Samira Alfayumi-Zeadna

Late pregnancy loss, including stillbirth (following intrauterine fetal death) and termination of pregnancy (TOP), can cause a variety of poor psychiatric

Postpartum depression (PPD) is a complex condition that can have negative outcomes for mothers, children, and their families and may affect mothers' quality of life (QoL(. This study examined the impact of PPD symptoms (PPDs) on QoL among mothers in the first year postpartum, with a particular focus on vulnerable populations, specifically Arab women, and comparing them with Jewish mothers in Israel. For this cross-sectional study, we recruited 601 mothers (478 Jewish, 123 Arab), up to 12 months postpartum. The questionnaire battery included the Edinburgh Postnatal Depression Scale (EPDS) and the WHOQoL-BREF Assessment (QoL). Elevated PPD symptoms were defined as EPDS ≥ 13. Statistical analysis included bivariate associations and multiple linear regression to identify factors associated with QoL, adjusted for sociodemographic and obstetric variables. The prevalence of PPDs in this sample was 23.8%, with 21% among Jewish and 33% among Arab mothers. PPDs were significantly associated with QoL, with higher EPDS scores correlating with lower QoL scores. Ethnicity also showed a significant association with QoL, with Arab mothers reporting lower QoL. Additionally, low income, unemployed mothers, and those experiencing obstetric complications reported significantly lower QoL. These findings highlight the importance of early screening, diagnosis, and treatment of PPD to improve postpartum QoL. The observed disparities underscore the need for culturally tailored interventions to address ethnic differences. Future research should develop targeted strategies addressing psychological and socioeconomic factors in vulnerable populations effected by PPD.

Background/Objectives: There is a growing need for programs addressing perinatal mental health, particularly for new mothers. Postpartum depression (PPD) may occur during pregnancy or within the first year postpartum, with both short- and long-term negative consequences for both mothers and their infants. This study describes the cultural adaptation, implementation, and one-year follow-up of the Mom-to-Mom (M2M) program for minority Bedouin women in Southern Israel. Methods: We conducted a community-based intervention (M2M) emphasizing cultural adaptation. Outreach efforts were conducted in collaboration with healthcare professionals to encourage referral to the M2M program. A total of 111 mothers completed a self-administered questionnaire that included socio-demographic characteristics and PPD symptoms (PPDs) at two time points: prior to the intervention (Time-1) and one year after participating in the program (Time-2). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), using a score cutoff of ≥10. Results: There was a significant decrease in PPDs (EPDS ≥ 13) between Time-1 and Time-2 after one year of follow-up in the M2M program (from 45% to 19.8%). Of the participants, 75% were referred to the program by healthcare professionals. Among those with EPDS ≥ 10, 30% were referred to mental health services. This program provided education, professional support, and led to the establishment of the first M2M center within a Bedouin community, located in the Negev (Naqab). Conclusions: The results emphasize the importance of culturally sensitive approaches to increase awareness, early diagnosis, and professional support in addressing PPD, tailored to a cultural context. Culturally adapted programs can be effective in minority populations and contribute to reducing disparities in maternal mental health care.

Objectives: Housing First (HF) is an evidence-based approach to ending homelessness, particularly for individuals with mental illness. Yet, limited research explores which aspects of HF programmes facilitate change over time, within the context of a programme theory of change (ToC). A particular research gap includes how mechanisms of change within HF programmes differ between men and women. This study examines gender-specific pathways of change in the HF model based on secondary qualitative data from Toronto’s original At Home/Chez Soi (AH/CS) trial, focusing on outcomes of housing stability, socio-economic status, health and overall well-being. Design: This was a secondary qualitative analysis of the AH/CS trial data. This analysis was guided using a gender-sensitive ToC framework. Settings: This multisector study was conducted in a large Canadian urban centre in Toronto, Canada. Participants: A total of 32 participants (23 men and nine women) who identified themselves as male or female, 18 months after their enrolment in the treatment arm of the Toronto site of the AH/CS randomised controlled trial. Data collection and analysis: Semistructured interviews were conducted as part of the trial’s qualitative study. Thematic analysis was guided by the ToC framework and conducted using NVivo software. We assessed differences between men and women across the following outcome domains: housing stability, financial status, physical and mental health, substance use recovery and inpatient care. Results: The findings largely confirmed the ToC with participants, particularly women, experiencing greater improvements across all mechanisms of change, especially in housing stability, financial status and health outcomes. Men faced ongoing challenges, including difficulty maintaining stable income, limited engagement with education/training and continued struggles with mental health and substance use. Despite these improvements, both men and women participants reported ongoing challenges in achieving consistent income and accessing education or training opportunities. Conclusions: This study provides insight into how mechanisms of change within HF programmes differ between men and women. It underscores the need for ongoing programme adaptation and gender-responsive evaluation to meet the diverse needs of individuals, particularly those with mental health illness and histories of chronic homelessness.

Background A healthy lifestyle is a crucial step in disease prevention and management, as well as a significant predictor of health promotion. Yet, despite an increase in chronic morbidity among Bedouin women in southern Israel, little research has been conducted on their health behaviors. Therefore, the aim of this study is to examine barriers to adopting a healthy lifestyle and health promotion among ethnic minority Bedouin women in southern Israel. Methods This qualitative study was based on data collected through focus groups during June and July 2021. Participants included 44 Bedouin women aged 18–55. Focus groups were recorded and transcribed. Transcriptions were thematically analyzed and coded using the ecological model. Results We found multiple barriers at various levels that prevent Bedouin women from adopting a healthy lifestyle and health promotion. At the individual level, such factors included the impact of financial limitations on healthful nutrition, as well as a lack of awareness or knowledge regarding healthy lifestyle and health promotion. At the organizational level, barriers include a lack of clinics, accessibility, and availability of health services and cultural incompatibility of the health services. At the community level, impediments to a healthy lifestyle include inaccessibility to sports facilities and suppression of physical activity. At the public policy level, participants, especially those living in unrecognized villages, described difficult living conditions related to environmental and social neglect as affecting their health status and ability to maintain a healthy lifestyle. Conclusion Study findings emphasize the need for policymaking and a systemic approach to address health disparities and ensure equal health promotion for the Bedouin population.