Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme

"All Children in Focus": Effects of a Universal Parenting Program at a 6-Month Follow-Up in a Randomized Controlled Trial in Sweden

Parenting programs have been shown to empower parents and prevent mental health problems in children. However, few programs are designed to promote wellbeing, which led to the development of the Swedish-promotive universal program, "All Children in Focus" (ACF). This study aimed to understand the effects of parents' participation in the ACF program on parents' emotion regulation and parenting practices over a 6-month follow-up and if intervention-produced changes predict child wellbeing (CW). Parental self-efficacy (PSE) was also included to assess the relation with parental outcomes and CW. This is an evaluation of a multicenter randomized waitlisted control trial conducted in Stockholm County, Sweden, with parents of children aged 3 to 12 years (n = 621) in 2012. Parents were randomized 1:1 to enter the program or to a waitlist. Questionnaires were completed by parents at baseline, post-intervention, and 6 months post-baseline. We used generalized mixed modeling to test effects on parental outcomes over time and regression analyses to study the predictive role of parental outcomes on CW. From baseline to the post- and to the 6-month follow-ups, parents in the intervention group reported greater levels of emotion regulation skills, cognitive reappraisal, and positive parenting than did parents in the control group. A decrease in negative and harsh parenting was evident in both groups, although it was greater in the intervention group. An increase in PSE was associated with high negative parenting at baseline in the intervention group. Child gender moderated positive parenting, suggesting that parents of girls in the intervention group had more favorable development of positive strategies. The findings indicate that a change in PSE predicts a change in CW at 6 months. The ACF program can be used to strengthen and develop parenting. This study advances our knowledge about the potential advantages of using a health-promoting approach to strengthen the wellbeing of families in the general population. Clinical trial registration: ISRCTN70202532 Current Controlled Trials.

Indirect effect of ADHD on parenting stress through increased child anxiety and decreased emotional regulatory coping

Parents of children with ADHD experience significantly more parenting stress in comparison to parents of typically developing children due to the emotional and behavioral difficulties related to ADHD. Additionally, approximately 30% of children with ADHD experience co-occurring anxiety. Parents of children with co-occurring anxiety and ADHD report increased stress due to role restriction and isolation compared to parents of children with ADHD alone. Poor emotional regulatory coping in children with ADHD has been linked to elevated negative affect and irritability, which also contributes to increased stress among parents. The present study examined the direct and indirect associations of child anxiety symptoms and emotional regulatory coping on elevated ADHD symptoms and parenting stress. Participants were 203 children aged 7-12-years-old and their parents. Parents completed a self-report measure of parenting stress and measures of their child's ADHD symptoms, anxiety, and emotional regulatory coping. Additionally, children completed self-report measures of emotional regulatory coping. Model testing indicated that the overall model demonstrated excellent fit to the data. Parameter testing supported an indirect effect of child ADHD symptoms on parenting stress through child anxiety symptoms and an indirect effect of child ADHD symptoms on parenting stress through child emotional regulatory coping. These results suggest that child anxiety and emotion dysregulation in children with ADHD have a negative impact on parental stress. The current study adds to the understanding of the important roles emotional regulatory coping and anxiety play in children with ADHD to contribute to increased parenting stress.

A cost-effectiveness analysis of a universal, preventative-focused, parent and infant programme

BACKGROUND

This study assessed whether a relatively newly developed Parent and Infant (PIN) parenting support programme was cost-effective when compared to services as usual (SAU).

METHODS

The cost-effectiveness of the PIN programme versus SAU was assessed from an Irish health and social care perspective over a 24-month timeframe and within the context of a non-randomised, controlled before-and-after trial. In total, 163 parent-infant dyads were included in the study (86 intervention, 77 control). The primary outcome measure for the economic evaluation was the Parenting Sense of Competence Scale (PSOC).

RESULTS

The average cost of the PIN programme was €647 per dyad. The mean (SE) cost (including programme costs) was €7,027 (SE €1,345) compared to €4,811 (SE €593) in the control arm, generating a (non-significant) mean cost difference of €2,216 (bootstrap 95% CI -€665 to €5,096; p = 0.14). The mean incremental cost-effectiveness of the PIN service was €614 per PSOC unit gained (bootstrap 95% CI €54 to €1,481). The probability that the PIN programme was cost-effective, was 87% at a willingness-to-pay of €1,000 per one unit change in the PSOC.

CONCLUSIONS

Our findings suggest that the PIN programme was cost-effective at a relatively low willingness-to-pay threshold when compared to SAU. This study addresses a significant knowledge gap in the field of early intervention by providing important real world evidence on the implementation costs and cost-effectiveness of a universal early years parenting programme. The challenges involved in assessing the cost-effectiveness of preventative interventions for very young children and their parents are also discussed.

TRIAL REGISTRATION

ISRCTN17488830 (Date of registration: 27/11/15). This trial was retrospectively registered.

Explainable Machine Learning Classification to Identify Vulnerable Groups Among Parenting Mothers: Web-Based Cross-Sectional Questionnaire Study

BACKGROUND

One life event that requires extensive resilience and adaptation is parenting. However, resilience and perceived support in child-rearing vary, making the real-world situation unclear, even with postpartum checkups.

OBJECTIVE

This study aimed to explore the psychosocial status of mothers during the child-rearing period from newborn to toddler, with a classifier based on data on the resilience and adaptation characteristics of mothers with newborns.

METHODS

A web-based cross-sectional survey was conducted. Mothers with newborns aged approximately 1 month (newborn cohort) were analyzed to construct an explainable machine learning classifier to stratify parenting-related resilience and adaptation characteristics and identify vulnerable populations. Explainable k-means clustering was used because of its high explanatory power and applicability. The classifier was applied to mothers with infants aged 2 months to 1 year (infant cohort) and mothers with toddlers aged >1 year to 2 years (toddler cohort). Psychosocial status, including depressed mood assessed by the Edinburgh Postnatal Depression Scale (EPDS), bonding assessed by the Postpartum Bonding Questionnaire (PBQ), and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) between the classified groups, was compared.

RESULTS

A total of 1559 participants completed the survey. They were split into 3 cohorts, comprising populations of various characteristics, including parenting difficulties and psychosocial measures. The classifier, which stratified participants into 5 groups, was generated from the self-reported scores of resilience and adaptation in the newborn cohort (n=310). The classifier identified that the group with the greatest difficulties in resilience and adaptation to a child's temperament and perceived support had higher incidences of problems with depressed mood (relative prevalence [RP] 5.87, 95% CI 2.77-12.45), bonding (RP 5.38, 95% CI 2.53-11.45), and sleep quality (RP 1.70, 95% CI 1.20-2.40) compared to the group with no difficulties in perceived support. In the infant cohort (n=619) and toddler cohort (n=461), the stratified group with the greatest difficulties had higher incidences of problems with depressed mood (RP 9.05, 95% CI 4.36-18.80 and RP 4.63, 95% CI 2.38-9.02, respectively), bonding (RP 1.63, 95% CI 1.29-2.06 and RP 3.19, 95% CI 2.03-5.01, respectively), and sleep quality (RP 8.09, 95% CI 4.62-16.37 and RP 1.72, 95% CI 1.23-2.42, respectively) compared to the group with no difficulties.

CONCLUSIONS

The classifier, based on a combination of resilience and adaptation to the child's temperament and perceived support, was able identify psychosocial vulnerable groups in the newborn cohort, the start-up stage of childcare. Psychosocially vulnerable groups were also identified in qualitatively different infant and toddler cohorts, depending on their classifier. The vulnerable group identified in the infant cohort showed particularly high RP for depressed mood and poor sleep quality.

Development and validation of a parental competence questionnaire in the paediatric hospital emergency setting (ECP-U)

OBJECTIVE

To develop and validate a parental competence questionnaire for parents of children seeking care in hospital emergency departments.

METHODS

An instrumental study of the development of an assessment questionnaire was carried out in three phases: 1) review of relevant measures and item generation, 2) content validity evaluation, 3) psychometric evaluation. Exploratory factor analysis was performed to examine the factorial structure. Internal consistency was evaluated using ordinal alpha. Hypothesis testing was determined between the resulting factors, the Parental Stress Scale and the State-Trait Anxiety Inventory.

RESULTS

The participants were 270 parents of children aged 0-14 years old from a referral hospital in Valencia (Spain). An 18-item questionnaire was developed, comprising five factors that explain 53.0% of the variance: 1) "emotional management and expression", 2) "passive social support", 3) "parental agency", 4) "basic needs and care" and 5) "active social support". The internal consistency for the different factors was modest (>0.70). A negative correlation between the Parental Stress Scale and the parental competence questionnaire was found for most of the factors.

CONCLUSIONS

This questionnaire on parental competence in the hospital emergency department (ECP-U) is a useful and simple self-report instrument for assessing the parental competence of parents with children in the emergency department.

PRACTICAL IMPLICATIONS

The resulting questionnaire is of practical value to both healthcare professionals and researchers in this field. It can be administered quickly in clinical practice and used to identify parents' levels of parental competence and refer those with difficulties to appropriate support services.

Factor structure and validity of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U)

OBJECTIVE

To confirm the structure and examine the psychometric properties of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U).

METHODS

An instrumental validation study of the ECP-U questionnaire and an examination of its psychometric properties were carried out.

RESULTS

The participants were 260 mothers and fathers seeking care in the paediatric emergency department of a hospital in Valencia (Spain) with children aged 0 to 14 years old. The five-factor structure of the ECP-U was confirmed with excellent statistical fits. Second-order models and a more parsimonious four-factor structure with adequate but marginal fits are proposed. With the exception of the "parental agency" factor (in both models examined) and the "active social support" factor (in the original five-factor structure), the internal consistency of the different factors was modest (≥ 0.70). A negative correlation was found between the Parental Stress Scale and the ECP-U for most factors.

CONCLUSIONS

Validity and reliability analyses indicate that the ECP-U is an instrument with modest psychometric properties.

IMPLICATIONS FOR PRACTICE

The ECP-U is an instrument that can be used by future researchers to identify different levels of parental competence in paediatric hospital emergency departments. This will enable help to be given to families with parenting issues and problems. The underlying concern is to reduce the number of frequent users and "Non-Urgent Presentations" to paediatric emergency departments due to low parental competence.

Understanding women's suffering and psychological well-being: exploring biopsychosocial factors in mothers of children with ADHD - a case study

Overview

Parents play a dynamic part in child development. Mothers have a great responsibility towards the upbringing child. Previous research has demonstrated that parenting stress levels are high among Parents of children with attention deficit hyperactivity disorder (ADHD).

Aim

Parenting stress affects the psychological well-being of the mother. It is necessary to identify the factors that affect psychological well-being based on Biopsychosocial factors, including biological, psychological, and social factors.

Methodology

An in-depth case study was conducted with the mother of a 7-year-old child diagnosed with attention deficit hyperactivity disorder.

Results

The mother lacks self-efficacy and low perceived social support in. Equipping themselves and building up the knowledge on handling the child and training the child with the developmental disorder increase parenting self-efficacy. Support from family, partner, and society will help them strengthen themselves and may have high psychological support.

Child ViReal Support Program: A Randomized Controlled Trial Study for Effective Support of Parents Raising Children with Attention Deficits

Attention deficit hyperactivity disorder (ADHD) results in various functioning impairments in children's lives and families. Parents of children with ADHD report high levels of parenting stress, low levels of parental self-efficacy, and use of more authoritarian and/or permissive parenting practices than parents of typically developing children. Intervention programs need to address both children's and parents' needs and multimodal intervention programs could cover this demand. The aim of this study was to examine the efficacy of "Child ViReal Support Program"-a multi-level evidence-based comprehensive program-on parenting stress, parental self-efficacy, parenting practices, and the core symptoms of children's ADHD. Families with a child diagnosed with ADHD (n = 16) were randomly allocated to two groups (PC and CP; P = parent training, C = child training), and a cross-over design was utilized. Participating parents completed, in four different times during the study, the Parenting Stress Index-Short Form, the Parenting Sense of Competence Scale, the Parenting Styles and Dimensions Questionnaire-Short Version, and the parent form of the ADHD Rating Scale-IV. Parents from both groups, after their participation in the parent training, demonstrated reduced parenting stress, enhanced parental self-efficacy, and increased the employ of democratic parenting practices. More than that, they reported decreased levels of inattention and impulsivity/hyperactivity for their children. Evidence-based multi-level intervention programs could produce positive effects on parents and children by incorporating effective methods and tools in accordance with the needs and the demands of the family context.

Negative Parenting Mediates the Longitudinal Association between Parental Internalizing Symptoms and Child Oppositional Symptoms

Research has pointed to both cross-sectional and longitudinal associations between parental internalizing symptoms and child externalizing symptoms. This study analyzed whether the association is mediated by negative parenting behavior in view of previous reports that both parental internalizing symptoms and child externalizing symptoms are related to parenting behaviors. Longitudinal data for the current analyses were derived from a randomized controlled trial on the efficacy of a web-assisted self-help intervention for parents of children with elevated levels of externalizing symptoms. Two different mediation models were analyzed, one using attention-deficit/hyperactivity disorder (ADHD) symptoms as the dependent variable and the other using oppositional defiant disorder (ODD) symptoms. Both models included parental internalizing symptoms as the independent variable, negative parenting behavior as a mediator, and study condition as a confounder. The longitudinal analyses support the mediating role of negative parenting behavior in the association between early parental internalizing symptoms and later child ODD symptoms.

Antenatal predictors of postnatal maternal attachment and competence after assisted conception-a prospective cohort study in South India

The aim of this study is to examine the influence of antenatal factors such as anxiety, depression, perceived stress, marital satisfaction, maternal antenatal attachment, and social support on postnatal maternal attachment and competence in women who received assisted reproductive treatment. A prospective longitudinal cohort design was adopted with two groups-50 women who received assisted reproductive treatment and 50 women who had natural conception. Both the groups were assessed using self-report measures over three time points: T1, 7th month of pregnancy; T2, 2 weeks postpartum; and T3, 3 months postpartum. A final sample of 44 women who had assisted conception and 47 women who had natural conception completed assessments across all three time points. Descriptive, bivariate analyses, and stepwise multiple linear regression analyses were carried out. In the assisted conception group, maternal antenatal attachment, depression, and marital satisfaction significantly predicted postnatal maternal-infant attachment. Perceived social support, depression, and duration of marriage significantly predicted postnatal maternal competence. In the naturally conceived group, maternal antenatal attachment and social support significantly predicted postnatal maternal-infant attachment; perceived stress significantly predicted postnatal maternal competence. Antenatal depressive symptoms and relational factors significantly influenced postnatal maternal attachment and competence highlighting the need for screening and targeted psychological interventions during pregnancy.

[Children's mental health: the role of screen time, parenting behavior, and parenting stress-a secondary data analysis of KiGGS and BELLA data]

BACKGROUND

Previous studies established a link between high screen time and mental health problems in childhood. The role of possible influencing factors is currently unclear. This study aims at testing correlations among mental health problems, high screen time, parenting stress, and inconsistent and positive parenting behavior.

METHODS

This study is based on data from the KiGGS and BELLA studies. For the present study, data from preschool children (age: 3-5 years, N = 417) and school children (age: 7-13 years, N = 239) were analyzed. Binary-logistic regressions were carried out to test for correlations between high screen time and children's mental health problems in cross-sectional and longitudinal analyses. Socioeconomic status, the child's gender, the parent's gender, parenting stress, and inconsistent and positive parenting behavior were used as control variables.

RESULTS

In the cross-sectional analysis, mental health problems in preschool children were associated with high screen time (OR = 3.02; p = 0.003), parenting stress (OR = 17.00; p < 0.001), and positive parenting behavior (OR = 0.24; p < 0.001). In the longitudinal analysis, mental health problems in school children were associated with parenting stress (OR = 4.04; p < 0.001). Socioeconomic status and the child's and parent's gender were at no point associated with mental health problems.

DISCUSSION

The sole existence of high screen time cannot explain mental health problems in children. Parental variables seem to be critical for children's mental health and should be considered in a holistic apporach on children's mental health in terms of strengthening parental competencies.

The effectiveness of the serious game "Broodles" for siblings of children with intellectual disabilities and/or visual impairment: study protocol for a randomized controlled trial

BACKGROUND

Siblings of children with disabilities also need support. However, there are only a few evidence-based interventions for these siblings. The current study aims to assess the effectiveness of a newly developed serious game for young siblings of children with intellectual disability (ID) and/or visual impairment (VI). This serious game is hypothesized to improve sibling's quality of life, adjustment to their brother's or sister's disability, and multiple aspects of psychosocial well-being.

METHODS

The intervention consists of a serious game called "Broodles" (in Dutch: "Broedels") that helps children to recognize and deal with thoughts, feelings, and difficult situations. The game consists of eight 20-minute levels that all have the same structure with eight game elements. Each level addresses a domain of sibling quality of life and combines animations, mini-documentaries, fun mini-games, and multiple-choice questions. In addition to the game, siblings make a worksheet after playing each level. In order to support the child, the parents or caregivers receive a short brochure with information and tips. The effectiveness of the intervention will be investigated among a sample of 154 children aged 6-9 years and their parents or caregivers, using a two-arm parallel RCT design. The experimental group will play the serious game "Broodles" over a period of 4 weeks, whereas the control group will be placed on a waiting list. Assessments will take place at three time points: pre-test (week 1), post-test (week 5), and follow-up (weeks 12-14). At each timepoint, children and parents will complete several questionnaires on quality of life and different aspects of psychosocial well-being. In addition, children will make drawings to assess the sibling relationship. Next to that, parents and children will answer closed and open-ended questions about the sibling adjustment to their brother or sister's disability. Finally, parents and children will evaluate the serious game through closed and open-ended questions.

DISCUSSION

This study contributes to the knowledge about sibling interventions and serious games. Additionally, if the serious game is proven to be effective, it will be a readily available, easily accessible, and free of charge intervention for siblings.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05376007, registered prospectively on April 21, 2022.

Intergenerational risk and resilience pathways from discrimination and acculturative stress to infant mental health

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers' exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related to more infant negative emotionality at approximately 12 months old (M = 12.6, SD = .75). In contrast, maternal report of parenting self-efficacy when infants were 6 months old was related to lower levels of infant negative emotionality. Further, higher levels of parenting self-efficacy mitigated the relation between acculturative stress and negative emotionality. Preconception and prenatal exposure to sociocultural stress may be a risk factor for poor offspring mental health. Maternal and child health researchers, policymakers, and practitioners should prioritize further understanding these relations, reducing exposure to sociocultural stressors, and promoting resilience.

Brief emotion-focused family therapy: A 12-month follow-up study

This study provides a 12-month follow-up evaluation of caregivers after participating in a 2-day Emotion-focused family therapy (EFFT) intensive, a brief intervention for caregivers of youth struggling with mental health difficulties. Caregivers (N = 498) of children (N = 337) completed measures of caregiver self-efficacy and child mental health difficulties 1 week before the intervention, immediately after the intervention, and at 4, 8, and 12-month follow-ups. Piecewise latent trajectory models revealed that parental self-efficacy showed a large immediate increase following the intervention, β = 1.61 (1.32, 2.14), and although this effect was attenuated by 4 months, β = -0.77 (-1.31, -0.52), it did not change further by 12 months. Reductions in child mental health difficulties were observed by 4 months, β = -0.54 (-0.77, -0.37), and remained stable through the 12-month follow-up. Caregivers reporting more increases in self-efficacy also reported greater reductions in their children's symptoms at 4 and 12 months.

Parenting Styles, Family Characteristics, and Teacher-Reported Behavioral Outcomes in Kindergarten

It is well established that parenting influences child behavior at home, but less is known about the associations between parenting and teacher reports of child behavior at school, an environment more distal from the home context. This study investigated the presence of authoritarian, authoritative, permissive, and uninvolved parenting styles (PS) in a community sample of 321 parents with kindergarteners (M_age = 5.45 years) in the Northwestern United States. This study analyzed (1) which PS were present, (2) if PS was associated with family characteristics, (3) if teacher reported behavior problems in spring of children's kindergarten year varied by PS, and (4) whether associations between PS and child behaviors were moderated by parenting stress. Study hypotheses were that PS would be associated with family characteristics, that teacher reported child behaviors would differ by PS, and that parenting stress would moderate the relationship between PS and behavior problems at school. Results indicated all PS were present. Chi-squares and ANOVA's identified that PS were significantly associated with parenting stress and child problem behaviors. ANOVAs determined differences in parenting stress and problem behaviors depending on PS. ANOVAs revealed parenting stress moderated the relation between PS and child problem behavior. Few studies to date have analyzed the presence of all four PS among kindergarteners and the relationship this has with teacher-reported classroom behavioral concerns. This study sought to fill this gap as results have implications for targeted parenting prevention interventions to promote children's social and behavioral adjustment during the transition to elementary school.

The Effect of Parenting Peer Education Interventions for Young Mothers on the Growth and Development of Children under Five

One of the contributing factors in the growth and development of children under five is the mother's ability to provide childcare, but young mothers do not have enough parenting skills. The goal of the current study was to examine the effect of the parenting peer education (PPE) programme on young mothers' parenting self-efficacy and behaviour, and the growth and development of children under five. There were two groups, which were a control group (without intervention) and an intervention group, in which there were 15 participants in each group. Analysis covariance with the pre-test scores as covariates was used in this study. The results showed that, compared with the control group, the intervention group reported significantly better parenting self-efficacy, parenting behaviour, children's growth, and children's development, including cognitive, language, and motoric aspects. The PPE programme can exchange the young mothers' experiences on how their children grow and develop, and the mothers will also receive psychological support. In conclusion, the PPE programme affected the young mothers' parenting self-efficacy and parenting behaviour and the children's growth and development.

Examining the influence of irritability and ADHD on domains of parenting stress

Parents of children with ADHD typically report higher levels of parenting stress than parents of typically developing children. Children with ADHD display developmentally inappropriate levels of hyperactivity, impulsivity, and inattention. Some children with ADHD are also prone to particularly high levels of tonic irritability that may explain some of the impairments typically found in ADHD. The present study sought to determine the unique impact of ADHD and tonic irritability on child-related parenting stress domains (e.g., difficult child, parent-child dysfunctional interactions). 145 mothers of children with and without ADHD aged 7-12 years participated in the current study. Mothers completed self-report measures of parenting stress as well as a diagnostic structured interview. Ecological momentary assessment (EMA) was used to assess tonic irritability in an ecological environment. Indirect effects models were specified using PROCESS Model 4. For the parent-child dysfunctional interaction domain, the data were best fit by a model specifying a significant total effect of ADHD that was fully accounted for by an indirect effect through irritability. For the difficult child domain, model testing indicated a significant total effect of ADHD that was partially accounted for by an indirect effect through irritability. The current study adds support to the growing body of literature acknowledging the role of tonic irritability in children with ADHD. Furthermore, the results provide novel insight in the complex relation of irritability, child ADHD, and domains of parenting stress.

A preliminary evaluation of Kids Matter: A community-based parenting intervention

Parents living in deprived communities are more likely to report lower parental self-efficacy and wellbeing. Poor parental wellbeing and self-efficacy are known risk factors in the development of a range of health and behavioural problems in childhood, adolescence and adulthood. Parenting interventions are key to prevent adverse outcomes in children, however, the mechanisms by which parents learn to understand and support their children are still not well understood. This study evaluated the acceptability of Kids Matter, a parenting intervention targeting parents who are struggling with financial adversity. Secondarily, the relationship between parental wellbeing and and self-efficacy was examined. The present is a retrospective, consecutive case series design study, comparing routinely collected data at pre-intervention, post-intervention, and at 3-month follow-up. Descriptive frequencies were drawn to explore parents' impressions of the programme. Multivariate analysis of variance and regression modelling were used to evaluate associations between parental wellbeing and self-efficacy at different time points. Parents found the programme enjoyable and useful. The intervention led to significant improvements in parental wellbeing and self-efficacy. Improvements in parental wellbeing were significantly associated with improvements in self-efficacy. This study provides evidence of the acceptability and effectiveness of Kids Matter.

Poverty, social exclusion, and mental health: the role of the family context in children aged 7-11 years INMA mother-and-child cohort study

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7-11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7-11) (HEFAS 7-11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood.

The relationship between parental involvement and psychological adjustment among Chinese children with autism spectrum disorder in the transition from kindergarten to primary school: A chain-mediating model

Introduction

This study examined the impact of parental involvement on the psychological adjustment of children with autism spectrum disorder (ASD), and the role of parenting self-efficacy and parenting stress in the transition from kindergarten to primary school.

Methods

Using the questionnaires, we collected data from 237 Chinese parents of children with ASD.

Results

Mediation analyses showed that parental involvement partially promoted the psychological adjustment of children with ASD, which was reflected in the fact that parental involvement promoted children's prosocial behavior but did not reduce their emotional/behavioral problems. Mediation analyses also revealed the role of the mediator in parenting stress between parental involvement and the psychological adjustment of children. Additionally, the results suggested that parenting self-efficacy and parenting stress played a chain-mediating role in the association between parental involvement and psychological adjustment in children with ASD.

Discussion

These findings enhance our understanding of the mechanisms underlying the relationship between parental involvement and psychological adjustment in children with ASD in the transition from kindergarten to primary school.

Latina mothers' mental health: An examination of its relation to parenting and material resources

The demands and stressors associated with motherhood can increase a mother's risk for mental health concerns. Latina mothers are particularly vulnerable to the relation between motherhood-related stressors and maternal mental health given that they are at an increased risk for mental health concerns, that they are likely to have their mental health needs go unmet, and that traditional Latinx cultural values/gender roles emphasize women assuming the role of primary caregiver of the family's children. In an attempt to better understand how motherhood impacts Latina mother's mental health, this study explored the relations among parental self-efficacy, parenting stress, and maternal mental health. This study also explored how a mother's perception of her material resources influenced these relations. One hundred and thirty-two Latina mothers completed questionnaires to assess parenting stress, parental self-efficacy, and maternal mental health risk. The moderating effect of maternal perception of material resources in the aforementioned relations was assessed through the creation of a composite variable derived from items in the demographic questionnaires. Multiple linear regression analyses were used. Higher levels of parenting stress, but not parental self-efficacy, were related to increased maternal mental health risk. Furthermore, mothers who perceived themselves to have lower material resources were at increased risk for diminished mental health in the context of low parental self-efficacy. Results of this study yielded important information that is necessary for informing healthcare best practices, identifying targets for future interventions, and ultimately improving the health outcomes of Latinx mothers and their families.

Effects of health promotion program on maternal attachment, parenting self-efficacy, infant development: a randomised controlled trial

This study was designed to test the efficacy of the health promotion program used on maternal-infant attachment, parental self-efficacy, infant development. For this experimental study parallel-group randomised control design was used. Data was collected from 64 mother and their infants. The intervention group received the health promotion program in addition to standard care, the control group received only the standard care. Family Information Form, Prenatal Attachment Inventory, Maternal Attachment Inventory, Parenting Self-Efficacy Scale, and Denver II Developmental Screening Tests were used for the collection of the data. Pearson χ2 test, Yates corrected χ2 test, independent t-test, and Mcnemar test were used for analysing the collected data. The groups on maternal-infant attachment (d:1.20 [CI:0.671-1.736]), parental self-efficacy (d:1.37 [CI:0.835 to 1.925]), and development delays of infants (p = .003, C.V: 0.41) were found to be statistically significant. Health promotion program positively influenced the maternal attachment, parental self-efficacy, the development of the infants.IMPACT STATEMENTWhat is already known on this subject? Pregnancy and postpartum is a difficult period for mothers. Mothers need support. Parenting self-efficacy and maternal attachment are important for improving infant health. Infant should be supported to prevent developmental delays.What do the results of this study add? With the education and support program applied before and after birth, mother and baby were evaluated together and multi-faceted support was provided.What are the implications of these findings for clinical practice and/or further research? Supporting parenting self-efficacy, maternal attachment and infant development should be started during pregnancy and should be continued in the postpartum period.

An online self-directed program combining Community Reinforcement Approach and Family Training and parenting training for concerned significant others sharing a child with a person with problematic alcohol consumption: a randomized controlled trial

BACKGROUND

There is an urgent need for interventions helping children affected by parental problematic alcohol consumption (PAC). Such interventions could target partners to individuals with PAC, partners who often themselves show impaired quality of life and mental health. The aim of this study was to investigate the efficacy of an online self-directed intervention combining components from Community Reinforcement Approach and Family Training (CRAFT) with a parenting training program for concerned significant others (CSOs) sharing a child with a co-parent with PAC.

METHODS

A randomized controlled parallel-group superiority trial compared the efficacy of the online intervention for CSOs sharing a child (3-11 y/o) with a co-parent with PAC (N = 37), to an active control group (N = 39) receiving written psychoeducational material. Assessment of outcomes was conducted at baseline, 3 weeks, 8 weeks and 12 weeks. Primary outcome was children's mental health, while secondary outcomes included parental self-efficacy, CSO mental health and co-parent alcohol consumption and level of dependence. Linear mixed effect models with a factorial time variable were used to model time by group interaction effects.

RESULTS

Recruitment rate was slow and a vast majority of interested CSOs were excluded at baseline assessment, mainly due experience of co-parent violence. The target sample size was not met. The intention to treat analysis did not show any significant time by group effects on either the primary or secondary outcomes during the follow-up period: the CSOs reported a significant reduction in co-parent alcohol consumption and severity of alcohol dependence and showed significant improvements in parental self-efficacy for how to handle effects of co-parent alcohol consumption, but no differences were found between the two conditions.

CONCLUSIONS

The current study found no evidence supporting efficacy of a novel, online self-directed intervention on children's mental health, CSO mental health and co-parent alcohol related outcomes. Engaging in a support program or receiving information appears to initiate behavior change in the CSOs which affects the alcohol consumption and severity of dependence for co-parents with PAC. It is suggested that future studies may preferably focus on CSOs in more severely affected contexts. Trial registration The trial was pre-registered at isrctn.com reference number ISRCTN38702517, November 28, 2017.

Children's anxiety and parenting self-efficacy during the COVID-19-related home confinement

BACKGROUND

The COVID-19 crisis influenced the lives of families and preschoolers, worldwide. School closures and restriction measures introduced distance learning for preschoolers and remote working for parents. Social distancing narrowed opportunities to meet with peers and enjoy leisure activities. Additionally, social and mental services closures limited young children's accessibility to mental, speech and occupational health services. The aim of the current study was to investigate how home confinement during the third wave of the COVID-19 pandemic affected parenting self-efficacy and preschoolers' anxiety.

METHOD

An online survey based on a convenience sample took place on April 2021 to evaluate how home confinement to halt the third wave of COVID-19 pandemic influenced children's anxiety and parenting self-efficacy (PSE). Parents of 146 children (65 girls [44.5%] and 81 boys [55.5%]; aged 2-6 years old) were enrolled and completed a demographics form, the Preschool Anxiety Scale (PAS) and the Tool to Measure Parenting Self-efficacy (TOPSE).

RESULTS

Most of the participants reported that the relationship with their child was positively affected from staying at home. TOPSE mean scores reflected average parenting self-efficacy. PSE was negatively correlated with children's anxiety. COVID-19-related variables 'Parent's vaccine hesitancy' and 'Death of a loved one' had a clear effect on preschoolers' anxiety, whereas the latter also on PSE.

CONCLUSION

Findings highlight the necessity of implementing public health strategies to strengthen families and support parents and their children during the ongoing health crisis.

Direct and indirect effects from parenting self-efficacy and parenting practices to social-emotional adjustment in 3- to 5-year-old children

Parenting self-efficacy has been tied to myriad child outcomes during middle childhood and adolescence, directly and indirectly through parenting practices. The present study examines contemporaneous associations between parenting self-efficacy, parenting practices, and child outcomes during the preschool years in a community sample of 1455 Danish parents (76.7 % mothers) of 3-5-year-old children (49 % girls). Parents (M = 39.2 years old) completed a survey describing parenting self-efficacy and three facets of parenting practices: inductive reasoning, psychological control, and instrumental reward. Parents also described child adjustment in four domains: prosocial behavior, hyperactivity, conduct problems, and emotional problems. Results revealed direct concurrent associations between parenting self-efficacy and each child outcome, with greater efficacy tied to more prosocial behavior and less hyperactivity, conduct problems, and emotional problems. Parent psychological control mediated associations from parenting self-efficacy to child hyperactivity, conduct problems, and emotional problems. Inductive reasoning mediated associations from parenting self-efficacy to child prosocial behavior. Consistent with previous findings from older children, parental use of psychological control had debilitating consequences for preschool children. Inductive reasoning, in contrast, appeared to promote positive development.

Ecological factors influencing parenting self-efficacy among working mothers with a child under 36 month old in South Korea: a cross-sectional and correlational study

BACKGROUND

Parenting self-efficacy is an essential component for parents to successfully perform their role and is important for mother and child well-being. To support parenting self-efficacy amongst working mothers, it is necessary to understand the factors influencing parenting self-efficacy amongst this group. However, the majority of previous studies regarding factors influencing parenting self-efficacy did not focus on working mothers. Therefore, this study aimed to identify the factors influencing parenting self-efficacy of working mothers using an ecological framework.

METHODS

The research design was a cross-sectional, correlational study. The participants were 298 working mothers with a child under 3 years of age, who were recruited from ten nurseries. Data were collected from August 8 to September 22, 2017 using structured questionnaires, including the Parenting Sense of Competency scale, a one-item Short Form Health Survey scale, the Maternal Role Satisfaction scale, the Parenting Stress Inventory, the Work and Parent Role Conflict scale, the Parenting Alliance Inventory, the Social Support scale, and the Childbirth and Parenting Friendly System scale. The study process of this study was approved by the Institutional Review Board. Collected data were analyzed by SPSS 23.0 Win program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression.

RESULTS

Working mothers who were the primary caregiver had higher parenting self-efficacy compared to those who were not the primary caregiver (β = .13, p = .022). At the individual level, the higher maternal role satisfaction, the higher parenting self-efficacy of working mothers (β = .27, p < .001). In the micro-system level, higher parenting support by a spouse was associated with higher parenting self-efficacy of working mothers (β = .19, p = .002).

CONCLUSIONS

Educational interventions for increasing the awareness and satisfaction of maternal role and various strategies for fathers' active participation in parenting should be developed. In addition, practical interventions that reduce the burden of parenting while supporting parenting self-efficacy of working mothers who are the primary caregiver should also be considered.

Maternal Self-Efficacy Buffers the Effects of COVID-19-Related Experiences on Postpartum Parenting Stress

OBJECTIVE

To examine the associations of maternal self-efficacy (MSE) and perceived social support with parenting stress during the postpartum period during the COVID-19 pandemic and whether these two psychosocial factors account for variance in parenting stress in addition to the effects of COVID-19-related experiences and sociodemographic factors.

DESIGN

Cross-sectional survey.

SETTING

Online survey, the Perinatal Experiences and COVID-19 Effects (PEACE) study, launched in May 2020.

PARTICIPANTS

Participants included 310 women who gave birth in the past 24 weeks.

METHODS

The survey included self-report quantitative measures of MSE, social support, COVID-19-related experiences, parenting stress, symptoms of depression and anxiety, and a range of sociodemographic factors.

RESULTS

Hierarchical multiple regression analysis indicated that MSE and social support were negatively associated with postpartum parenting stress in addition to the effects of COVID-19-related experiences, maternal symptoms of depression and anxiety, and a range of demographic factors. Furthermore, MSE interacted with COVID-19-related experiences such that higher levels of MSE mitigated the effects of COVID-19-related experiences on parenting stress.

CONCLUSION

Our findings underscore the importance of protective factors at the individual and interpersonal levels and provide insights for prevention and intervention programs aimed at mitigating postpartum parenting stress during a wide-scale disaster such as the COVID-19 pandemic.

Developing a Comprehensive Scale for Parenting Resilience and Adaptation (CPRA) and an assessment algorithm: a descriptive cross-sectional study

Background

Adapting to child-rearing is affected by multiple factors, including environmental and individual factors. Previous studies have reported the effect of a single factor on childcare maladjustment; however, to prevent maladaptation in and to support child-rearing, a comprehensive evaluation of factors is necessary. Therefore, this study developed a comprehensive assessment tool for childcare adaptation.

Methods

We conducted semi-structured interviews with specialists whose jobs entailed supporting parents. Items were extracted from the interview data and used to develop a new questionnaire. Mothers with a child aged 0–3 years completed the Quick Inventory of Depressive Symptomatology as a depression index. We performed both factor and correlation analyses on the collected, data and multiple regression analyses to determine which factors predict depressive tendencies leading to childcare maladaptation. Subsequently, an assessment algorithm model was built.

Results

1,031 mothers responded to the questionnaire which had 118 items in five domains. A factor analysis was performed on each domain to develop the Comprehensive Scale for Parenting Resilience and Adaptation (CPRA). The CPRA comprised 21 factors and 81 items in five subcategories: Child’s Temperament and Health (1 factor, 5 items); Environmental Resources (5 factors, 20 items), Perceived Support (4 factors, 15 items); Mother’s Cognitive and Behavioural Characteristics (6 factors, 22 items), and Psychological Adaptation to Parenting (5 factors, 19 items). Correlations between all factors and depressive symptoms were identified. Depressive symptoms were predicted by factors from four subcategories: Environmental Resources, Perceived Support, Mother’s Cognitive and Behavioural Characteristics, and Psychological Adaptation to Parenting. A comprehensive model of mothers’ psychological adjustment was developed using the CPRA’s domain structure.

Conclusions

The CPRA enables researchers to understand the strengths and weaknesses of mothers. Mother’s maladaptive states can potentially be predicted by understanding the interactions between these multiple factors. The developed model can provide the necessary support to mothers and increase mothers’—and others’—awareness of the support that can prevent childcare maladjustment.

Family-Centered Early Intervention (FCEI) Involving Fathers and Mothers of Children Who Are Deaf or Hard of Hearing: Parental Involvement and Self-Efficacy

(1) Background: Studies related to family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) have largely focused on mothers, at the exclusion of fathers. Yet, understanding fathers’ experiences with FCEI is also important and may inform service delivery. The present study explores self-efficacy and involvement with FCEI in both fathers and mothers. (2) Methods: Dutch fathers and mothers completed questionnaires about their parental self-efficacy, involvement in FCEI, perceived support from their primary EI provider, and the impact of raising a child who is DHH on parenting. (3) Results: Both fathers and mothers reported relatively high levels of self-efficacy. Mothers reported higher levels than fathers on some domains of self-efficacy and tended to be more involved in their child’s FCEI than fathers. In fathers, but not mothers, higher levels of self-efficacy were related to higher levels of involvement and higher levels of perceived support. (4) Conclusions: Similarities and differences were found between fathers and mothers in their perspectives on self-efficacy and involvement. This points to potential differences related to their FCEI needs. EI providers need to address both the needs of fathers and mothers to promote optimal development among child who are DHH.

Family Factors Associated with Hands-On Play and Screen Time During the COVID-19 Pandemic

Background

Parent–child interactions are crucial for child development. The COVID-19 pandemic has negatively affected mental health and increased parenting challenges impacting parent–child functioning.

Objective

This study examined parent factors related to more and less enriching child activities during the pandemic through Bronfenbrenner’s Ecological Systems framework.

Methods

A convenience sample of parents (N = 708), primarily mothers (n = 610; 87.4%) aged 35.59 years old (SD = 5.59; range = 21–72), with children ages 2–8 years completed an online questionnaire between April 14-June 1, 2020. Participants mostly resided in Canada, had an income of > $100,000, and identified as White (82.4%). Parent–child activities were measured as total weekly time and combined time across activities within two categories: hands-on play and screen time. Bivariate correlations informed blockwise linear regression models.

Results

For families with childcare needs, parental anxiety was associated with higher total hands-on play, combined hands-on play, and combined screen time. Families without childcare needs indicated parenting stress was associated with lower total hands-on play and combined hands-on play, and higher supervised screen time. Family structure and indices of socioeconomic status were also predictive of activities across childcare needs and child ages.

Conclusions

To promote high-quality parent–child interactions and positive developmental outcomes during the pandemic, childcare needs and parent wellbeing should be supported, while evidence-based guidelines for child screen time should be further researched in this context.

A photo-elicitation exploration of UK mothers' experiences of extended breastfeeding

In this qualitative study we explored the experiences of women breastfeeding children over 12 months of age. Data were collected from 24 participants using semi-structured photo-elicitation interviews and photo-prompted online surveys. Participants took photographs of their extended breastfeeding experiences over one week and reflected on how the events depicted made them feel, and what they represented in terms of their experience. Data were analysed using Interpretative Phenomenological Analysis. Four themes were developed; parenting through breastfeeding: meeting the needs of my child, my body is not my own, social influences on the breastfeeding experience, and thinking about stopping: my choice or theirs? Findings highlight that extended breastfeeding was experienced as beneficial for both mother and child, promoting closeness, and bonding, and providing a valued parenting tool. However, some mothers reported conflict between their desire for child-led extended breastfeeding and the need to regain autonomy and control of their own bodies. The dangers of negative societal responses to extended breastfeeding and risks to mental health posed by cultural constructions of 'ideal' motherhood are discussed.

"Sometimes I think my frustration is the real issue": A qualitative study of parents' experiences of transformation after a parenting programme

Introduction

Parenting programmes help to alleviate conduct problems in children, but ensuring that all parents feel supported to attend, complete and learn from these programmes has proven difficult. Parents can feel overwhelmed and struggle to change their parenting. This article aims to inform the future refinement of parenting programmes by examining parents’ narratives of how programmes motivated them to change and enabled them to put changes into practice.

Method and results

Forty-two parents, most of whom had attended Incredible Years group sessions, were interviewed about their views and experiences of parenting programmes that focused on positive parenting practices. Analysis of interview transcripts drew on thematic approaches. Parents perceived that parenting programmes helped them to better understand their child and themselves and to let go of anxieties surrounding their child’s behaviour. Better understanding included greater awareness of emotions and of behaviours their child could and could not control. Parents believed this awareness helped them to change the ways that they interacted with their child, which, in turn, helped them and their child to feel calmer. With greater understanding and calmness parents believed they became more able to see for themselves the changes that they could make in their parenting and everyday lives, and to feel more confident in putting these into practice.

Discussion

By supporting parents to reflect on their own and their child’s situation, parents perceived that programmes enabled them to improve interactions with their children without getting stuck in self-blame or feeling overwhelmed. Parents of children whose behaviour remained challenging believed that programmes led to beneficial changes in the way they felt about their child’s behaviours. Enhanced support for reflection by parents could potentially help more families to benefit from parenting programmes.

Brief Transdiagnostic Intervention for Parents With Emotional Disorder Symptoms During the COVID-19 Pandemic: A Case Example

Concerns regarding parent mental health and well-being during the COVID-19 pandemic are justifiably on the rise. Although anxiety, depression, and traumatic stress levels have risen precipitously across all demographics during the pandemic, parents residing with their children are under particular and unique strain. Caregivers with children in the home are responsible not only for their own health, financial security, and safety during this time, but often full-time caregiving, household management and, in many cases, their children's schooling. In this case paper, we describe the development of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Caregivers (UP-Caregiver) and provide a case example of its implementation. This 4-session indicated prevention for caregivers is a modification of existing versions of the Unified Protocols for adults and children, modified to maximize its responsiveness to issues faced by parents and caregivers living with youth (ages 6-13) during the current pandemic. UP-Caregiver was offered as part of a randomized, controlled trial via telehealth in a small group format to any parent with a child in the specified age range with mild or greater anxiety, depression or traumatic stress symptoms during an initial screening. The case example provided is of a White, Hispanic mother with a range of self-reported emotional disorder concerns at an initial assessment. Declines in anxiety, depression and traumatic stress symptoms were all noted, as well as improvements in parenting self-efficacy and distress tolerance 6-weeks after initiating UP-Caregiver. An ongoing randomized, controlled trial of UP-Caregiver will further evaluate the utility and feasibility of this approach to alleviate parental distress during COVID-19.

Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model

Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.

Changes in Parents' Home Learning Activities With Their Children During the COVID-19 Lockdown - The Role of Parental Stress, Parents' Self-Efficacy and Social Support

As a result of the abrupt closures of daycare centers in Germany due to the COVID-19 pandemic, parents' ability to provide learning opportunities at home became all the more important. Building on the family stress model, the study investigates how parental stress affected changes in parents' provision of home learning activities (HLA) during the lockdown, compared to before the lockdown. In addition, the study considers parental self-efficacy and perceived social support as protective factors that may play important roles in disrupting the negative effects of stress. Data stems from a nation-wide survey of 7,837 German parents of children ages 1-6 years, which was conducted in Spring 2020 during the first wave of COVID-19 infections and at a time of strict restrictions in Germany. Results revealed that parental stress was negatively related to changes in the provision of HLA. Parental self-efficacy and an intact social support system were protective of parental stress during the lockdown. Additionally, parental self-efficacy and - to a larger extend - perceived social support interacted with parental stress in the relation to changes in the provision of HLA. Specifically, self-efficacy and perceived social support acted as protective factors that buffered the negative influence of stress on parents' ability to provide educational activities for their children at home. These results have important implications for supporting families with young children during challenging times, such as the COVID-19 pandemic and the temporary closure of daycare centers.

Parental Self-Efficacy to Promote Children's Healthy Lifestyles: A Pilot and Feasibility Study

Positive parenting programs are a key strategy to promote the development of parental competence. We designed a pilot study based on parental self-efficacy to promote healthy lifestyles in their children aged between 2 to 5 years old. In this pilot study, we aimed to assess the effects of a parenting program on parental self-efficacy and parenting styles. Twenty-five parents were allocated into intervention (N = 15) and control group (N = 10). Parents from the intervention group received four group sessions (120 mi per session) to develop a positive parenting, parenting styles and parenting skills regarding to children’s diet, exercise, and screen time, and two additional sessions about child development and family games. Parents from the control group received these two latter sessions. Parental self-efficacy, parenting styles, and meal-related parenting practices were measured before and after the intervention and at 3-month follow-up. Acceptability and feasibility of the program was also measured. Quantitative data were analyzed using the repeat measures ANOVA and ANCOVA tests and the effect size calculation. Content analysis was used to analyse open questions. Positive trends were found regarding parental self-efficacy and the use of authoritative parenting style. Parents also reported a great acceptability of the program getting high satisfaction. According to the feasibility barriers and facilitators aspects were identified. The positive trends founded in this study support the development of parenting programs to promote healthy lifestyle in children.

Parental eating disorders: A systematic review of parenting attitudes, behaviours, and parent-child interactions

A substantial proportion of adults with eating disorders are parents. Studies suggest these parents may experience a range of parenting challenges, and their children may be at an increased risk for the development of eating disorders themselves. With parenting practices being one potential environmental mechanism for the intergenerational transmission of eating disorders, we systematically searched Scopus, Web of Science, PubMed, MEDLINE, PsychINFO, and PsychArticles for controlled studies in which parenting attitudes, behaviours, and parent-child interactions were examined for parents with and without probable eating disorders. 26,512 abstracts were screened, and 167 full-text manuscripts were retrieved, with 33 studies meeting the review inclusion criteria. Studies suggest that parents with eating disorders experience higher levels of parenting stress than control parents, and may on average be more intrusive, less sensitive, and provide less structuring/facilitation in non-feeding interactions with their children. These parents also appear, on average, to experience increased concern about their children's weight, and parent-child mealtime interactions may be problematic and characterised by high levels of conflict. Suggestions for future research are made with a view to enhancing understandings of the intergenerational transmission of eating disorders, which may lead to the identification of intervention targets for parents with eating disorders and their children.

A Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) for first-time families: study protocol of a three-arm randomised controlled trial

Background

Enhanced parenting self-efficacy (PSE) contributes to positive parenting and future parental-child health. First-time parents, in particular, are in need of support since the pregnancy until post-delivery to strengthen their early PSE. However, there is a lack of effective and sustainable relevant programmes in the community. The Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) aims to develop a self-learning eco-community throughout the pregnancy and early childhood to promote PSE among first-time parents. We apply choice architecture strategy using behavioural nudges and midwife-led continuity care during the first 1000 days, and test their effects on PSE and mother-child health for first-time families in Singapore.

Methods

This three-arm randomised controlled trial will recruit up to 750 pregnant women from the KK Women’s and Children’s Hospital, Singapore. Participants will be randomly assigned to receive: (1) standard routine care; (2) behavioural nudges (text messages) along with the use of a social media platform; or (3) midwife-led continuity care involving individualised teleconferencing sessions, during pregnancy and post-delivery. Using web-based questionnaires, participants will be assessed for baseline socio-demography and health status in the first visit, with follow-up assessments in the third trimester, at birth, 6-week (primary end-point), 6-, 12-, 18- and 24-month post-delivery. The primary outcome is PSE. Secondary outcomes include health and birth experience, mental wellness, feeding practice, maternal and child nutritional status. Intention-to-treat and per-protocol analyses will be performed using general linear models to test the effects of interventions across three arms. Recruitment has begun in June 2020 and is estimated to complete in September 2022.

Discussion

This study may identify a sustainable effective strategy in the community by helping first-time parents to have a positive experience during the pregnancy, childbirth and parenthood, leading to an enhanced PSE and health outcomes for both mother and child. Findings from this study will provide insight into the implementation of early parenting and mother-child care programmes.

Trial registration

ClinicalTrials.gov NCT04275765. Registered on 19 February 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05144-5.

Parental Efficacy Moderates the Association Between Empathy and Burden Among Parents of Children Admitted to a Psychiatric Ward

Empathy is considered a positive aspect of caregiving, although in certain circumstances, being empathic might increase the burden of caregivers. The current study assessed the associations between empathy, parental efficacy, and family burden among parents of children who were hospitalized in a psychiatric unit. Specifically, we examined whether the association between empathy and family burden was moderated by the parents' sense of self-efficacy. Seventy parents of children with psychiatric disorders, hospitalized in an inpatient psychiatric unit, filled out questionnaires of empathy, parental efficacy, and family burden. Results supported a moderating role of parental efficacy between empathy and family burden (interaction effect: β = -1.72, p = .0406). Specifically, empathy was positively related to family burden among parents with low self-efficacy (conditional effect = 0.70, p = .032) and negatively related to family burden among parents with high self-efficacy (conditional effect = -0.39, p = N.S). Implications for practice include the importance of self-efficacy and address the possible negative implications of empathy among parents of children treated in a psychiatric hospital.

Overcoming Language Barriers between Interventionists and Immigrant Parents of Children with Autism Spectrum Disorder

This study used a video prompting intervention to overcome language barriers between English-speaking trainers and Spanish-speaking immigrant parents of children with autism. Parents were taught instructional skills targeting independent dressing. A multiple baseline design across three families and a replication using an alternating treatments design with a fourth family were used to evaluate the effects of the intervention. All mothers reached mastery criterion and generalization of instructional skills was observed for three mothers, with treatment gains maintaining during follow-up. Improvement in independent dressing skills was observed for four children. Findings suggest that video prompting can be used to teach immigrant parents of children with autism who have limited English proficiency when there is a language mismatch between parents and trainers.

Correlation between parents' self-efficacy and quality of life of children with cancer aged 8-12 years

This study aims to determine the correlation between parents' self-efficacy and the quality of life of children with cancer aged 8-12 years. Quantitative research using a crosssectional design was carried out on 39 parents and 39 children with cancer. The participants were selected using a consecutive sampling method. The measurement instruments used were the Self-Efficacy for Parenting Task Index (SEPTI), the Pediatric Quality of Life Inventory^TM (PedsQL^TM) 4.0 Generic Core Scale, and the PedsQL^TM 3.0 Cancer Module in the Indonesian version. Data analysis was performed using Pearson's correlation coefficient. The results showed that parents' self-efficacy and the quality of life of children were strongly correlated and that the direction of the correlation was positive (r= 0.680). Parents' self-efficacy and quality of life children with cancer were also strongly correlated, and the direction of the correlation was positive (r = 0.715). It is recommended that parents and children with cancer ensure the adequate management of cancer treatment.

Improving multicultural parenting program for children with emotional and behavioral problems: An integrated review

Children with emotional and behavioral problems are often managed using medications or behavioral therapy, but in some countries, there is no structured parenting intervention to equip parents from different cultural backgrounds with adequate parenting skills to help these children. This paper aims to synthesize key findings from previous research on multicultural parenting programs and produce a comprehensive integrated view by looking into three separate themes: effective multicultural parenting programs, ethnocultural groups and cultural adaptation process. Literature search through Scopus and Google Scholar from 1999 to 2019 was conducted using the terms "effective parenting program", "effective parenting intervention", "effective multicultural parenting program", "effective multicultural parenting intervention", "multicultural parenting program", "multicultural parenting intervention", "parenting program and ethnic groups", "parenting intervention and ethnic groups", "adapted parenting program", "adapted parenting intervention", "cultural adaptation of parenting program'' and "cultural adaptation of parenting intervention". By applying the "Literature Review Synthesis Process", authors conducted cross-analysis, integrated possibilities, and prioritized the synthesized information gearing towards highly probable solutions for improving multicultural parenting programs to manage emotional and behavioral problems in children better. Development of a culturally fit parenting intervention and its implications on existing parenting programs are also discussed. The findings highlight the need 1) to engage with ethnocultural groups of parents during development of a new multicultural parenting program, and 2) to incorporate specific measures for engaging with parents during multicultural parenting program implementation. This paper contributes in acknowledging cultural components in future parenting intervention programs. Finally, recommendations are made for future directions of research.

The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app

BACKGROUND

Health mobile applications (apps) have become very popular, including apps specifically designed to support women during the ante- and post-natal periods. However, there is currently limited evidence for the effectiveness of such apps at improving pregnancy and parenting outcomes. This study aims to assess the effectiveness of a pregnancy and parenting app, Baby Buddy, in improving maternal self-efficacy at 3 months post-birth.

METHODS

Participants were 16 years old or over, first-time mothers, 12-16 weeks gestation, recruited by midwives from five English study sites. The Tool to Measure Parenting Self-Efficacy (TOPSE) (primary outcome) was used to compare mothers at 3 months post-birth who had downloaded the Baby Buddy app with those who had not downloaded the app, controlling for confounding factors.

RESULTS

Four hundred and eighty-eight participants provided valid data at baseline (12-16 weeks gestation), 296 participants provided valid data at 3 months post-birth, 114 (38.5%) of whom reported that they had used the Baby Buddy app. Baby Buddy app users were more likely to use pregnancy or parenting apps (80.7% vs. 69.6%, P=0.035), more likely to have been introduced to the app by a healthcare professional (P=0.005) and have a lower median score for perceived social support (81 vs. 83, P=0.034) than non-app users. The Baby Buddy app did not elicit a statistically significant change in TOPSE scores from baseline to 3 months post-birth [adjusted odds ratio (OR) 1.12, 95% confidence interval (CI): 0.59 to 2.13, P=0.730]. Finding out about the Baby Buddy app from a healthcare professional appeared to grant no additional benefit to app users compared to all other participants in terms of self-efficacy at 3 months post-birth (adjusted OR 1.16, 95% CI: 0.60 to 2.23, P=0.666). There were no statistically significant differences in the TOPSE scores for the in-app data, in terms of passive use of the app between high and low app users (adjusted OR 0.82, 95% CI: 0.21 to 3.12, P=0.766), nor in terms of active use (adjusted OR 0.47, 95% CI: 0.12 to 1.86, P=0.283).

CONCLUSIONS

This study is one of few, to date, that has investigated the effectiveness of a pregnancy and early parenthood app. No evidence for the effectiveness of the Baby Buddy app was found. New technologies can enhance traditional healthcare services and empower users to take more control over their healthcare but app effectiveness needs to be assessed. Further work is needed to consider: (I) how we can best use this new technology to deliver better health outcomes for health service users and, (II) methodological issues of evaluating digital health interventions.

Effectiveness of the Stepping Stones Triple P group parenting program in reducing comorbid behavioral problems in children with autism

Children with autism spectrum disorders often exhibit comorbid behavioral problems. These problems have an impact on the severity of the core symptoms, the progression of the disorder as well as on the families’ quality of life. We evaluated the effectiveness of the Stepping Stones Triple P group parent training program as a supplementary intervention in the treatment of children with autism spectrum disorder. Therefore, we employed a single group repeated measures design and assessed child variables via parents’ and teachers’ judgments at four successive time points. The participants were parents of 24 children with autism spectrum disorder aged between 3.6 and 12 years. We found a significant reduction of comorbid behavioral problems in the children, primarily in the parents’ judgment at follow-up. Furthermore, a reduction of the autism spectrum disorder core symptoms emerged. The teachers’ judgment particularly revealed an improvement in children’s social relationships. Effect sizes were large ( ƞ2 ranging from 0.14 to 0.23). The findings demonstrate the effectiveness of the Stepping Stones Triple P as a supplementary intervention for reducing comorbid behavioral problems in the treatment of children with autism spectrum disorder. Higher parental self-efficacy and parental attributions, including parents’ ability to influence child problem behaviors, are discussed as important factors for the effectiveness of Stepping Stones Triple P.

Parental self-efficacy in managing the home care of children with Hirschsprung's disease or anorectal malformation: Development and validation of a new measure

OBJECTIVE

This study aimed to develop a scale specifically to measure parental self-efficacy (PSE) in managing the home care of children with Hirschsprung's disease (HD) or anorectal malformation (AM) (the PSE-HDAM scale), and to validate its psychometric properties.

METHODS

The PSE-HDAM Scale was developed through focus group with parents and Delphi questionnaire responses of experts. A total of 230 parents of children with HD or AM were recruited to fill the PSE-HDAM, the Chinese version of the Tool to Measure Parenting Self-Efficacy (TOPSE), and the Holschneider Criteria. Content validity was measured using the Content Validity Index. Principal Component Analysis was conducted to identify dimensions of the scale. Cronbach's Alpha and Guttman's Split-Half Reliability Coefficient were used to evaluate the internal consistency of the scale. External validity was measured using the Pearson correlation coefficient between PSE-HDAM, and the Chinese version of the TOPSE and Holschneider Criteria.

RESULTS

Principal Component Analysis identified five domains of the PSE-HDAM scale. The final version of the scale consisted of 19 items. The content validity was 0.89. The correlations between items and the total scale ranged between 0.75 and 0.87. The overall scale and subscales have good to excellent internal consistency (Cronbach ɑ ranged 0.67 to 0.91), and the Split-Half Coefficient of the whole scale is 0.85. The correlation between PSE-HDAM score and the TOPSE and the Holschneider Criteria was 0.68 and 0.32 respectively (p < .001).

CONCLUSIONS

The PSE-HDAM is a reliable and valid scale to evaluate PSE in managing home care of children with HD or AM.

Brief Emotion Focused Family Therapy: An Intervention for Parents of Children and Adolescents with Mental Health Issues

This study evaluated the 2-day intensive modality of Emotion Focused Family Therapy (EFFT). The intervention attempts to prepare parents to take a primary role in their child's recovery from a range of mental health issues. One hundred and twenty-four parents completed the intervention and provided data a week prior to intervention, post-intervention and at 4-month follow-up. Results include significantly reduced parent blocks and increased parental self-efficacy in relation to involvement in their child's recovery, as well as significant improvement in child symptomatology. The findings confirm positive results from an earlier pilot study involving eating disorders and demonstrate the potential for EFFT as an intervention for a range of clinical problems in children and youth.