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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.

OBJECTIVE: This study investigates the association between parental precarious employment (PE) and the mental health of their adolescent children, with a particular focus on how the association differs based on whether the mother or father is in PE. METHODS: This register-based study used the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort. A sample of 117 437 children aged 16 years at baseline (2005) were followed up until 2009 (the year they turned 20). A multidimensional construct of PE (SWE-ROPE 2.0) was used to classify parental employment as either precarious, substandard or standard. The outcome, adolescents’ mental disorders, was measured as a diagnosis of a mental disorder using ICD-10 codes or by prescribed psychotropic drugs using ATC codes. Crude and adjusted Cox regression models produced hazard ratios (HR) with 95% confidence intervals (CI) to estimate the association between parental PE and adolescents’ mental health. RESULTS: Adolescents with parents in PE exhibited a higher risk of developing mental disorders. The association was more pronounced for paternal PE (HR 1.22, 95% CI 1.10–1.35) compared to maternal PE (HR 1.11, 95% CI 1.00–1.21). These associations largely persisted after adjusting for important confounders, including parental mental health. CONCLUSION: This study addresses a significant gap in the literature on parental PE and adolescents’ mental health. As PE is growing more common across countries, this study provides relevant insights into the intergenerational role that parental low-quality employment may have in terms of mental health within families.

ObjectivesHousing 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.DesignThis was a secondary qualitative analysis of the AH/CS trial data. This analysis was guided using a gender-sensitive ToC framework.SettingsThis multisector study was conducted in a large Canadian urban centre in Toronto, Canada.ParticipantsA 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 analysisSemistructured 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.ResultsThe 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.ConclusionsThis 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 Across the globe, Indigenous women in subordinate social positions (minoritized, racialized, facing discrimination) experience poorer health outcomes and greater social inequalities than non-Indigenous women. Although intimate partner violence (IPV) may significantly exacerbate these disparities, the extent of IPVs contribution to the excess of health inequality has not been systematically quantified. Methods We estimated IPVs relative contribution to the excess of health inequalities between Indigenous Palestinian ( N  = 436) and Jewish women ( N  = 965) citizens in Israel, aged 18–50. We calculated adjusted odds ratios (AORs) and 95% confidence intervals for 10 mental and physical health conditions, considering socioeconomic and demographic factors. Mental health outcomes included: postpartum depression (PPD; EPDS ≥ 10), depressive symptoms (CES > 0.9), anxiety (STAI ≥14), self-rated health (SRH). Physical health included: abortions, miscarriages, preterm birth, unplanned pregnancy, chronic illness. Multimorbidity included: two-plus above conditions. IPVs specific contribution to health inequalities was calculated by % change (Δ) in AORs from adjusted model (socioeconomics and demographics) to a model that also considered IPV. Results Palestinian women had significantly poorer health than Jewish women for 7 of 10 conditions: OR (95%CI): PPD = 3.57 (2.41–5.31); depression = 3.46 (2.40–4.99); anxiety = 2.06 (1.63–2.60); unplanned pregnancy = 4.83 (3.18–7.34); miscarriages = 1.89 (1.47–2.71); preterm birth = 1.97 (1.51–2.57); multimorbidity = 1.48 (1.10–1.99). OR for chronic illness was significantly lower among Palestinian women (0.11, 0.05–0.23). Abortions and SRH were non-significant. Adjusting for IPV above socioeconomic and demographic factors, AORs for ethnonational inequalities were attenuated: physical health, 0.09% to 50.4%; mental health, 23.3% to 57.8%; multimorbidity, 29.7% (non-significant). The net contribution of IPV to the excess of ethnonational health inequalities was as follows: depression = 16.76%, anxiety = 20.39%, PPD = 20.19%, SRH = 14.65%, chronic illness = no contribution, abortions = 2.60%, miscarriages = 3.17%, preterm birth = 4.09, planned pregnancy = 24.43%, and multimorbidity = 24.33%. Conclusions Intimate partner violence (IPV) is a structural phenomenon shaped by intersecting social, economic, and systemic determinants that intensify health disparities between Palestinian and Jewish women during pregnancy and the postpartum period, and beyond what can be explained by socioeconomic or sociodemographic factors alone. Effectively addressing IPV and its underlying structural and social causes is essential for mitigating these persistent health inequalities.

Background Prevalence rates of postpartum depression (PPD) are 10 to 20% among various populations. Little is known about the characteristics of PPD among populations experiencing cultural transition. This study aimed to assess PPD symptoms (PPDS) prevalence and to identify risk factors unique to Arab‐Bedouin women in southern Israel. Methods The sample included 564 women who visited maternal and child health clinics. Sociodemographic characteristics were obtained using in‐person interviews. PPDS were assessed using a validated Arabic translation of the Edinburgh Postnatal Depression Scale (EPDS). Prevalence of PPDS was estimated using the cut‐off score of EPDS ≥10; a more stringent cut‐off score of EPDS ≥13 was used to define women with moderate to severe PPDS. Results The prevalence of PPDS among women was 31%, of which 19.1% were assessed as having moderate to severe symptoms (EPDS ≥ 13). In a multivariate logistic regression, the variables associated with EPDS ≥10 were having an ill‐infant odds ratio (OR) = 3.9, lack of husband's support (OR = 2.6), history of emotional problems (OR = 3.2), low income (OR = 1.6), low level of education (OR = 1.6), high marital conflicts (OR = 1.5), and an unplanned pregnancy (OR = 1.5). Conclusion In the generally understudied population of Arab‐Bedouin women living in southern Israel, we found a high prevalence of PPDS. The unique risk factors described in our research can inform health care professionals in designing interventions for early detection and prevention of PPD.

Background Residential segregation can foster health inequality mechanisms by increasing stress related to neighborhood violence and disorder. Aims We studied the association between neighborhood violence and disorder and inequalities in anxiety between two groups of perinatal Israeli women (Jewish, Palestinian-Arab) living in ethno-nationally segregated neighborhoods, and explored the influence of neighborhood characteristics; social support and chronic stress to this inequality. Methods We linked survey data on neighborhood violence and disorder, neighborhood social characteristics (collective efficacy, social capital and social support) and aggregate discrimination to neighborhood SES census data. The survey data was obtained from the “Family Relations, Violence and Health” study (2014–2015) and included a stratified national sample of women (Palestinian-Arab = 436, Jewish = 965) residing in 63 segregated neighborhoods. We conducted multi-variable logistic regression analysis for anxiety (measured based on State-trait Anxiety Inventory) using generalized estimating equation (GEE) to estimate odds ratios of the association with neighborhood violence and disorder (total score for 10 problems) while considering neighborhood characteristics (SES; social characteristics; aggregate discrimination), social support and chronic stress in different models for the total sample, and separately for Palestinian-Arab and Jewish women. Results Palestinian-Arab women had higher anxiety (60.5% vs. 42.1%, respectively) and higher severity of neighborhood violence and disorder (49.5% vs. 16.2%, respectively) compared to Jewish women. After considering individual and neighborhood variables, adjusted odds ratio (AOR) and 95% confidence intervals (CI) = 1.63, 1.04–2.56. The association between neighborhood violence and disorder and anxiety was significant for low vs. no problems in the final model for the total sample (AOR, 95%CI = 1.28, 1.00–1.64). Similarly, significant association was found only for low severity vs. no problems for Jewish women (1.40, 1.07–1.86). While among Palestinian-Arab women the association between neighborhood violence and disorder and anxiety rendered insignificant in the final model. Neighborhood social cohesion and social support were protective factors from anxiety in both groups, high neighborhood SES was protective factor only among Jewish women, and neighborhood aggregate discrimination was a risk factor only in Palestinian-Arab women. Conclusions Inequalities in anxiety related to neighborhood violence and disorder in ethno-national perinatal groups of women likely reflect residential segregation. Policies entrenching segregation might have affected neighborhood mechanisms (SES inequalities, aggregate discrimination and low social cohesion) that lead to higher stress and ethno-national inequalities in anxiety among perinatal women.

PurposeEndometrial scratching (ES) using a biopsy catheter prior to the IVF cycle in the repeated implantation failure (RIF) population has been suggested, but no convincing evidence of its benefit has been presented until now.MethodsA retrospective mono-center study among 300 consecutive IVF-RIF cycles following evaluation of the ovarian reserve, hysterosalpingography or hysteroscopy, pelvic ultrasound, thrombophilia evaluation, karyotyping and assessment of male sperm parametrs. The findings within normal limits. All the patients offered ES, 78 consented and underwent ES prior to their next IVF cycle.ResultsA comparison of treatment outcomes between the post-ES cycles (n = 78) and the non-ES cycles (222) demonstrated the following: 34 (43.5%) versus 14 (6.3%) conceptions, respectively (p = 0.001) and 30 (38.4%) versus 2 (0.9%) clinical pregnancies, respectively (p < 0.001%), emphasizing an extremely high biochemical pregnancy rate among the non-ES cycles. Implantation rate was 19.7% versus 0.4%, respectively (p < 0.001) and live birth rate was 33.33% (26 newborns) versus 0.45% (1 newborn), respectively (p < 0.001). Since there were more embryos available for transfer and more top-quality embryos in the post-ES–IVF conception cycles, the role of ES became questionable. A multivariate analysis that included ES and the percentage of top-quality embryos demonstrated that ES was an independent factor highly correlated with conception in this particular RIF population.ConclusionsES proved to be an efficient tool in a particular subgroup of RIF patients with fertility investigation results within normal limits, an optimal ovarian response to gonadotropins, and a high percentage of top-quality embryos. Nevertheless, the results should not be overestimated, since the study has limitations related to its retrospective model.

This study aimed to analyse the role of governmental responses to the coronavirus disease 2019 (COVID-19) outbreak, measured by the Containment and Health Index (CHI), on symptoms of anxiety and depression during pregnancy and postpartum, while considering the countries’ Inequality-adjusted Human Development Index (IHDI) and individual factors such as age, gravidity, and exposure to COVID-19. A cross-sectional study using baseline data from the Riseup-PPD-COVID-19 observational prospective international study (ClinicalTrials.gov: NCT04595123) was carried out between June and October 2020 in 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Participants were 7645 pregnant women or mothers in the postpartum period—with an infant aged up to 6 months—who completed the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Assessment (GAD-7) during pregnancy or the postpartum period. The overall prevalence of clinically significant depression symptoms (EPDS ≥ 13) was 30%, ranging from 20,5% in Cyprus to 44,3% in Brazil. The prevalence of clinically significant anxiety symptoms (GAD-7 ≥ 10) was 23,6% (ranging from 14,2% in Israel and Turkey to 39,5% in Brazil). Higher symptoms of anxiety or depression were observed in multigravida exposed to COVID-19 or living in countries with a higher number of deaths due to COVID-19. Furthermore, multigravida from countries with lower IHDI or CHI had higher symptoms of anxiety and depression. Perinatal mental health is context-dependent, with women from more disadvantaged countries at higher risk for poor mental health. Implementing more restrictive measures seems to be a protective factor for mental health, at least in the initial phase of the COVID-19.

ObjectiveThe adverse effects of precarious employment (PE) on workers’ health are well documented, ranging from depression and anxiety to cardiovascular disease and work-related injuries. However, it is cogent to look beyond the impact PE has on worker health and investigate how PE may impact the family unit, particularly children’s health. Currently, little is known about the impact of parental PE on children’s mental health. This study responds to this gap by examining the effects of parental PE on the mental health of their adolescent children. Moreover, we explore how this association varies depending on whether it is the mother or the father who are in PE.Materials and MethodsThis register-based study uses the Swedish Work, Illness, and Labour-market Participation (SWIP) cohort. A sample of n=117,453 children aged 15 years at baseline (2005) were followed-up until the age of 19 (2009). A multidimensional construct of PE (SWE-ROPE 2.0) was used to classify parental employment conditions into three groups ‘precarious’, ‘substandard’ and ‘standard employment’. The outcome, adolescents’ mental health, was measured as a diagnosis of a common mental disorder using ICD-10 codes. Crude and adjusted Cox regression models produced Hazard Rations (HR) with (95%CI) to estimate the effect of parental PE on adolescents’ mental health.ResultsPreliminary results show an increased risk of mental disorders among adolescents whose parents were in PE. A stronger association is observed for paternal PE compared to maternal PE. The associations remain after accounting for confounders, including parental mental health.ConclusionsOur longitudinal study-design aims to fill a large research gap on parental PE and adolescents’ mental health. As PE is growing more common in many countries, this study provides relevant insights on the role that insecure and unstable employment may have in terms of mental health within families.