Category Archives: Published Works

Swedish Child Health Centers’ Built Environment: Do They Include Fathers?

Swedish child health centers have historically been a place for new mothers and children. We assessed 31 child health centers’ waiting rooms to see the extent to which they included images of mothers, fathers, and children. 75% did not include fathers…at all. Read the full article here.

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Background: Sweden is trying to create a gender equal country and around 97% of all families in Sweden visit the child health centers for routine check-ups, vaccinations, to monitor their child’s growth and development, and to receive parenting advice, either for their specific child’s problems or via parenting groups.

Study Design:Prior to the study, we defined what constituted a mother, father, and/or child environment (or any combination thereof).

 

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Note: None of the environments were father-mother, father-child, or father centered, so those definitions have been removed.

I then visited and took pictures of 31 child health centers throughout Sweden. I visited centers in rich and poor neighborhoods, urban and rural areas, and private and public child health centers.

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Pictures were taken of everything in their waiting room, magazine titles were written down, and all pamphlets that could be handed out to parents were collected.

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I then met up with two co-researchers, where we independently viewed the waiting room via the pictures and samples to determine if that space included the mother, father, and/or child.

The waiting room was determined to be mother, father, and/or child centered as long as at least 25% of the space consisted of that individual; leaving the last 25% to be aimed at any or all of these types of individuals (neutral items [e.g. abstract art, pictures of nature] did not count for or against any individual family member).

The messages on the bulletin boards were broken down using manifest and latent analysis using semiotic visual analysis.

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The magazine readership was sought out

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Results

31 Child Health Centers

  • 12 = Mother-Child Centered
  • 8  = Family-Centered
  • 6  = Child-Centered
  • 2  = Women-Centered
  • 3  = Neutral

The most common waiting room had lots of items for mothers (e.g. images of mothers, magazines that mothers typically read) and toys and books for children, as well as images of children, but very little or nothing for fathers.

In fact, only one category, family-centered, included fathers, while the rest were composed of mothers and/or children.

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Observations

We also observed parents, mothers and fathers, visiting the child health centers to see what they did while in the waiting room–read books, talk on their cell phone, interact with their child, talk with each other….just sit in their chair.

Mothers’ behavior did not change between environments, but fathers were more likely to play with their child and read the brochures/pamphlets if they were in a non-women centered environment (e.g. either family centered or child centered).

Conclusions: People are affected by their environments–people read in libraries, party at concerts, act posh at fine dining establishments. They don’t typically do the reverse (read at concerts and party in libraries).

The child health centers are no different. Their built environment sends messages on who’s welcomed and how they should act.

To further promote involved fathering in child health, the child health centers should rebuild their environments to be more inclusive of fathers.

To help ensure an inclusive waiting room (for all types of people), we created (in Swedish) a checklist they can use!!!

Click here or on the picture to see the full checklist.

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Swedish Child Health Nurses’ Attitude Toward Fathers

We published a qualitative article in Acta Paediatrica on how Swedish child health nurses felt about fathers coming into the child health centers. While child health nurses accepted and welcomed fathers, they did little to invite, include, or further support fathers (click here to read the full article).

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I interviewed 17 child health nurses from various places in Sweden: north, south, east, west; urban and rural; experienced and inexperienced; young and old. All child health nurses were women–Not uncommon since there are only a handful of men that are child health nurses in the whole country.

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Four themes were discussed in this article.

While child health nurses are experts on children’s health and believe that fathers are attending the child health centers more than ever; they seem to be attending in spite of rather than because of support they receive from the child health nurses.

Child health nurses say that they value mothers to a much greater extent than fathers and provide more support to mothers.

However, child health nurses are in various stages of providing more support to fathers: while some have never thought about actively involving fathers, others have tried to, but feel their hands are tied when it comes to making changes, while others have even tried to make changes (e.g. discuss with their boss about having evening and weekend hours, magazines for fathers, pictures emphasizing fathers). However, no child health nurses that were interviewed had yet made any real changes.

downloadConclusion: If we want mothers and fathers to be equal parents, fathers will need to be accepted and encouraged to participate, just like mothers.

The Swedish child health centers provide great child development advice, host parenting groups, are seen as parenting experts, and are appreciated throughout Sweden.

For example, their services benefit parents…mothers.

The extra support mothers receive aides mothers in continuing to raise their child, at least as far as their child’s health in concerned, since she is the parenting expert because she receives the most support and is the most welcome at the child health centers.

Changing routine practices at the child health centers to further promote and support fathers will aid Sweden’s goal of becoming a gender equal country.

PhD Defense: The Party

A couple of hours after my PhD Defense, I was famous.

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My PhD dissertation could now be found on academic bookshelves everywhere (Swedish university libraries are found).

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Going to my PhD party felt like I had made it through a marriage ceremony, and now got to finally enjoy myself; except for the fact that I’m too exhausted to fully enjoy myself.

Booze are needed. Lots and lots of booze.

It doesn’t hurt to add in loads of friends, colleagues, supervisors, and family to cheer you on.

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Speeches start with the big hitters–the supervisors….and my partner.

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Anna toasting me with a silver spoon (with an “A” engraved on it)
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Raziye sharing wisdom and giving me books of knowledge.
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Sarah sharing our research story
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Sarah giving me Buckeyes; which works on so many levels!
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Lisa emotionally sharing our story as I traversed through my PhD.

Food is ever important for lifting your spirits.

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And if that doesn’t work, then you should start singing.

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A song created by the Wellander Family!

Flowers (and gifts) aren’t bad either; they always brighten your day!

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To really wake everyone up, my colleagues put on quite a show, highlighting my journey of learning and blending in with Swedish culture and Swedish research.

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Once their speech was complete, I received their gifts.

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Some fancy bicycle cuff-links.

 

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And a seemingly ordinary blue coffee mug…that meant substantially more to me than any other present. 

Which was promptly followed up by the comical conspirators The Wellanders! Led by Linus and Fredrik, they proceeded to barrage and embarrass me with typical high school hijinks that I of course didn’t get to participate in when I was 18, and therefore, I get to now relive those moments, in order to feel truly like a graduating Swede….complete with embarrassing baby photos.

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Fredrik and Louise preparing my embarrassment.
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The comical stylings of Linus & Fredrik!
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Having the whole Wellander Family celebrate me!

I know some truly gifted, loving, and inspiration people!

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Me enjoying the evening (complete with a Swedish/American pin).

Thank you for a wonderful journey!

Now time to sleep.

 

 

Defending my PhD Dissertation: Swedish Style

Sweden is a lot different than the USA when you have to defend your PhD dissertation (PhD avhandling). For example, there is a lot more pomp and circumstance surrounding the event.

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Announcements letting people know where my defense will commence.

You get your PhD Dissertation book in the mail weeks in advance (after all, you need to mail them to your PhD committee and opponent [more on them in a minute]).

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My defense is on parental gender issues, so                                                       how could I not where blue and pink?

Your defense is publically announced weeks before your actual defense and anyone may attend your defense (either as friend or foe).

It always helps to go to your defense room, pre-defense, to practice your speech, be challenged by your supervisors (and other colleagues).

And make sure all of the equipment (lights, shades, microphone, powerpoint, etc) all work and that you know how to work them.

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Main University Building, Uppsala University. The sign reads “To think free is big, but to think right is bigger.”

When the day of my defense finally happened, I had to decorate it with my research posters.

After everyone arrives, the opponent, committee members, supervisors, and the PhD student are announced via a chairperson.

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Dr. Jan Gustafsson, former Head of Women’s and Children’s Health was the Chairmaster of my defense.

After the announcements are made, and your dissertation book is passed out, you now make a 30 minute speech about your research; telling a story of where the field is, why your research is needed, the strengths and limitations to your research, how your research contributes to the field, and future needed research.

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The title slide of my Defense (click the picture to see the full presentation [complete with all of the additional slides I included at the end just in case the committee had questions on those topics]).
Another difference from the USA: you have an opponent. An opponent is a professional within your field who is not connected to you or anyone that you’ve worked with (e.g. your supervisors) within the past five years. They are there to critically challenge your dissertation.

For me, this meant facing Professor Anders Broberg, a psychologist from Göteborg Universitet (Gothenburg University).

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Me (on the left) vs. my opponent (Dr. Broberg)

While professors in public health have a reputation for seeing how your work fits in a larger framework, psychologists have reputations for picking apart the methodology and statistics you use. My opponent met that stereotype.

Beyond the opponent, you also have to face a battering ram of committee members. This consists of three professors who also have not worked with you or your advisors for the past five years. The PhD student typically meets these committee members at their half-time: when they are half-way completed with their PhD and need to defend their progress thus far, while also receiving support and advice on how to strengthen their dissertation and future research projects.

I had three committee members for my half-time: Dr. Sven Bremberg, Dr. Pia Enebrink, and Dr. Birgitta Essen. However, by the time of my defense, only Birgitta would be on my PhD committee, as various other research projects began to take hold between my supervisor, Dr. Anna Sarkadi and Sven and Pia, respectively. So two new replacements were needed: Dr. Anneli Ivarsson and Dr. Lars Plantin.

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The three in the front row are my committee members; all of whom are feverishly taking notes.

Hours later–After you’ve faced down your opponent and the three committee members, then anyone from the audience is allowed to challenge your work. This is most tedious, because you’re exhausted from defending, and it’s much harder to prepare for audience members, since they could bring up pretty much any topic.

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Some members of the audience (mostly friends and colleagues)

Thankfully, I didn’t have any audience questions.

At this point, everyone came up to congratulate me on my “job well done” while they committee, opponent, and my supervisors (Anna and Dr. Raziye Salari) went into a private room to discuss the defense. After 10-20 minutes, my supervisors are dismissed and the committee decides your fate.

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A pre-party starts, with champagne and snacks while we await the verdict.

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Promoting my dissertation…a picture speaks 1000 words                             (too bad I didn’t have more pictures 😉

I graduated!

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Colleagues and friends toasting my graduation!

Now time for the party!

 

My Research Year in Review: Publications, Citations, and Attractions

Last year I wrote a blog post about my research from 2008 until the present (2014).

Today, I’ll write my one year review.

Clearly the highlight of my year was writing, publishing, and defending my PhD dissertation (PhD avhandling) entitled An Unequal Chance to Parent: Examples on Support Fathers Receive from the Swedish Child Health Field.

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Preparing the dissertation, as well as preparing to defend took nearly half a year, starting at the tail-end of 2014, and on through until April 29th, 2015…the magical defense day. You can read more information about the artwork, the spikning, the final product (aka the defense), and the party.

While working on my dissertation, I had two other main projects: 1) to mentor a medical student in how to conduct research and 2) to plan and execute the itinerary for my former master’s advisor, Dr. Sarah Schoppe-Sullivan. After receiving a travel grant, we flew her over from the USA to Sweden to have her provide lectures to different groups of researchers, individually work with various PhD Students, and to have her promote her research to different researchers.

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Sarah flew over to support our research group, and provided invaluable advice while preparing for my defense.

It was a highlight of my year to be able to give a little something back to my former advisor…even if preparing for my PhD defense was a full-time job.

Research Gap

The most unfortunate thing after graduating was having to leave the country for an unknown period of time, while I waited for my visa to change from a student visa to a visiting researcher visa. But at least I was employable!

I had two job offers: one as a postdoc at the Child Health and Parenting (CHAP) Research Group in Women’s and Children’s Health at Uppsala University (AKA- the same research group I earned my PhD from) (60%) and a researcher position via St. Goran’s Hospital & Women’s and Children’s Health at Karolinska Institutet (40%). In the latter position, I started working with Dr. Malin Bergström.

Malin was the first person to ever approach me at a conference and utter the words “I’ve read your work.” That simple sentence led us down a path to our current projects (and obviously made me feel super cool!).

While my postdoc position at CHAP was to continue finishing up current projects, I was to start a very natural progression of analyzing data on Swedish child health nurses’ current attitudes toward father involvement at the child health centers, and to start helping to develop an evaluation protocol for a new program the nurses were providing to families of three-year-olds with Malin (as well as Dr. Emma Fransson & Dr. Anders Hjern via CHESS, Stockholm University).

Publications

  1. Wells, M.B., Salari, R., & Sarkadi, A. (In Press). Mothers’ and Fathers’ Attendance in a Community-Based Universally Offered Parenting Program in Sweden. Scandinavian Journal of Public Health, Volume (Issue), page numbers.
  2. Wells, M.B., Engman, J., & Sarkadi, A. (2015). Gender equality in Swedish child health centers: An analysis of their physical environments and parental behaviours. Accepted for publication in Semiotica: Journal of the International Association for Semiotic Studies.
  3. Wells, M.B. (2015). Predicting Preschool Teacher Retention and Turnover in Newly Hired Head Start Teachers Across the First Half of the School Year. Early Childhood Research Quarterly. 30, 152-159.

Article 1 is my fourth and final article that completes my PhD dissertation! It is the first article to explore gender differences between parents (e.g. mothers and fathers) in relation to why they participate in a parent support program (e.g. Triple P Positive Parenting Program).

Of those researchers on ResearchGate, this article was the most read article from Women’s and Children’s Health (for that week). It felt cool to see that people were interested in my research, especially since there are so many researchers doing really highly quality research.

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Article 2 was also in my PhD dissertation. This was the first article I ever collected data on, and the first article I ever tried to get published. The fact that I have since had five other publications before this one though is a tribute to the valuable lessons I learned from this first research project: how to collect data, how to write an article for publication, and the most valuable lesson–learning the importance of developing a strong methodology. But now it’s finally published! 🙂

Article 3 was discussed in last year’s update.

Technically, a 4th article was published:

  • Wellander, L., Wells, M.B., & Feldman, I. (2015). Does prevention pay?: Health and economic impact of preventive interventions for school children aimed to improve mental health. Journal of Mental Health Policy and Economics, 18(S1).
    *The actual citation writes Inna Feldman’s name as “Jima Feldman”.

This article is published in a supplementary edition of the journal since it is a conference abstract (the conference took place in Venice, Italy and was run by the aforementioned journal).

Citations

My citations greatly increased this year according to ScholarGoogle from 19 in 2014 to 34 in 2015.

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I have also learned some valuable lessons about citations:

  1. Self-citations definitely happen
    • My dissertation alone vastly boosted my alleged citations
  2. Your research network cites your work
    • Maintain healthy relationships to get more citations
  3. Masters and doctoral students will cite you
    • Apparently established researchers are mainly only following lesson number 2 (above); even if your research would fit in perfectly with their own
  4. Use conferences and send personal emails to promote your work
    • People will cite you if they 1) know that your research exists and 2) if you take a few minutes to introduce yourself

I haven’t had too many citations from professional researchers who either my colleagues or myself do not already know. Hopefully this will be a nut that gets cracked as I build my resume, produce more, and establish a bigger name for myself…either that or networking is just as important in garnering citations, as it is in getting employed.

Downloads
My PhD dissertation has been viewed and downloaded quite a bit (relative to others).

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ResearchGate also states that my articles (as a group) have been “read” (a combination of viewed and downloaded) over 1000 times. It’s hard to compare from 2014, since they changed their terminology. For example last year, I had 816 views and 969 downloads.

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These numbers though must pale in comparison to downloaded articles from the actual journal (imagine that, a professional organization does better than my personal website 😉

For example, in just looking at my Early Childhood Research Quarterly article, over a 9-month period, this one article was viewed 655 times.

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Invited Talks

I was invited to provide a conference talk for the Stockholm University Demography Unit and the Linnaeus Center on Social Policy and Family Dynamics in Europe at Stockholm University. I gave a presentation and a paper entitled “The Swedish Ploy of Promoting Equal Parenting:  Paradoxes in Policy Implementation Regarding Paternal Involvement in Childcare.”

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Click here to see the presentation.

I was also invited to speak at the 6th Annual Conference: Focus on Fatherhood for around 100 child health nurses in Kista, Stockholm, Sweden. I gave a presentation called “Father Involvement is Important: Ways to Decrease Paternal Barriers.”

My Blog
This blog has increased traffic quite a bit as well. While my blog received 15,000 views in 2014, my views significantly increased to 25,000 in 2015. The most common views are by far the posts related to different questionnaires and scales (e.g. not my personal work).

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I find this interesting because it tells me that 1) people want to look up questionnaires and scales to learn more about them and 2) there aren’t many websites that promote questionnaires and scales.

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I wrote about the different questionnaires and scales (e.g. research tools) that I use in my own research–not so much to inform others, but just to remind myself what that tool could be used for. However, it seems that people crave more knowledge about particular tools. So far though, I have taken little responsibility in updating and adding to the tool-related posts–since they aren’t my tools that I’ve developed.

Even so, my website often comes up as the number one hit on Google. People who have invested interests in these tools could benefit from promoting them to a greater extent….and other researcher would also benefit from their knowledge.

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Summary
Researchers always question if they have done enough throughout the year. Writing about a few of my highlights puts my accomplishments in perspective.

And I haven’t even written about the “soft” accomplishments–like learning new methodologies and statistics, mentoring PhD students, leading seminars, teaching, and presenting at conferences.

Keeping in mind what I have accomplished all year helps raise my self-esteem and lowers my self-deprecating thoughts of not doing enough.

Future Research:

As 2015 winds down, I look forward to starting a new postdoc position in Public Health at Karolinska Institutet working in Dr. Finn Rasmussen’s research group (80%) and another postdoc position with Dr. Malin Bergström, Dr. Emma Fransson, and Dr. Anders Hjern at the Centre for Health Equity Studies (CHESS) at Stockholm University/Karolinska Institutet in the Elvis Project.

I am eager to see what 2016 brings!

Head Start Preschool Teacher Retention

I recently published an article in Early Childhood Research Quarterly (the best early childhood education journal) showing the factors that can predict Head Start preschool teachers quitting their employment across the first half of the school year (click here to read the published article).

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Study Design: Ten Head Start centers in one major Midwest city were recruited to participate (170 total preschool teachers). Head Start preschool teachers with two years or less of experience, were asked to complete a 16-item questionnaire, as well as a demographics questionnaire at the beginning of the school year (n = 65 participating preschool teachers).

In January, half-way through the school year, I learned from the Center Directors who had continued teaching and who had quit. I then compared the scores of those who stayed and those who quit for any differences.

Results:
Preschool teachers came from a variety of backgrounds, according to the demographic questionnaire–different races, ages, work experiences, education, etc. There were also some differences between lead and assistant preschool teachers (see full article). However, all but one of the participants were female.

Huge Turnover Rates:

  • 48% of all Head Start teachers were newly hired (within the last two years)!
  • 36% of newly hired teachers quit during the first half of the school year!

Salary:
The preschool teachers’ salary was not a contributing factor to their quitting their job. In fact, on a one-to-seven scale, preschool teachers who stayed rated their salary as a 3.9, while those who quit rated theirs as a 3.7 (statistically identical)–and both are just above the middle (3.5 out of 7), suggesting that both stayers and quitters think their salary is adequate.

Five factors differed between those who stayed and those who quit:

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Preschool teachers were more likely to quit if they:

  1. did not want to stay teaching in the early childhood education (ECE) field
  2. were not happy
  3. had a bad relationship with their supervisor
  4. did not like their work environment
  5. had a lower education

In addition, the more factors that an individual teacher possessed the more likely they were to quit (e.g. if they did not want to stay in ECE AND were not happy AND did not like their supervisor AND did not like their work environment AND had a low education).

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While those preschool teachers who kept teaching, either did not have any or had only one of these five risk factors.

Conclusion: Preschool teacher turnover affects child outcomes, the quality of the preschool program, the teachers who continue teaching, and those who feel they need to quit their job.

Interventions should use this information to tailor their programs, so that fewer preschool teachers quit their job; yielding positive outcomes for children, parents, the school, and the teachers.

Father & Mother Attendance at a Parent Support Program

We recently published a paper that looks at why mothers and fathers attend a parent support program–in this case, Triple P – Positive Parenting Program in the Scandinavian Journal of Public Health (Click here to read the published article).

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Most research on this topic looks at parents in general, and some only on mothers. Fathers however come much less often to parent support programs compared to mothers–so we wondered why that might be?

The intervention: The program was offered free-of-charge to all parents in one community in Sweden. We then looked at the background factors of mothers and fathers who attended compared to those who did not attend to see if there were any differences.

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Results: Turns out that mothers are much more likely to attend the program if they perceive their child as having behavior problems, while fathers were approaching significance of attending if they perceived their child as having emotional problems.

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Future research should look further into various background factors to see how to increase rates of other minority groups, such as those who are not native to the country the program is held in or those parents with less education.

Marketing Strategies:
Since it is the goal of public health ventures, like parent support programs, to reach as much of the population as possible, direct and specific marketing methods should be employed, rather than marketing to parents–since parents, based on their gender, have different needs.

Future research can better target parents via marketing/advertising strategies that appeal to the parents’ needs. In other words, if you only market for improving children’s behavior problems, you can expect more mothers to come to the program than father, since they are more likely to perceive that as an issue.