Cultural Models of Supervision-Interdisciplinary Study

描述（由申请人提供）：美国疾病控制与预防中心的研究议程指出，“监督通常被认为是抵御多种家庭和社区伤害的最强但最不为人所知的保护因素之一。”这种说法凸显了监督概念的悖论。缺乏监督经常被认为是造成伤害的一个因素。然而，目前尚不清楚这一概念对建议将监督作为一种伤害预防策略的卫生专业人员或必须实施这种策略的父母意味着什么。最近的研究还指出，与非拉丁裔白人相比，拉丁裔儿童的儿科伤害率较低。对这些发现的解释尚不清楚。本研究将运用人类学、伤害流行病学和观察研究相结合的方法，探讨伤害预防监管的概念和行为。考虑到目前缺乏对预防伤害的有效监督的理解，我们定义文化模型为加强“监督”作为伤害预防策略奠定基础是至关重要的。本研究的总体目标是：1)确定监督的文化意义；2)确定在以下群体中是否存在一种共同的关于伤害预防监督的文化模式：卫生专业人员、拉丁裔母亲和非拉丁裔白人母亲；3)确定模型是否与自然环境中伤害危险情况下的现场监督观察相一致；4)确定偏离模型是否预示着对伤害预防的不当监管；5)确定文化模型是否可以用于指导医疗机构的预期咨询。将对讲西班牙语和英语的拉丁裔母亲、非拉丁裔白人母亲、儿科医生和护士进行深入的人种学访谈。文化共识方法将用于确定是否有一个共同的文化意义监督作为伤害预防策略。溺水和行人伤害是幼儿死亡的主要原因，监督是一项关键的预防策略。对在公园中靠近这些严重伤害危险的地方监督幼儿的父母进行观察，并与文化模型进行比较。将与母亲和卫生专业人员进行小组讨论，以验证我们的研究结果并实施监督概念。这些发现将加强对监管概念的理解，这对于制定文化上适当的伤害预防干预措施和策略是必要的。

DESCRIPTION (provided by applicant): The CDC Research Agenda states, "Supervision is generally considered one of the strongest yet least understood protective factors against many types of home and community injuries." This statement highlights the paradox of the concept of supervision. The absence of supervision has frequently been cited as a contributing factor for injury. Yet, it is unclear what this concept means to the health professionals who recommend supervision as an injury prevention strategy or to parents who must implement the strategies. Recent studies have also noted lower rates of pediatric injury among Latino children compared to Non-Latino Whites. The explanation of these findings is unclear. This study will use the combined approaches and methods of anthropology, injury epidemiology, and observational research to explore concepts and behaviors regarding supervision for injury prevention. Considering the current lack of understanding of what constitutes effective supervision for preventing injury, it is vital that we define cultural models to lay a foundation for enhancing "supervision" as an injury prevention strategy. The overall goals of this study are to 1) determine the cultural meaning of supervision; 2) determine if there is a shared cultural model(s) regarding supervision for injury prevention among the following groups: health professionals, Latina mothers and non-Latina white mothers; 3) determine if the model(s) is consistent with field observations of supervision in the context of injury hazards in the natural environment; 4) determine if deviation from the model(s) predicts inappropriate supervision for injury prevention; and 5) establish if the cultural model(s) can be used to guide anticipatory counseling in the health care setting. In-depth ethnographic interviews will be conducted with Spanish and English speaking Latina mothers, non-Latina White mothers, pediatricians and nurses. Cultural consensus methods will be used to determine if there is a shared cultural meaning of supervision as an injury prevention strategy. Drowning and pedestrian injuries are leading causes of death for toddlers for which supervision is a critical prevention strategy. Observations of parents supervising toddlers near these serious injury hazards in a park will be conducted and compared to the cultural model. Small group discussions with mothers and health professionals will be conducted to validate our findings and operationalize concepts of supervision. These findings will enhance understanding of supervision concepts that are necessary for developing culturally appropriate injury prevention interventions and strategies.