Parenting Interventions for Drug-Dependent Mothers and Their Young Children: The Case for an Attachment-Based Approach

Maternal substance abuse is the most common factor involved when children come to the attention of the child welfare system. Although there is a clear need for clinical trials to evaluate parenting interventions for drug-dependent women, few studies to date have systematically examined the efficacy of interventions for this population. We first review six published reports of outpatient interventions that aimed to enhance the caregiving skills of substance-abusing mothers caring for children between birth and 5 years of age. After discussing implications of these preliminary studies, we then describe an attachment-based intervention that addresses these implications and has demonstrated preliminary feasibility in a pilot trial.     

Effects of Combining Public Assistance and Employment on Mothers and Their Young Children

SUMMARY

One goal of recent welfare reform legislation is to move welfare-dependent mothers with young children into the paid labor force. However, prior to the new legislation, many welfare-dependent women were already engaged in employment activities. In this paper we examine whether child or maternal well-being is influenced by a mother's strategy of combining work and public assistance receipt in the late 1980s. Measures of well-being include children's cognitive test scores and behavior problems, parenting behavior, and maternal mental health, social support, and coping strategies collected when children were 2 ½ to 3 years of age. Data from the Infant Health and Development Program (a sample of low birthweight, premature infants born in 8 sites in 1985) were used to identify low-income families (incomes under 200% of the poverty threshold; N = 525). Comparisons were made among mothers in the following groups: (a) Work Only, (b) Some Work-Some Welfare, (c) Some Work-No Welfare, (d) No Work-No Welfare, and (e) Welfare Only. Mothers in the Some Work-Some Welfare group had children with cognitive and behavioral scores similar to children whose mothers were in the Work Only group; these two groups also had similar mental health, social support, and coping scores. However, not working and receiving welfare (Welfare Only) was associated with negative cognitive and behavioral outcomes for children, with less stimulating home learning environments, lower maternal mental health, less social support, and more avoidant coping strategies. We discuss the proposition that welfare and work may be complementary rather than opposing strategies, in terms of putting together a family income package.     

Perceptions of Body Size in Mothers and Their Young Children in the Galapagos Islands

Introduction Little specific information has been published about the health of people who live in the Galapagos Islands. As part of determining the status of the nutrition transition that may be occurring in the islands mothers of young children in the Galapagos perceptions of their child’s body size and therefore health status was evaluated along with actual body size. Methods This paper presents data collected as part of a pilot study that used a mixed methods approach to identify and describe health and nutrition issues for mother–child pairs on Isla Isabela in Galapagos, Ecuador. It includes participant anthropometric assessment and self-perception of body size using silhouettes for themselves and one of their children along with open-ended questions to elicit further understanding of body size perceptions. Twenty mothers of children greater than 6 months of age but less than 6 years of age were interviewed. Results The women preferred a smaller body size for themselves but a larger body size for their children. Findings of different body size combinations between mothers and children in the same household demonstrated that the island is undergoing or may be post the nutrition transition. Discussion This dual burden of body weights (especially overweight or obese mothers) in the same household with underweight, normal and overweight or obese children and the potential nutrition related chronic disease burden in the future will require more educational resources and innovative health services than are currently available for the people of the Galapagos.     

Family Social Capital: Links to Weight-Related and Parenting Behaviors of Mothers with Young Children

Family social capital includes the social relationships, values, and norms shared by a family and is positively linked with children’s mental and physical health status. This cross-sectional study addresses a gap in the literature related to family social capital vis-à-vis weight-related behaviors and home environments of 557 mothers and their young children (ages 2 to 9 years). Mothers completed an online survey comprised of valid, reliable questionnaires assessing family relationships and weight-related behavioral and home environment measures. The measures that determined family social capital (i.e., supportive, engaged parenting behaviors; family cohesion; family conflict; and family meal frequency) yielded distinct tertile groups that differed significantly (p < 0.001) on every family social capital measure with large effect sizes. Analysis of variance with Tukey post-hoc test revealed greater family social capital was linked to significantly better maternal health, dietary intake, physical activity, and sleep behavior. Additionally, maternal modeling of healthy eating and physical activity, child feeding practices, and home environments was higher in groups with greater family social capital. Child mental and physical health, physical activity, and sleep quality were better in families with greater family social capital. Findings suggest greater family social capital is linked to healthier weight-related behaviors and home environments. Future intervention studies should incorporate strategies to build family social capital and compare longitudinal outcomes to traditional interventions to determine the relative value of family social capital on health behaviors.     

Evaluation of Raising Adolescent Families Together Program: A Medical Home for Adolescent Mothers and Their Children

Objectives. This study described a medical home model for adolescent mothers and their children, and their 1- and 2-year preventive care, repeat pregnancy, and psychosocial outcomes.Methods. In this prospective, single cohort demonstration project, adolescent mothers (14–18 years old) and their children received care in a medical home. Demographic, medical and social processes, and outcomes data were collected at enrollment through 24 months. Change over time and predictors of repeat pregnancy were analyzed.Results. A total of 181 adolescents enrolled, with 79.6% participating for 2 years. At 2 years, 90.2% of children were completely immunized. Children and adolescent mothers met standards for health care visits, and adolescent condom use improved. Rates of cumulative repeat pregnancy were 14.7% and 24.6%, school attendance 77.6% and 68.7%, and employment 21.2% and 32.3% at 1 and 2 years, respectively.Conclusions. A medical home model with comprehensive and integrated medical care and social services can effectively address the complex needs of adolescent parents and their children.Adolescent mothers are at risk for depression and low self-esteem, and face significant health and socioeconomic risks.1–5 Although most complete high school, they do so later than their peers, and have lower earnings.6 Their children face significant long-term risks, with increased rates of adolescent pregnancy, school failure, and behavioral problems.7 Young fathers often disengage with their children over time.8,9 At least 20% of adolescent pregnancies in this country occur in adolescents who have already given birth to at least 1 child.7 Delaying repeat pregnancy may enhance outcomes for both mothers and their children.10–13To address the complex and multidimensional needs of adolescent parents, intervention programs must provide a broad scope of services, targeting life and reproductive health skills, addressing social needs, and providing preventive care while teaching effective parenting behaviors.10 Multidisciplinary programs have demonstrated improved child development and maternal long-term outcomes and modest reductions in repeat pregnancy.12,14–17 Our previous work showed that adolescent parenting groups embedded within a medical and social services model enhanced self-esteem and decreased stress.18The medical home has been promoted as a transformative model for children with complex needs and is potentially an effective strategy for addressing the multiple medical, social, and educational needs of adolescent families.19–21 The American Academy of Pediatrics (AAP) published a 1992 policy statement, which was modified in 2002, defining medical homes to include 8 desirable characteristics: accessible, family centered, continuous, comprehensive, coordinated, compassionate, developmentally appropriate, and culturally sensitive.22,23 In 2001, the AAP recommended this approach for adolescent parents.24,25 In 2007, the Joint Principles of the Patient-Centered Medical Home added emphasis on quality, safety, and value.26 First described in the 1980s, teen-tot programs contained many of the elements of a medical home. They provided medical care and psychosocial support in an efficient, “one stop shopping” model.27,28 However, few comprehensive evaluations of these programs have been published.29,30 In this study, we describe a family-centered medical home model for adolescent mothers, fathers, and their children. We hypothesized that adolescent families receiving care within the teen-tot model would have improved medical and social outcomes compared with local and national benchmarks. We presented data on 3 major outcomes: (1) maternal and child health preventive care indicators, (2) repeat pregnancy rates and contraceptive adherence, and (3) adolescent life skills, including education, job attainment, and independent living.     

Measuring Cultural Socialization Attitudes and Behaviors of Mexican‐Origin Mothers with Young Children: A Longitudinal Investigation

We describe the development and psychometric testing of the Cultural Socialization Behaviors Measure (CSBM) and the Cultural Socialization Attitudes Measure (CSAM). The CSBM assesses cultural socialization behaviors that parents use with young children, and the CSAM assesses the attitudes that parents have regarding the importance of socializing their young children about their culture. Both measures demonstrated strong reliability, validity, and cross‐language equivalence (i.e., Spanish and English) among a sample of 204 Mexican‐origin young mothers (M_age = 20.94 years, SD = 1.01) with 4‐year‐old children. In addition, the measures demonstrated longitudinal equivalence when children were 4 and 5 years of age.     

Consulting with Children and Young People: The Office of Law Reform's Experience

This paper is a short discussion of the experiences of the Office of Law Reform in relation to consulting young people about law reform issues. Ten years ago or even 5 years ago, this paper would have been even shorter because consultation with young people just did not take place. It is a sign of the evolution of government in Northern Ireland that an emphasis is now being placed on effective and wide-ranging consultation on policy throughout the community of Northern Ireland.     

Mothers and Their Children: An Exploration of the Relationship Between Maternal Mental Health and Child Well-Being

Maternal and Child Health Journal - Psychosocial factors and life stressors have an impact on long-term health effects on mothers and their children. Recent studies examining maternal mental health...     

Incarcerated Mothers and Fathers: A Comparison of Risks for Children and Families

Abstract: The current study investigates differences between inmate mothers’ and fathers’ reported rates of incarceration for family members, adult children, predictors of adult children’s incarceration, and living situations of minor children. Participants included 6,146 inmates who participated in the U.S. Department of Justice Survey of Inmates in State and Federal Correctional Facilities. Mothers were 2.5 times more likely to report that their adult children were incarcerated than fathers; mothers’ regular drug use predicted adult child incarceration. Incarcerated mothers reported greater familial incarceration and their minor children were more likely to be in foster and other nonfamilial care situations than incarcerated fathers. As risk factors accumulated, there were greater rates of adult child incarceration, with a more obvious relationship for mothers.     

Adolescents’ and Young Adults’ Routine Care Use: The Role of Their Mothers’ Care Use Behaviors

Purpose

Little is known whether mothers' own care use is differentially associated with their adolescents’ routine care use by gender. The main purpose of this study is to examine whether mothers’ healthcare use prospectively predicts their adolescents’ routine care use stratified by gender, after controlling for predisposing (child's age, race/ethnicity, region of residence, urbanicity, and mother's age at child's birth), enabling (mother's education, adolescent and mother health insurance), and need (child health status) factors.

The Adaptation of Mothers and Fathers to Children With Cystic Fibrosis: A Comparison

This study compared the adjustment of mothers and fathers who have a child with cystic fibrosis On most scales mothers, but not fathers, were found to have significantly poorer mental health than the general population Both mothers and fathers' perceptions of the stresses associated with rearing children with cystic fibrosos were related to their mental health Fathers mental health was also related to their wives' concerns about rearing children with cystic fibrosis The support of fathers appeared to protect mothers from the stress associated with cystic fibrosis, especially when fathers placed a high value on child-rearing activities.     

The Adaptation of Mothers and Fathers to Children With Cystic Fibrosis: A Comparison

This study compared the adjustment of mothers and fathers who have a child with cystic fibrosis On most scales mothers, but not fathers, were found to have significantly poorer mental health than the general population Both mothers and fathers' perceptions of the stresses associated with rearing children with cystic fibrosos were related to their mental health Fathers mental health was also related to their wives' concerns about rearing children with cystic fibrosis The support of fathers appeared to protect mothers from the stress associated with cystic fibrosis, especially when fathers placed a high value on child-rearing activities.     

Cost-Savings Analysis of the Better Beginnings,Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n?=?401) and two comparison neighborhoods (n?=?225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children’s development.     

Socializing Positive Emotion: A Qualitative Study of African American Single Mothers and Their Adolescent Youth

This study addressed limitations of emotion socialization (ES) research and is the first to explore socialization of positive emotion (PE) in 20 single African American (AA) mothers and their adolescents. Considering the dearth of research on ES with AA adolescents, an inductive, qualitative approach was warranted. A portion of mothers reported elevated depressive symptoms, which is important given their prevalence in AA women and that very few studies of ES have considered parental mental health. Although PE is gaining warranted attention in the scientific community based on recent data linking it to mental and physical health, PE has traditionally been a cornerstone of AA interactional style. The results suggest that AA mothers use complementary and contradictory responses to youth PE, often sharing and expanding, other times diminishing or teaching lessons. The findings emphasize the importance of racial and cultural considerations in ES practices and highlight the potential impact of elevated maternal depressive symptoms.     

The Participation of Disabled Children and Young People: A Social Justice Perspective

There is an increasing expectation that children, young people and their parents should participate in decisions that affect them. This includes decisions about their health and social care and collective or public decisions about the way in which such services are designed, delivered and evaluated. Indeed this has become a policy priority across the United Kingdom. The participation of disabled children and young people, however, has been slow to develop in the United Kingdom and concerns have been expressed about progress in this area. Drawing on the results of an Economic and Social Research Council-funded, mixed-methods study, the aim of this article is to explore the participation of disabled children and young people through a social justice lens. Participants, recruited by purposeful sampling, included 18 disabled children and young people, 77 parents and 90 professionals from one health and social care trust in Northern Ireland. There were four phases of data collection: surveys to parents and professionals, parent interviews, interviews with children and young people using creative and participatory techniques, and a focus group with professionals. Results showed that for most disabled children and young people, decision-making was firmly grounded in a family-centred model. However, when children and young people were drawn into participatory processes by adults and recognised as partners in interactions with professionals, they wanted more say and were more confident about expressing their views. Choices, information and resources were at times limited and this had a key impact on participation and the lives of these children, young people and their parents. The article concludes by exploring implications for further research and practice. The need for a two-pronged, social justice approach is recommended as a mechanism to advance the participation agenda.     

Effects of an Evidence-Informed Healthy Eating Blog on Dietary Intakes and Food-Related Behaviors of Mothers of Preschool- and School-Aged Children: A Randomized Controlled Trial

BackgroundAlthough social media such as blogs are still considered innovative communication technologies, some registered dietitians (RDs) are using them to promote healthy eating; however, evidence regarding the effects of healthy eating blogs on users’ diet is lacking.ObjectiveThis study evaluated the effects of an evidence-informed healthy eating blog written by an RD on dietary intakes, with a focus on vegetables and fruit and milk and alternatives consumption, and food-related behaviors of Canadian mothers.DesignThis study was a parallel, randomized, controlled trial.Participants/settingData were collected from 84 French-speaking adult mothers of children aged between 2 and 12 years living in Quebec City, Quebec, Canada, who were recruited between October 2015 and February 2017 using institutional e-mail lists, flyers, newspapers, social media advertisements, and word of mouth.InterventionThe intervention was exclusively delivered through an evidence-informed healthy eating blog—integrating theory-based intervention methods to improve diet quality by increasing vegetables and fruit and milk and alternatives consumption in mothers—for 6 months at a dose of one new post written by an RD each week. Mothers could engage with the RD and fellow participants by posting comments on the blog.Main outcome measuresMain outcomes were daily intakes of vegetables and fruit and milk and alternatives. Outcome assessments were performed at baseline, 3 months, and at the end of the 6-month intervention.Statistical analysisDifferences between the groups were examined using mixed linear models.ResultsAt 6 months, no significant difference was observed between groups for intakes of vegetables and fruit (P=0.923), milk and alternatives (P=0.271), or food-related behaviors and body weight (P=0.180).ConclusionsA healthy eating blog, at a dose of 1 post per week, had no effects on dietary intakes, food-related behaviors, and body weight of mothers after 6 months. Methodologic issues are discussed to inform future health behavior research using blogs to promote healthy eating.     

Assessing Experiences of Children Who Attended a Camp for Children with Cancer and Their Siblings: A Preliminary Study

Summer camps are commonly implemented as a psychosocial intervention for children with chronic illnesses; however, there have been few published consumer (parent and child) satisfaction evaluations of summer camps. Such evaluations are important both for improving existing services for children and families, as well as to build an empirical understanding of camp interventions. To illustrate the use of a program evaluation methodology within the context of a chronic illness summer camp, a program evaluation was conducted of a camp for children with cancer and their siblings. Results from the evaluation indicated that parents and children were highly satisfied with the camp experience, ranging from the food, staff, facilities, to campers’ activities. Campers reported that the recreation opportunities, peer support, and respite from their lives at home were reasons they appreciated the camp experience. Parents reported that peer support for their children, respite for themselves and their children, and improvements to their child’s behaviors and level of independence were helpful features of the camp experience.