for this particular study include the following: 1) The Adult Problem Questionnaire (APQ), a self-rating scale of ADHD-related symptoms in adults; 2) A computerized cognitive test battery designed for population studies (CogState®) which measures core cognitive abilities such as reaction time, working memory, and visual learning; 3) Sleep assessment by actigraphy, the Basic Nordic Sleep Questionnaire, and the Morningness-Eveningness Questionnaire. Actigraphs are wrist-worn accelerometers that separate sleep from wakefulness by registering body movements. Contrary to expectations, VLBW adults as a group reported no more ADHD-related behavioral symptoms than did controls. Further subdivision of the VLBW group into SGA (small for gestational age) and AGA (appropriate for gestational age) subgroups, however, revealed more symptoms on ADHD subscales pertaining to executive dysfunction and emotional instability among those born SGA. Thus, it seems that intrauterine growth retardation (for which SGA served as a proxy) is a more essential predictor for self-perceived ADHD symptoms in adulthood than is VLBW birth as such. In line with observations from other cohorts, the VLBW adults reported less risk-taking behavior in terms of substance use (alcohol, smoking, and recreational drugs), a finding reassuring for the VLBW individuals and their families. On the cognitive test, VLBW adults free from neurosensory deficits had longer reaction times than did term-born peers on all tasks included in the test battery, and lower accuracy on the learning task, with no discernible effect of SGA status over and above the effect of VLBW. Altogether, on a group level, even high-functioning VLBW adults show subtle deficits in psychomotor processing speed, visual working memory, and learning abilities. The sleep studies provided no evidence for differences in sleep quality or duration between the two groups. The VLBW adults were, however, at more than two-fold higher risk for sleep-disordered breathing (in terms of chronic snoring). Given the link between sleep-disordered breathing and health sequelae, these results suggest that VLBW individuals may benefit from an increased awareness among clinicians of this potential problem area. An unexpected finding from the sleep studies was the suggestion of an advanced sleep phase: The VLBW adults went to bed earlier according to the actigraphy registrations and also reported earlier wake-up times on the questionnaire. In further study of this issue in conjunction with the follow-up three years later, the VLBW group reported higher levels of morningness propensity, further corroborating the preliminary findings of an advanced sleep phase. Although the clinical implications are not entirely clear, the issue may be worth further study, since circadian rhythms are closely related to health and well-being. In sum, we believe that increased understanding of long-term outcomes after VLBW, and identification of areas and subgroups that are particularly vulnerable, will allow earlier recognition of potential problems and ultimately lead to improved prevention strategies.

Eficacia de la aplicación de la terapia Mindfulness para resucir los síntomas de ansiedad en personas adultas de Atención Primaria

En la última década Mindfulness ha despertado gran interés como tratamiento terapéutico en la salud psicológica. Está inmerso en lo que ya se denominan Terapias de Tercera Generación, donde la aceptación es el concepto en cuál se centra. Existen varios programas en los que se aplica esta terapia y se han realizado estudios para numerosas aplicaciones clínicas, dando evidencia científica al respecto. El objetivo de esta revisión narrativa es la de conocer la eficacia de la aplicación de la terapia Mindfulness para reducir los síntomas de ansiedad en personas adultas de Atención Primaria. Para ello, se revisan los fundamentos teóricos y mecanismos de acción de Mindfulness, y de qué manera actúa en los trastornos de ansiedad. Dentro de este marco, se expone en la discusión la aplicación de la terapia en Atención primaria y la posibilidad de ser una herramienta para el profesional de Enfermería. Finalmente, se concluye que Mindfulness tiene un efecto moderado para reducir los niveles de ansiedad, aunque sin gran diferencia respecto a las Terapias Cognitivo Conductuales utilizadas hasta el momento. Se observa una necesidad de mayor evidencia científica que respalde la idoneidad de la aplicación de Mindfulness en personas adultas de Atención Primaria para reducir los niveles de ansiedad. Y siendo esta terapia una herramienta idónea para ofrecer por parte del personal de Enfermería, existen pocos estudios en los que Enfermer@s sean los que aplican Mindfulness

A influência da habilidade empática sobre o perdão interpessoal

Diversos estudos têm apontado os benefícios da habilidade empática. Ela está associada à saúde e bem-estar psicológicos, a relacionamentos mais satisfatórios, a comportamentos pró-sociais e morais, à resiliência etc., ao passo que sua ausência está associada a diversos prejuízos pessoais e interpessoais. Como habilidade social, entende-se que a empatia é um fenômeno multidimensional, com aspectos cognitivos, afetivos e comportamentais. Respectivamente, envolve a capacidade de compreender o ponto de vista do outro, de se interessar genuinamente pelo seu bem-estar, e de expressar, por meio de comportamentos verbais e/ou não verbais, sua compreensão e interesse ao interlocutor, permitindo a este se sentir entendido e validado em suas experiências. Esta habilidade tem sido associada, mais recentemente, por diversos estudos internacionais, à capacidade de perdoar um ofensor por suas transgressões. Com isso, o propósito do presente trabalho foi investigar a influência da habilidade empática sobre o perdão interpessoal, em uma amostra brasileira. O perdão também vem sendo considerado uma experiência multifatorial, com domínios cognitivos, afetivos e comportamentais, que abrangem os pensamentos, as emoções e os comportamentos em relação a um ofensor. Para a realização desta investigação, 172 participantes responderam o Inventário de Empatia (IE), a Escala de Atitudes (o Enright Forgiveness Inventory EFI) e uma ficha sobre dados socidemográficos. O IE apresenta quatro subescalas: Tomada de Perspectiva, Sensibilidade Afetiva, Flexibilidade Interpessoal e Altruísmo. O EFI apresenta uma Escala Global de perdão e três Subescalas: Afetiva, Cognitiva e Comportamental. Testes correlacionais e de regressão foram processados a fim de investigar as relações entre os fatores do IE e do EFI, bem como a predição da empatia sobre o perdão. Os resultados indicaram diversas relações positivas e significativas estatisticamente: a Tomada de Perspectiva se relacionou à Escala Global do perdão e às Subescalas Afetiva e Comportamental; a Sensibilidade Afetiva e o Altruísmo se relacionaram à Escala Global e à Comportamental do perdão; a Flexibilidade Interpessoal foi o único fator empático que não apresentou correlações significativas com o perdão. Com a regressão, constatou-se que: Altruísmo e Tomada de Perspectiva, combinados, ou Tomada de Perspectiva, sozinha, predisseram o Perdão Global; Sensibilidade Afetiva, Tomada de Perspectiva e Altruísmo, combinados ou individualmente, tiveram valor preditivo sobre a Subescala Comportamental do perdão; e apenas a Tomada de Perspectiva, sozinha, predisse a Subescala Afetiva do perdão. Nenhum fator do IE teve valor preditivo sobre a Subescala Cognitiva do perdão e a Flexibilidade Interpessoal não predisse qualquer dimensão do EFI. Os resultados encontrados apoiam pesquisas anteriores, confirmando a importância da empatia para a ocorrência do perdão interpessoal. Contudo, ressalta-se que a Tomada de Perspectiva se destacou como a dimensão empática mais importante, sugerindo a relevância que a capacidade de adotar o ponto de vista do outro tem para que o perdão seja alcançado.

中学生自我评价、泛化信任和应对方式及其于心理健康的关系

The aim of this research is to explore the relationships between Self-evaluation, general trust, coping styles and psychological health of secondary school students. Three studies were carried out. A total of 1024 middle school students ranging in age from 11 to 20 years complete SCL-90, secondary school students self-evaluation scale, questionnaire of coping styles and GTS. It is found that: 1. There were three self-evaluation in middle school students: the self-evaluation in study, in human relations and in appearance. 2. The three factors of self-evaluation are all correlated to gender, grade and single children. 3. General trust of secondary school students is no difference in gender, grade and single children. 4. Aside from the negative exterior copied ones, three self-evaluation and general trust significantly predict the other three coping styles. 5. When we control the gender , grade and and the only-child in multiple linear regression, we found that the coping style has more effect on their psychological health than the gender , grade and and the only-child and influencing of negative coping style is highest. 6. Three self-evaluations and general trust have direct influences on psychological health of secondary school students. Taking coping styles as intermediate variables , three self-evaluations and general trust have direct influences on psychological health of secondary school students.

武警工作倦怠及相关因素分析

Accumulating studies have been conducted on job burnout in the fields of organizational psychology and health psychology, but there are few studies investigating job burnout for people in the Chinese Armed Police Force(CAPF). This thesis explored the antecedents (social comparison, perceived control and perceived organizational support) and outcomes (incumbents’ level of task performance and psychological health) of job burnout, using data collected from 458 teachers (study 1) and 792 officers (470 lower level army cadres,150 commandos and 172 teachers, study 2) in CAPF. Two studies were carried out. The results are as follows: 1. There were significant differences among the three dimensions of job burnout for teachers: reduced accomplishment was rated significantly higher than cynicism and emotional exhaustion. 2. For the emotional exhaustion dimension, special technical soldiers gave the highest ratings and cadres provided the lowest ratings. Besides, special technical soldiers and teachers rated higher on cynicism than cadres did. 3. Perceived control significantly influenced job burnout: the higher the perceived control, the lower the three dimension of job burnout (emotional exhaustion, cynicism and reduced accomplishment). 4. Perceived control exerted impacts on psychological health directly and indirectly: the higher the perceived control, the better psychological health. Moreover, perceived control had significant effects on psychological health through emotional exhaustion: the higher the perceived control, the lower emotional exhaustion and the better psychological health. 5. The higher perceived organizational support, the lower the three dimensions of job burnout; perceived organizational support impacted psychological health through emotional exhaustion: the higher perceived organizational support, the lower emotional exhaustion and the better psychological health. 6. Job burnout exerted significant influence on task performance: the higher reduced accomplishment, the lower task performance rated by participants themselves. Drawing on the above results, measures would be taken in CAPF to enhance perceived control and perceived organizational support, to alleviate burnout and improve task performance and psychological health.

工作幸福感的结构、测量及作用机制

With the emergence and development of positive psychology, happiness has been the focus of academia and business. However, there is no uniform measure of happiness, because of many different theories of happiness, which are not compatible with others. It bounds the further development of happiness theory. It is also the same with the research of work well-being, which refers to the emotional experience and quality of psychological functioning of employee in the workplace. Subjective well-being (SWB) and psychological well-being (PWB) are two major theories of happiness. Prior research has demonstrated the integration of these two theories theoretically, but still needs more empirical support. Besides, in line with the development of positive psychology, a body of knowledge about positive leadership is advocated. Transformational leadership is treated as one kind of positive leadership, since it emphasizes the leader’s motivational and elevating effect on followers. But the extent to which the transformational leadership can enhance work well-being, and what the mechanism is, these are the questions need to be explored. Based on the integration of SWB and PWB, this research tried to investigate the structure, measurement and mechanism of work well-being, and combining with the theory of transformational leadership, this study also tried to investigate the relationship between transformational leadership and work well-being. The structure and measurement of work well-being, the relationships between work well-being and job characteristics (including job resources and job demands), the relationships among transformational leadership, job resources, work well-being and corresponding outcomes, the relationships among transformational leadership, job demands, work well-being and corresponding outcomes, and the relationships among transformational leadership, group job characteristics, group work well-being and corresponding group outcomes were explored by using content analysis, Subject Matter Experts (SMEs) discussion, and structural questionnaire surveys. More than 7000 subjects were surveyed, and Explore Factor Analysis (EFA), Confirm Factor Analysis (CFA), Structural Equation Modeling (SEM), Hierarchical Linear Modeling (HLM) and other statistics methods were used. The following is the major conclusions. Firstly, work well-being is a two high-order factors structure, which includes affective well-being (AWB) and cognitive well-being (CWB). AWB is similar to SWB, and CWB is similar to PWB. Besides, the construct of AWB includes sub-dimensions of positive emotional experience and negative emotional experience. And the construct of CWB consists of work autonomy, personal growth, work competent, and work significance. Secondly, the relationships between job characteristics and AWB and CWB are different. On one hand job demands are directly related to AWB, and are indirectly related to CWB through the full mediation of AWB, on the other job resources are directly related to CWB, and are indirectly related to AWB through the full mediation of CWB, which means AWB and CWB reciprocally influences each other in the model of job demands-resources. These results were concluded as the process model of work well-being. Thirdly, AWB and CWB are positively related to many workplace outcomes, including job satisfaction, group satisfaction, organizational commitment, turnover intention, job performance, organizational citizenship behavior (OCB), and general psychological health and general physiological health. Fourthly, transformational leadership is indirectly related to CWB through the full mediation of job resources, and is related to AWB through the partial mediation of job demands. Meanwhile, transformational leadership is related to many workplace outcomes through the mediation of job characteristics and work well-being. These results implied that transformational leadership is indeed one kind of positive leadership. Fifthly, in the group level, transformational leadership is indirectly related to group CWB through the full mediation of group job resources, and is related to group AWB through the full mediation of group job demands. Group AWB has positive influence on group CWB, but not vice versa. Group job characteristics and group work well-being fully mediate the relationships between transformational leadership and intragroup cooperation and group performance.

下岗（失业）求职人员再就业的预测因素研究

How to improve the reemployment of lay-offs and unemployed is a big concern of Chinese society now. Based on literatures in related fields, the thesis investigated predictive factors of job-seeking behavior, reemployment status, quality of reemployment, psychological health among lay-offs (unemployed), and also the relationship between reemployment and psychological health. Lay-off (unemployed) participants for this study were recruited from four public employment centers in Beijing. participants completed two surveys. Results mainly demonstrated: 1 There were significant relationships between Job-seeking self-efficacy, motivation control and job-seeking frequency; age was negatively associated with job-seeking frequency and mental health; 2 Joh-seeking support was highlighted as the only lagged predictor of reemployment status; job-seeking frequency predicted job satisfaction of reemployed individuals; 3 The mental health of reemployed was significantly improved; but mental health of continously unemployed people deteriorated during these three months. High quality reemployment significantly improved mental health, low quality reemployment had no effect on mental health. The research demostrated some psychological factors predicting reemployment and relationships between reemployment and mental health. The results can improve the understanding relationships of reemployment and psychological factors. The results also can improve effective reemployment counseling and reemployment social services.

The effects of prayer on Muslim patients' well-being

The purpose of this study is to investigate the effects of Islamic prayer (du’a, dhikr, and Qur’anic recitation) on Muslim patients. Relying on the Qur’an and sunnah, Islamic scholars state that prayer has positive effects on patients’ psychological and physical well-being. To examine this, the principal investigator recruited 60 adult in-patients at Brigham and Women’s Hospital. Patients completed questionnaires that were used to assess the respondents’ psychological/emotional well being as well as determine the level of religiosity or spirituality (from an Islamic perspective). Vital sign recordings and self-report surveys were used before and after prayer sessions to measure effects of prayer. A non-religious text served as a control. Results support the hypothesis of the positive effects of prayer. A greater degree of religiosity/spirituality was associated with better psychological health. Physical changes were clinically insignificant but statistically meaningful.

The effect of patient characteristics upon uptake of the influenza vaccination: a study comparing community based older adults in two healthcare systems

Background: Uptake of influenza vaccination represents a simple marker of proactive care of older people. However, many still do not receive the vaccine. To understand this challenge better, we investigated the relationship between patient characteristics (demographic, physical and psychological health, and health service use) and vaccination uptake in a sample of community-dwelling older people in two adjacent but differently structured healthcare systems (Northern Ireland (NI) and the Republic of Ireland (RoI)). Methods: 2,033 randomly selected community-dwelling older adults (65 years and older) were interviewed in their homes. Results: Rates of uptake were 78% in NI and 72% in RoI. Uptake was greater with older age (odds ratio (OR) 1.6, 95% confidence interval (CI) = 1.3-2.1, p

Multidimensional rehabilitation programmes for adult cancer survivors

This is the protocol for a review and there is no abstract. The objectives are as follows:

To assess the effectiveness of multidimensional rehabilitation programs in terms of maintaining or improving the physical and psychosocial well-being of adult cancer survivors.

The review will evaluate the extent to which:

Professionally led multidimensional rehabilitation programs achieve better outcomes than standard services for patients with cancer and their caregivers
Rehabilitation programmes exert a different impact on different domains (e.g. psychological health, physical functioning)
Different modes of delivery and different settings influence outcomes
There is relationship between the number, duration and intensity of rehabilitation sessions and degree of change in measured outcomes.

Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

Background: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services.

Methods: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement.

Results: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.

Conclusions: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.