This research investigated physician and emergency room use among representative samples of children in the Dallas metropolitan area (N = 1606) and among patients who used Children's Medical Center of Dallas' First Care services (N = 612). Through telephone interviewing, caregivers to children under fifteen years of age were asked about an array of health service use behaviors, social-psychological issues related to acquiring health care for their children, and demographic characteristics as outlined by the Andersen & Newman model of health care service use. Children's use of physician services is best predicted by whether or not they have medical insurance, their level of income, and whether or not they have medical homes. Although having commercial managed care and fee-for-service Medicaid insurance consistently predicted increased physician use, neither independently reduced reliance on emergency rooms for non-emergent care. Managed care insurance and Medicaid did, however, significantly improve the odds that children would have medical homes, which significantly decreased emergency room use for non-emergent care. Further, increasing physician use and reducing reliance on hospital emergency rooms for non-emergent care will require ensuring that children have medical homeseither private physicians or community health centersat which they can readily and consistently receive sick and well care. Although some ethnic differences were observed, few of the broad array of factors in the Behavioral Model significantly predicted either physician or emergency room use. Moreover, educational levels and health beliefs rarely, and if significant negligibly, influenced physician and emergency room use. Health policy for children would best be served by focusing on programs that facilitate parent's ability to secure health insurance for their children and allocating children to medical homes where they can readily and consistently access sick and well care.

Using critical feminist theories and methodologies, my research investigates the power relations and influences at play within the field of children's environmental health. I begin with the research question of how a parent's everyday purchase of a toy or other children's product is "hooked into" extra-local governance (agenda-setting, rule-making and monitoring). Focusing on Bisphenol A and phthalates as an example, in-depth interviews were conducted with six government officials (three federal and three municipal), three non-governmental organization (NGO) representatives, a politician, six higher education faculty members and a parent, as well as two focus groups of 23 parents. Legislation and other relevant documents from governments, NGOs, industry and media were analyzed together with reports of their activities and attitudes to theorize "how things work" in the identification and management of toxic substances in products for sale, with a special interest in how this affects children's environmental health. My research revealed the influence of neo-liberalism, corporate power and over-reliance on strictly evidence-based biomedical reductionism in slowing down assessment and regulation of chemicals while many health professionals and grassroots activists have called for swifter responses based on the precautionary principle, as favoured by European governments. That is, politics and bureaucracy, with the approval of industry, over the past two decades, have clung to reductionist science as the only paradigm for understanding toxicity, thus slowing down regulatory processes. Although the historical and epistemological power relations mapped in my research work together to legitimize scientific certainty rather than the precautionary principle, I argue that the resulting regulatory logjam has been and could be addressed by reference to European examples, knowledge produced by collectives and the establishment of upstream and equity-based public health strategies with public input into the process.

Using critical feminist theories and methodologies, my research investigates the power relations and influences at play within the field of children's environmental health. I begin with the research question of how a parent's everyday purchase of a toy or other children's product is "hooked into" extra-local governance (agenda-setting, rule-making and monitoring). Focusing on Bisphenol A and phthalates as an example, in-depth interviews were conducted with six government officials (three federal and three municipal), three non-governmental organization (NGO) representatives, a politician, six higher education faculty members and a parent, as well as two focus groups of 23 parents. Legislation and other relevant documents from governments, NGOs, industry and media were analyzed together with reports of their activities and attitudes to theorize "how things work" in the identification and management of toxic substances in products for sale, with a special interest in how this affects children's environmental health. My research revealed the influence of neo-liberalism, corporate power and over-reliance on strictly evidence-based biomedical reductionism in slowing down assessment and regulation of chemicals while many health professionals and grassroots activists have called for swifter responses based on the precautionary principle, as favoured by European governments. That is, politics and bureaucracy, with the approval of industry, over the past two decades, have clung to reductionist science as the only paradigm for understanding toxicity, thus slowing down regulatory processes. Although the historical and epistemological power relations mapped in my research work together to legitimize scientific certainty rather than the precautionary principle, I argue that the resulting regulatory logjam has been and could be addressed by reference to European examples, knowledge produced by collectives and the establishment of upstream and equity-based public health strategies with public input into the process.

Source: Dissertation Abstracts International, Volume: 70-03, Section: B, page: 1622. Adviser: Stephen H. Linder. Includes bibliographical references.

Adviser: Stephen H. Linder. UMI number 3350227. Includes bibliographical references (p. 130-134).

Thesis (D.P.H.)--University of Michigan.

Dissertation (D.P.H.)--University of Michigan.

The purpose of this study is to examine the effectiveness of parent training seminars. The intention of this study is to find out if parents' knowledge increased in their understanding of 4 areas of parenting: Discipline, communication between parent-child, communication with teachers and effective parenting style.

No description available.

No description available.