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Dosman C, Koscielnuk D, Gallagher S. Pearls of wisdom: Updated skill-specific parenting strategies in the first 6 years. Paediatr Child Health 2023; 28:470-479. [PMID: 38638543 PMCID: PMC11022867 DOI: 10.1093/pch/pxac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/25/2022] [Indexed: 04/20/2024] Open
Abstract
This article provides knowledge translation on up-to-date parenting strategies (pearls of wisdom). These pearls support the development of specific skills in children from birth through 5 years of age. Paediatricians have indicated that they feel inadequately trained in providing parenting guidance. This article could be used by family physicians, community health nurses, nurse practitioners, and paediatricians as an office reference when providing anticipatory parenting guidance and when there are parent or clinician concerns that relate to various developmental stages. Included are general tips for guiding parents and pearls that support self-regulation, attachment, perspective taking, and developing the child's sense of self. The present review links pearls to specific reference sources in the literature which cite developmental standards and advice. Evidence-based parenting programs are cited for children with more complex presentations due to developmental, regulatory, or behavioural disorders, temperament individual differences, or limited parenting support. Website links for parents are recommended, and Parenting Pearls handouts provided, to solidify understanding and follow through.
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Affiliation(s)
- Cara Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | | | - Sheila Gallagher
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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2
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Hails KA, Wellen BC, Simoni M, Gaultney WM, Petts RA, Hostutler CA, Riley AR. Parents' Preferences for Primary Care-Based Behavioral Services and the COVID-19 Pandemic: A Mixed Method Study. J Pediatr Psychol 2023; 48:879-892. [PMID: 37369014 PMCID: PMC11025383 DOI: 10.1093/jpepsy/jsad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This study examined how family factors impacted parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. We hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents' interest in IBH modalities. METHODS Parents of children ages 1.5-5 years (N = 301) from five primary care clinics completed a survey with measures assessing familial contextual factors (income, race and ethnicity, and parents' childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents' preferences for behavioral support in primary care. A subsample of parents (n = 23) completed qualitative interviews to provide deeper insights into quantitative relationships. RESULTS Higher COVID-19 impact was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Overall, lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews identified how pandemic stressors led to increases in parents' desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered. CONCLUSIONS Findings have important implications for the provision of behavioral supports for families in primary care, underlying the need to increase parents' access to IBH services by proactively providing evidence-based resources and continuing to offer telehealth support.
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Affiliation(s)
| | - Brianna C Wellen
- Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, USA
| | - Marisa Simoni
- Pediatric Mental Health Institute, Children's Hospital Colorado, USA
| | - Wendy M Gaultney
- Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, USA
| | - Rachel A Petts
- School of Psychology and Counseling, Fairleigh Dickinson University, USA
| | - Cody A Hostutler
- Department of Pediatric Psychology and Neuropsychology, Nationwide Children’s Hospital, USA
| | - Andrew R Riley
- Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, USA
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3
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McGowan A, Boundy EO, Nelson JM, Hamner HC. Patterns in Mothers' Recollection of Health Care Providers' Young Child Feeding Recommendations. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:1024-1033. [PMID: 36357041 PMCID: PMC11036331 DOI: 10.1016/j.jneb.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Characterize feeding guidance mothers recall receiving from their child's health care provider (HCP). DESIGN Cross-sectional study of mothers participating in the 2017-2019 National Survey of Family Growth. PARTICIPANTS US mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). VARIABLES MEASURED Weighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics. ANALYSIS Logistic regression assessing the relationship between recall of feeding guidance and demographics. RESULTS In this sample, 36.9% of mothers (95% confidence interval, 32.3-41.4) recalled HCPs recommending solid food before 6 months old (34.6% at 4-5 months, and 2.3% before 4 months). Mothers who were older or had a higher education level were more likely than their counterparts to recall their HCP discussing several of the feeding topics examined. CONCLUSION AND IMPLICATIONS Mothers reported high recollection of early childhood nutrition guidance from their HCP; however, certain topics (eg, appropriate timing of solid food introduction) could be prioritized, and some subpopulations may need additional focus to improve receipt of messages. A better understanding of variability in recall of feeding guidance could provide information for interventions to address barriers to receiving and retaining guidance.
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Affiliation(s)
- Andrea McGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Ellen O Boundy
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
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Petts RA, Gaynor ST. Behavioral Health in Primary Care: Brief Screening and Intervention Strategies for Pediatric Clinicians. Pediatr Clin North Am 2021; 68:583-606. [PMID: 34044987 DOI: 10.1016/j.pcl.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the high prevalence of behavioral health concerns presenting in pediatric primary care and the growing support for integrating behavioral health services into this setting, a majority of primary care providers do not have access to on-site behavioral health specialists. Fortunately, primary care providers can implement some services typically provided by behavioral health clinicians. This article outlines screening, brief intervention, and referral guidelines for prominent behavioral health problems seen in primary care. The evidence-based approaches have the potential to supplement typical management of behavioral health problems in primary care and provide a foundation for future integrated behavioral health practice.
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Affiliation(s)
- Rachel A Petts
- Department of Psychology, Wichita State University, 1845 Fairmount Street, Wichita, KS 67260, USA.
| | - Scott T Gaynor
- Department of Psychology, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008, USA
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Panza C, Volta A, Broccoli S, Bonvicini L, Kendall S, Marchesi M, Giorgi Rossi P. Evaluation of an intervention aimed at supporting new parents: the Baby Newsletter project. Ital J Pediatr 2020; 46:123. [PMID: 32887637 PMCID: PMC7487811 DOI: 10.1186/s13052-020-00886-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/19/2020] [Indexed: 11/25/2022] Open
Abstract
Background Anticipatory guidance for parents is commonly used to improve parenting skills. The objective of this pre/post-intervention controlled study was to evaluate the effectiveness of a periodic newsletter with advice on childcare and development in improving parenting self-efficacy. Methods This was a non-randomized pre/post-intervention controlled study. All the parents of children born between September 2014 and December 2015 resident in the S. Ilario d’Enza municipality (Italy) received eight Baby Newsletters. Parents resident in other municipalities of the same Health District were the control. Parents with linguistic barriers or with preterm or hospitalized children were excluded. Improvement in parenting self-efficacy was measured through the TOPSE (Tool to Measure Parenting Self-Efficacy) questionnaire during the first week (t0) after delivery and at 5 (t1) and 12 months (t2) of life at two vaccination appointments. A score ranging from 0 to 60 was computed for each of the eight domains investigated by the TOPSE. Variations of each TOPSE score between delivery and 12 months in the two groups were compared, adjusting for parity, education, age of parents, and child’s sex, and stratifying by parity and education. Results /findings One hundred thirty-six families accepted to participate in the study. Scores at 12 months were higher than 1 week after delivery in both groups for all TOPSE domains. The improvement was slightly stronger in the Newsletter group for almost all the skills except learning and knowledge [difference in the mean of variation: -0.48 (95% CI: − 3.17; 2.21)]; the difference was significant only for play and enjoyment [2.18 (95% CI: 0.12; 4.25)]. The increase in scores in almost all domains was more pronounced for parents with high education level at first child. Conclusions The intervention was effective in improving parents’ ability to play. However, it risks worsening existing differences between parents with high and with low education levels. Trial registration Clinical trial registration: NCT03268408.
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Affiliation(s)
| | - Alessandro Volta
- Primary Care Service, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Serena Broccoli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | | | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Jansen R, Reid M. Communication Technology Use by Caregivers of Adolescents With Mental Health Issues: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e13179. [PMID: 32663143 PMCID: PMC7468639 DOI: 10.2196/13179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/11/2019] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Background Caregivers of adolescents with mental health issues experience challenges that may result in the caregivers having a variety of unmet needs. There is a growing need to support these caregivers. Effective support to strengthen positive caregiving behavior in caregivers may address their challenges. Communication technologies offer novel opportunities to assist these caregivers and may contribute to strengthening caregiver behavior. However, little is known about the use of communication technologies among caregivers of adolescents with mental health issues. Objective The study aimed to answer the question: “What is the best evidence available to strengthen positive behavior of caregivers of adolescents with mental health issues using communication technology.” Methods A systematic review of articles published between January 2007 and August 2018 was conducted. Searches included articles of multiple study designs from EBSCO Host and Scopus platforms with prespecified eligibility criteria. Methodological quality was evaluated using the applicable Critical Appraisal Skills Programme and Joanna Briggs Institute assessment tools. Results The search yielded 1746 articles. Altogether, 5 articles met the eligibility criteria and were included in the review for data synthesis. Data analysis and synthesis identified three thematic conclusions reflecting the types of communication technologies used, caregivers as the target population, and strengthening of positive behavior through determinants of the Integrated Model of Behavior Prediction. Conclusions The review reported the usefulness of communication technology by caregivers. Caregivers also demonstrated improvement in self-efficacy, knowledge, parent-child communication, and parental skills reflecting positive behavior. Although the use of communication technology is expanding as a supportive intervention to address caregivers’ needs, the evidence for usefulness among caregivers of adolescents with mental health issues is still scarce. More research and information related to preferred methods of communication delivery among caregivers of adolescents is still needed.
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Affiliation(s)
- Ronelle Jansen
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Marianne Reid
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
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7
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Riley AR, Walker BL, Hall TA. Development and initial validation of a measure of parents' preferences for behavioral counseling in primary care. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2020; 38:139-150. [PMID: 32297758 PMCID: PMC7292737 DOI: 10.1037/fsh0000481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION There is a significant need to understand the factors that contribute to parents' consumer preferences for behavioral health services in pediatric primary care; however, no validated measure of such preferences exists. We developed the BIPS (Behavioral Information Preferences Scale), a measure of parents' preferences for delivery of behavioral guidance in pediatric primary care and assessed its psychometric properties. METHOD An initial item pool consisted of 3 sections: Behavior topics, intervention approach, and delivery methods. In addition to the BIPS, parents of young children (N = 396) completed measures of child behavior problems and parenting self-efficacy. We conducted principle component analyses and examined correlations of the resulting factors. RESULTS The behavior topics section resulted in a two-factor solution (conduct/emotions and healthy habits), as did the intervention approach section (behavior change and psychoeducation), whereas the delivery methods yielded three factors (usual care, auxiliary care, and media resources). Patterns of association with parent reported child behavior problems and parenting self-efficacy were indicative of construct validity for the behavior topics and media resources sections. DISCUSSION The BIPS holds potential for informing the design and dissemination of primary care parenting interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Domek GJ, Szafran LH, Bonnell LN, Berman S, Camp BW. Using Finger Puppets in the Primary Care Setting to Support Caregivers Talking With Their Infants: A Feasibility Pilot Study. Clin Pediatr (Phila) 2020; 59:380-387. [PMID: 32037858 DOI: 10.1177/0009922820903407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Disadvantaged children often show disparities in early language development. We tested the feasibility, acceptability, and preliminary efficacy of introducing finger puppets in the primary care setting at the 2-month well visit to support caregivers talking with their infants. Caregivers completed a sociodemographic survey and were contacted by phone 2 weeks later to assess initial usage and satisfaction. Ages & Stages Questionnaires (ASQ-3) were independently recorded at well visits. A family cumulative risk score was calculated from the sociodemographic survey. Thirty-four caregiver-child pairs were enrolled. Caregivers reported high satisfaction with the intervention. ASQ-3 Communication and Total scores at 6, 12, and 18 months were significantly higher for high puppet users across all age levels with no significant interactions with age or cumulative risk. Finger puppets provide a low-cost way to promote language-rich interactions. Preliminary evidence suggests that high puppet usage may have long-lasting effects on child development and should be further evaluated.
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Affiliation(s)
- Gretchen J Domek
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | | | - Levi N Bonnell
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stephen Berman
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | - Bonnie W Camp
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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9
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Lipkin PH, Macias MM. Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics 2020; 145:peds.2019-3449. [PMID: 31843861 DOI: 10.1542/peds.2019-3449] [Citation(s) in RCA: 242] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Early identification and intervention for developmental disorders are critical to the well-being of children and are the responsibility of pediatric professionals as an integral function of the medical home. This report models a universal system of developmental surveillance and screening for the early identification of conditions that affect children's early and long-term development and achievement, followed by ongoing care. These conditions include autism, deafness/hard-of-hearing, intellectual and motor disabilities, behavioral conditions, and those seen in other medical conditions. Developmental surveillance is supported at every health supervision visit, as is as the administration of standardized screening tests at the 9-, 18-, and 30-month visits. Developmental concerns elicited on surveillance at any visit should be followed by standardized developmental screening testing or direct referral to intervention and specialty medical care. Special attention to surveillance is recommended at the 4- to 5-year well-child visit, prior to entry into elementary education, with screening completed if there are any concerns. Developmental surveillance includes bidirectional communication with early childhood professionals in child care, preschools, Head Start, and other programs, including home visitation and parenting, particularly around developmental screening. The identification of problems should lead to developmental and medical evaluations, diagnosis, counseling, and treatment, in addition to early developmental intervention. Children with diagnosed developmental disorders are identified as having special health care needs, with initiation of chronic condition management in the pediatric medical home.
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Affiliation(s)
- Paul H Lipkin
- Department of Neurology and Development Medicine, Kennedy Krieger Institute, and Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; and
| | - Michelle M Macias
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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Abstract
OBJECTIVE Early childhood parenting interventions are increasingly delivered in primary care, but parental engagement with those interventions is often suboptimal. We sought to better understand parents' preferences for the content and delivery method of behavioral health guidance in pediatric primary care and to determine the relationship of those preferences with demographic characteristics, child behavior problems, and parenting style. METHODS Participants were 396 parents of young children recruited from primary care offices. We collected measures of parental preferences (including behavioral topics, intervention strategies, and methods of delivery) for behavioral intervention in primary care, child behavior symptoms, parenting style, and demographic characteristics. Descriptive statistics were used to identify parents' most preferred behavioral topics and intervention delivery methods. We used a hierarchical regression approach to determine whether parenting style predicted parents' preferences beyond demographic and child-level factors. RESULTS Nearly all parents (96%) endorsed a behavioral topic (e.g., aggression) as important. Most preferred to receive intervention during routine medical appointments. Child behavior problems correlated with parents' overall interest in behavioral guidance, but clinically significant symptoms did not differentiate interest in any single topic. Socioeconomic factors and negative parenting practices predicted some parental preferences. Notably, lax parenting generally predicted higher interest in behavioral intervention, whereas hostile and physically controlling parenting predicted lower interest. CONCLUSION Most parents are interested in behavioral guidance as part of primary care, but their preferences for the content and delivery of that guidance vary by known socioeconomic, child, and parenting risk factors. Tailoring intervention to parents' preferences may increase engagement with available interventions.
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Doove B, Feron J, Feron F, van Os J, Drukker M. Validation of short instruments assessing parental and caregivers' perceptions on child health and development for personalized prevention. Clin Child Psychol Psychiatry 2019; 24:608-630. [PMID: 30628460 DOI: 10.1177/1359104518822673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Systematically exploring parental as well as other caregivers' concerns is a main component in preventive child health care (PCHC) for family-centred practice and personalized health care. To facilitate communication and early identification of emerging mental health problems, a PCHC toolkit based on short instruments was developed. This article investigates the reliability and validity of (1) two visual analogue scales (VAS) to assess parent-reported 'parenting' and 'child behaviour', (2) a professional caregiver-reported VAS to assess 'child competence' and (3) the parents' evaluation of developmental status (PEDS) in Dutch PCHC. Parents as well as child care, kindergarten and preschool teachers completed instruments in a community-based sample of children (N = 346) aged 3 years at baseline. The three VAS and PEDS were associated with standardized questionnaires assessing the same constructs. Overall predictive accuracy showed: good to excellent for 'parenting' VAS, fair to good for 'child behaviour' VAS and poor for 'child competence' VAS. The PEDS, 'parenting' VAS and 'child behaviour' VAS, demonstrated high sensitivity at various cut-off points of index test and reference standard. At follow-up, approximately 1 year later, results were similar. Although the 'child competence' VAS scored lower on one aspect of validity, the PEDS and the different VAS are reliable, valid and useful as brief monitoring tools in daily Dutch PCHC practice.
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Affiliation(s)
- Bernice Doove
- 1 Well-Child Care Centre, Preventive Child Health Care Division, Envida, The Netherlands.,2 Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands
| | | | - Frans Feron
- 2 Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands.,4 Youth Health Care Division, Regional Public Health Service South Limburg, The Netherlands
| | - Jim van Os
- 5 Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, The Netherlands.,6 King's Health Partners and Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,7 Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Marjan Drukker
- 5 Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, The Netherlands
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Hicks BL, Brittan MS, Knapp-Clevenger R. Group Style Central Venous Catheter Education Using the GLAD Model. J Pediatr Nurs 2019; 45:67-72. [PMID: 30503153 DOI: 10.1016/j.pedn.2018.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE This study aimed to examine the impact of group-based central venous catheter education (CVC) on the knowledge, skill and comfort of caregivers, length of stay (LOS) related to initial CVC placement and 30-day return hospital visit for central line associated blood stream infections (CLABSI). DESIGN AND METHODS This pilot study employed a pretest-posttest design comparing retrospective data collected before implementation of the group-based education (GLAD Model). Data were collected from children's caregivers before and after taking the educational class through use of the Comfort Survey, and collected though the electronic medical record. The data were analyzed using SPSS 24, repeated measures analysis of variance, and t-test. RESULTS Pre-post difference with the Comfort Survey indicated significant increase (M = 0.49, SD = 0.79), t(92) = 6.05, p = 0.001, d = -0.62) for skill, knowledge and comfort for the pre- and the post 2 (1 month after) and 3 (2 months after). After GLAD Model implementation, LOS related to initial CVC placement during retrospective review declined from 29.7 days to 27.7 and 30-day return hospital visit declined from twelve to zero. Our results suggest that use of the GLAD Model educational program might be effective in improving caregiver knowledge, skill and comfort as well as LOS and 30-day return hospital visit. CONCLUSION This study suggests that group-based, education with use of the GLAD Model should to be considered as an effective educational intervention in providing caregivers CVC education. This may help care for their child at home while enhancing their hospital experience and decreasing unplanned hospital visits.
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Affiliation(s)
- Beth L Hicks
- Clinical Patient and Family Education Specialist for the Center of Cancer and Blood Disorders and Health Literacy Program, Children's Hospital Colorado, United States of America.
| | - Mark S Brittan
- Pediatric Hospitalist, Children's Hospital Colorado, United States of America.
| | - Rhonda Knapp-Clevenger
- Director of Research, Nurse Scientist for the Pediatric and Perinatal Clinical Translational Research Center, Children's Hospital Colorado, United States of America
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Yordanova R, Ivanov I. Developmental performance of 5-year-old Bulgarian children-An example of translational neuroscience in practice. J Eval Clin Pract 2018; 24:851-858. [PMID: 29691944 DOI: 10.1111/jep.12919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/27/2018] [Accepted: 03/01/2018] [Indexed: 12/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Developmental testing is essential for early recognition of the various developmental impairments. The tools used should be composed of items that are age specific, adapted, and standardized for the population they are applied to. The achievements of neurosciences, medicine, psychology, pedagogy, etc. are applied in the elaboration of a comprehensive examination tool that should screen all major areas of development. The key age of 5 years permits identification of almost all major developmental disabilities leaving time for therapeutic intervention before school entrance. The aim of the research is to evaluate the developmental performance of 5-year-old Bulgarian children using the approach of translation neuroscience. METHOD A comprehensive test program was developed composed of 89 items grouped in the following domains: fine and gross motor development, coordination and balance, central motor neuron disturbances, language development and articulation, perception, attention and behavior, visual acuity, and strabismus. The overall sample comprises 434 children of mean age 63.5 months (SD-3.7). Male to female ratio is 1:1.02. From this group, 390 children are between 60 and 71 months of age. The children are examined in 51 kindergartens in 21 villages and 18 cities randomly chosen in southern Bulgaria. Eight children were excluded from the final analysis because they fulfilled less than 50% of the test items (7 children did not cooperate and 1 child was with autistic spectrum disorder). RESULTS The items with abnormal response in less than 5% of the children are 43. The items with abnormal response in 6% to 35% of the children are 37. The items with high abnormal response (more than 35%) rate are only 9. CONCLUSIONS The test is an example of a translational approach in neuroscience. On one hand, it is based on the results of several sciences studying growth and development from different perspective. On the other hand, the results from the present research may be implemented in other fields of child development-education, psychology, speech and language therapy, and intervention programs.
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Affiliation(s)
- Ralitsa Yordanova
- Department of Pediatrics and Medical Genetics, Medical University-Plovdiv, Bulgaria.,Department of Pediatrics, St. George University Hospital, Plovdiv, Bulgaria
| | - Ivan Ivanov
- Department of Pediatrics and Medical Genetics, Medical University-Plovdiv, Bulgaria.,Department of Pediatrics, St. George University Hospital, Plovdiv, Bulgaria
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Darling KE, Fahrenkamp AJ, Ruzicka E, Levitt M, Broerman L, Sato A. Provider perceptions of pediatric obesity management in clinical practice. CHILDRENS HEALTH CARE 2018. [DOI: 10.1080/02739615.2018.1471997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Katherine E. Darling
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Amy J. Fahrenkamp
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Elizabeth Ruzicka
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Michelle Levitt
- Pediatrics, Akron Children’s Hospital, Akron, OH, United States
| | - Lisa Broerman
- Pediatrics, Akron Children’s Hospital, Akron, OH, United States
| | - Amy Sato
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
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15
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Amherdt S, Kim UO, Basir MA. Effectiveness of Digital Multimedia Educational Aids Produced by Intensive Care Unit Providers. J Pediatr Intensive Care 2018; 7:182-187. [PMID: 31073492 DOI: 10.1055/s-0038-1637747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 02/13/2018] [Indexed: 10/17/2022] Open
Abstract
Multimedia improves understanding of information. Professionally developed digital multimedia educational modules are expensive. We tested educational modules developed by a medical student without extensive multimedia production training. The modules were developed with neonatologist collaboration, uploaded to YouTube, and presented via iPad to neonatal intensive care unit family members who were ≥ 18 years, English literate, and unexposed to topic they were reviewing. Thirty-six participants viewed the modules once and then answered topic-specific key questions. Thirty of 36 (83%) of the participants answered 4/4 (100%) of questions correctly and 6/36 (17%) answered three-fourths (75%) correctly, demonstrating success of the educational modules. Health care workers can economically create effective digital multimedia educational materials without extensive training.
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Affiliation(s)
- Sarah Amherdt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - U Olivia Kim
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mir A Basir
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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16
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Habibi E, Sajedi F, Afzali HM, Hatamizadeh N, Shahshahanipour S, Glascoe FP. Early Childhood Development and Iranian Parents' Knowledge: A Qualitative Study. Int J Prev Med 2017; 8:84. [PMID: 29142650 PMCID: PMC5672654 DOI: 10.4103/ijpvm.ijpvm_159_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/12/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Early childhood is the most important step throughout the lifespan and it is a critical period continuing to the end of 8-year-old. Mothers' knowledge is one of the important aspects of child development. The goals of this study were to determine the situation of knowledge in Iranian parents about the concept and the importance of early childhood development (ECD) and determining the sources of parental knowledge about ECD from the perspective of parents and grandparents. METHODS This qualitative study was conducted based on the directional content analysis in 2016. The purposive sampling method is utilized to select 24 participants among parents and grandparents in Tehran. The inclusion criteria consisted of speaking in Persian and having a child or grandchild <3-year-old. Data were collected through four focus group discussions and four individual interviews. RESULTS Iranian parental knowledge about integrative ECD is not enough, their knowledge about motor development and speech and language are relatively better, about cognitive development is little and socialemotional is very little. They said parents and other caregivers influence the process of children's development. Parents' knowledge resources about ECD included human resources, physical resources, virtual space, and the media. According to the majority of participants, "pediatricians are the most reliable source of parents' knowledge about ECD" even though the main focus of pediatricians is on treating diseases, physical health, and growth of children. CONCLUSIONS According to the results, the knowledge of Iranian parent is not enough about ECD; therefore, actions must be taken to increase their knowledge in these domains. Parents look for reliable and valid sources to enhance their knowledge and they rely the most on pediatricians in this regard. Therefore, more studies on assessing parents' knowledge in community and the practical methods for knowledge promotion in this field is recommended.
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Affiliation(s)
- Elham Habibi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Firouzeh Sajedi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hosein Malek Afzali
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikta Hatamizadeh
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Soheila Shahshahanipour
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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17
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Management of an Early Detection Program: Supporting Helpful Features. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2017. [DOI: 10.1007/s40474-017-0123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Riley AR, Wagner DV, Tudor ME, Zuckerman KE, Freeman KA. A Survey of Parents' Perceptions and Use of Time-out Compared to Empirical Evidence. Acad Pediatr 2017; 17:168-175. [PMID: 27856291 DOI: 10.1016/j.acap.2016.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess parents' perceptions and use of time-out (TO) in contrast to empirical indications and examine the relationship between reported implementation procedures and perceived effectiveness. METHODS We surveyed parents of preschool and school-age children (n = 401, aged 15 months to 10 years) at well-child visits with regard to their awareness, perception, and usage of TO. Parents were specifically surveyed regarding TO components that have been empirically evaluated or pertain directly to its underlying behavioral principles. Descriptive analyses, group comparisons, and correlational analyses were used to characterize responses and evaluate the relationship between TO administration variation and perceived effectiveness. RESULTS Most parents (76.8%) reported using TO in response to misbehavior, but a large majority of these parents (84.9%) reported implementing TO in a manner counter to empirical evidence. Parents who endorsed TO as effective varied significantly from those who did not on key implementation components (eg, use of a single warning). Further, several reported implementation practices were correlated with perceived effectiveness and challenging child behavior. For example, requiring a child to be calm before ending TO was positively correlated with perceived effectiveness. CONCLUSIONS These results cement TO as a widely disseminated practice but cast doubt on the fidelity with which it is typically implemented. Better methods of educating parents on evidence-based discipline are needed.
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Affiliation(s)
- Andrew R Riley
- Division of Psychology, Institute on Development and Disability, Oregon Health and Science University, Portland, Ore.
| | - David V Wagner
- Division of Psychology, Institute on Development and Disability, Oregon Health and Science University, Portland, Ore
| | - Megan E Tudor
- Division of Psychology, Institute on Development and Disability, Oregon Health and Science University, Portland, Ore; Child Study Center, Yale School of Medicine, New Haven, CT
| | - Katharine E Zuckerman
- Division of General Pediatrics, Department of Pediatrics, Oregon Health and Science University, Portland, Ore
| | - Kurt A Freeman
- Division of Psychology, Institute on Development and Disability, Oregon Health and Science University, Portland, Ore
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19
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Parent knowledge of children's sleep: A systematic review. Sleep Med Rev 2017; 31:39-47. [DOI: 10.1016/j.smrv.2016.01.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/21/2015] [Accepted: 01/07/2016] [Indexed: 11/19/2022]
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20
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Nelson BB, Dudovitz RN, Coker TR, Barnert ES, Biely C, Li N, Szilagyi PG, Larson K, Halfon N, Zimmerman FJ, Chung PJ. Predictors of Poor School Readiness in Children Without Developmental Delay at Age 2. Pediatrics 2016; 138:e20154477. [PMID: 27432845 PMCID: PMC4960729 DOI: 10.1542/peds.2015-4477] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current recommendations emphasize developmental screening and surveillance to identify developmental delays (DDs) for referral to early intervention (EI) services. Many young children without DDs, however, are at high risk for poor developmental and behavioral outcomes by school entry but are ineligible for EI. We developed models for 2-year-olds without DD that predict, at kindergarten entry, poor academic performance and high problem behaviors. METHODS Data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), were used for this study. The analytic sample excluded children likely eligible for EI because of DDs or very low birth weight. Dependent variables included low academic scores and high problem behaviors at the kindergarten wave. Regression models were developed by using candidate predictors feasibly obtainable during typical 2-year well-child visits. Models were cross-validated internally on randomly selected subsamples. RESULTS Approximately 24% of all 2-year-old children were ineligible for EI at 2 years of age but still had poor academic or behavioral outcomes at school entry. Prediction models each contain 9 variables, almost entirely parental, social, or economic. Four variables were associated with both academic and behavioral risk: parental education below bachelor's degree, little/no shared reading at home, food insecurity, and fair/poor parental health. Areas under the receiver-operating characteristic curve were 0.76 for academic risk and 0.71 for behavioral risk. Adding the mental scale score from the Bayley Short Form-Research Edition did not improve areas under the receiver-operating characteristic curve for either model. CONCLUSIONS Among children ineligible for EI services, a small set of clinically available variables at age 2 years predicted academic and behavioral outcomes at school entry.
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Affiliation(s)
- Bergen B Nelson
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; UCLA Center for Healthier Children, Families and Communities, Los Angeles, California;
| | - Rebecca N Dudovitz
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Tumaini R Coker
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; RAND Health, RAND Corporation, Santa Monica, California
| | - Elizabeth S Barnert
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Christopher Biely
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Ning Li
- Department of Biomathematics, University of California, Los Angeles, Los Angeles, California
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Kandyce Larson
- American Academy of Pediatrics, Elk Grove Village, Illinois, and
| | - Neal Halfon
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; UCLA Center for Healthier Children, Families and Communities, Los Angeles, California
| | - Frederick J Zimmerman
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Paul J Chung
- Department of Pediatrics, Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; RAND Health, RAND Corporation, Santa Monica, California; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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21
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Samia P, Donald KA, Schlegel B, Wilmshurst JM. Parental Understanding of Tuberous Sclerosis Complex. J Child Neurol 2015; 30:1281-6. [PMID: 25414235 DOI: 10.1177/0883073814558121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/04/2014] [Indexed: 11/17/2022]
Abstract
Tuberous sclerosis complex is a genetic disorder with multisystem involvement that poses significant challenges to the affected child and family. Caregiver knowledge in the South African population has not previously been reported. A prospective study of the parents of 21 children with tuberous sclerosis complex was undertaken. Median parental age was 38 (interquartile range 34.5-45) years. Parents were randomly allocated to receive written information about the condition, or to receive verbal counseling already established in clinic. A significant difference (P = .001) was observed in the change in the mean knowledge scores for the parent group that received written information (34.2 at baseline, 51.7 at the second visit. This impact was higher in parents with an education level of at least grade 8 (P = .003). Parental understanding of tuberous sclerosis complex can be improved by provision of written information and should be routinely available in a readily understandable format.
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Affiliation(s)
| | - Kirsten A Donald
- Division of Developmental Pediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Birgit Schlegel
- Department of Pediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Jo M Wilmshurst
- Department of Pediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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22
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Shah R, Sobotka SA, Chen YF, Msall ME. Positive Parenting Practices, Health Disparities, and Developmental Progress. Pediatrics 2015; 136:318-26. [PMID: 26216325 PMCID: PMC4516939 DOI: 10.1542/peds.2014-3390] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To describe interactive activities between parents and young children in a nationally representative sample. We hypothesized that the frequency of participation in interactive activities would be different across economic strata and would be associated with developmental delay. METHODS Children 4 to 36 months of age were identified by using The National Survey of Children's Health 2011-2012. Interactive caregiving practices were reported by poverty status. Developmental concerns were derived from caregiver responses and scoring of the Parents Evaluation of Developmental Status. Multivariable logistic regressions with weighting were used to explore the effect of interactive practices on risk for developmental delay across poverty levels. Covariates including age, gender, insurance type, maternal education, parenting stress, and ethnicity were adjusted in the models. RESULTS In our sample (n = 12,642), caregivers with the lowest income versus highest income reported lower participation in reading (33% vs 64%; P < .0001), singing or telling stories (52% vs 77%, P < .0001), and taking their child on an outing (13% vs 22%, P < .0001). Less frequent participation in interactive activities during the week were associated with increased risk of developmental delay among low-income families (Reading odds ratio [OR] 1.57, 95% confidence interval [CI] 1.15-2.13; Singing songs/Telling Stories OR 1.66, 95% CI 1.15-2.40; Outings OR 1.48, 95% CI 1.11-1.97). CONCLUSIONS Despite evidence emphasizing the protective effects of supportive parenting practices on early child development, our work demonstrates significant disparities in parenting practices that promote early child development between economically advantaged and disadvantaged parents. Innovative population-level strategies that enrich parenting practices for vulnerable children in early childhood are needed.
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Affiliation(s)
- Reshma Shah
- Department of Pediatrics, College of Medicine, and
| | - Sarah A Sobotka
- Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, The University of Chicago, Comer Children's Hospital and Pritzker School of Medicine, Chicago, Illinois
| | - Yi-Fan Chen
- Center for Clinical and Translational Science, The University of Illinois at Chicago, Chicago, Illinois; and
| | - Michael E Msall
- Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, The University of Chicago, Comer Children's Hospital and Pritzker School of Medicine, Chicago, Illinois
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