A dyadic analysis of Head Start parents’ depressive symptoms and parent involvement: sense of mastery as a mediator

This study used the actor–partner interdependence mediation model to examine the association among parents’ depressive symptoms, sense of mastery, and parent involvement. To address the research goal, this study conducted secondary analysis using the cross-sectional data collected from the 2000 cohort of the Head Start Family and Child Experiences Survey. Both mothers and fathers with children enrolled in Head Start programmes completed the phone interviews and questionnaires. Results showed that sense of mastery significantly mediated the association between parents’ depressive symptoms and Head Start involvement for both parents. Specifically, mothers’ increased depressive symptoms were related to lower sense of mastery, which in turn was related to fathers’ increased involvement at Head Start. Implications of this study and future research are discussed.     

Strengthening families in Head Start: the impact of a parent education programme on the emotional well‐being of Latino families

This study explores the impact of a Head Start add‐on programme, a matrix of services for parents which provides educational and vocational supports, on maternal depression and children’s behaviour in Latino families. We hypothesise that after having completed training, parents who participated in the add‐on programme would have lower levels of reported depression than parents receiving Head Start services alone. It was also hypothesised that decreased levels of reported depression would be related to increases in children’s social skills and reductions in their behaviour problems. Fifty Latino children from a local Head Start programme and their primary caregivers participated in the study. Results indicate that intervention group mothers had significantly lower levels of reported depression when compared to mothers who received regular services. Children’s social skills appeared to increase and their behaviour problems decrease, regardless of whether their parents were involved in self‐sufficiency promoting activities in the programme.     

Redefining parent involvement in Head Start: a two-generation approach

The present review of the literature aims to look at two-generation programs and their effects on children and parents as a potential strategy to improve parent involvement in Head Start while responding to the self-sufficiency needs of families. This paper reviews several two-generation program evaluations: Comprehensive Child Development Program, Even Start Family Literacy Program, Head Start Family Service Centers, New Chance and New Hope. Lessons learned from the evaluation of these programs are used to suggest options for enhancing Head Start program's ability to respond to the needs of low-income families and maintain a high level of parent involvement.     

Parent Training in Head Start: A Comparison of Program Response Among African American,Asian American,Caucasian, and Hispanic Mothers

The effectiveness of the Incredible Years Parenting Program was evaluated in a low-income sample of Caucasian, African American, Hispanic, and Asian mothers whose children were enrolled in Head Start. Data from two prior intervention studies [Webster-Stratton (1998) Journal of Consulting and Clinical Psychology, 66(5), 715–730; Webster-Stratton et al. (in press) Journal of Clinical Child Psychology] were combined, yielding a sample of 634 families (370 Caucasian, 120 African American, 73 Asian, 71 Hispanic) across 23 Head Start centers. Centers were matched and assigned randomly to either an experimental condition (8–12 weeks of weekly 2-hr parenting classes), or a control condition (the regular Head Start Program without parenting groups). Families in both conditions were assessed using home observations of parent–child interactions and parent reports of parenting style and discipline strategies and child behavior problems in the fall (baseline) and spring (postintervention) of the children's Head Start year. Families were reassessed 1 year later. Following treatment, intervention mothers were observed to be more positive, less critical, more consistent, and more competent in their parenting than were control mothers. Additionally, children of intervention parents were observed to exhibit fewer behavior problems than were control children. Differences in treatment response across ethnic groups were few, and did not exceed the number expected by chance. Parents from all groups reported high satisfaction levels following the parenting program. Results indicate that the Incredible Years Program is accepted by and effective with diverse populations.     

Head Start teachers' perceptions of children's eating behavior and weight status in the context of food scarcity

ObjectiveTo describe Head Start teachers' perceptions of mealtime, feeding, and overweight risk in Head Start students.DesignQualitative focus group study.SettingFive Head Starts in a greater metropolitan area in the Northeast.ParticipantsThirty-five teachers in 5 focus groups.InterventionTwo experienced focus group facilitators elicited comments from each group.Main Outcome MeasureIdentification of themes for future nutrition education programming.AnalysisParticipant comments were transcribed and common themes identified by 7 readers.ResultsTeachers felt (1) empowered to shape the content of children's diets; (2) that meals served at Head Start were chaotic; (3) uncertain how to address children's voracious appetites, since children often were from homes with limited food resources; (4) skeptical about the definition of overweight; (5) that children's eating behaviors and their weight status were not connected; and (6) uncomfortable addressing overweight with students' families.Conclusions and ImplicationsTeachers' skepticism about overweight, uncertainty around managing the seemingly voracious eating behavior of children perceived as hungry as a result of inadequate food at home, and discomfort in addressing overweight with families may all represent nutrition education opportunities. Tailoring prevention programs such that they evoke support and agreement from these teachers as well as harnessing strengths, such as teachers' confidence in shaping children's eating behaviors, will be important.     

Academy of Nutrition and Dietetics Benchmarks for Nutrition in Child Care 2011: Are Child-Care Providers across Contexts Meeting Recommendations?

The Academy of Nutrition and Dietetics (Academy) recommends feeding practices for child-care providers to establish nutrition habits in early childhood to prevent obesity. With >12 million US children in child care, little is known about child-care providers’ feeding practices. The purpose of this study was to examine child-care providers’ feeding practices to assess whether providers met the Academy’s benchmarks and whether attainment of benchmarks varied across child-care contexts (Head Start, Child and Adult Care Food Program [CACFP], and non-CACFP). Cross-sectional data was collected in 2011 and 2012 from 118 child-care providers who completed self-administered surveys regarding their feeding practices for 2- to 5-year-old children. χ² tests and analysis of variance were used to determine variation across contexts. Head Start providers sat more frequently with children during meals (P=0.01), ate the same foods as children (P=0.001), and served meals family style (P<0.0001) more often compared with CACFP and non-CACFP providers. Head Start providers (P=0.002), parents (P=0.001), and children (P=0.01) received more nutrition-education opportunities compared with CACFP and non-CACFP. Head Start providers encouraged more balance and variety of foods (P<0.05), offered healthier foods (P<0.05), modeled healthy eating (P<0.001), and taught children about nutrition (P<0.001) compared with CACFP and non-CACFP providers. Providers across all three contexts used significantly more non-internal than internal mealtime verbal comments (P<0.0001). Head Start providers had greater compliance with the Academy’s benchmarks compared with CACFP and non-CACFP providers. Possible reasons for this compliance might be attributed to Head Start nutrition performance standards and increased nutrition-training opportunities for Head Start staff. Head Start programs can serve as a model in implementing the Academy’s benchmarks.     

Oral Health of Early Head Start Children: A Qualitative Study of Staff,Parents, and Pregnant Women

Objectives.We explored the oral health knowledge, attitudes, and activities of Early Head Start (EHS) staff members, parents, and pregnant women, along with their suggestions related to future oral health educational interventions targeting EHS children.Methods. Nine focus groups were conducted with EHS staff, parents, and pregnant women. Audiotapes of sessions were transcribed and entered into ATLAS.ti 5.0 for coding and analysis.Results. Attitudes about the importance of children''s oral health among parents and pregnant women were mixed. Staff members voiced responsibility for children''s oral health but frustration in their inability to communicate effectively with parents. Parents in turn perceived staff criticism regarding how they cared for their children''s oral health. Gaps were noted in the oral health activities of EHS programs. Participants expressed confusion regarding the application of Head Start oral health performance standards to EHS. The need for culturally sensitive, hands-on oral health education was highlighted.Conclusions. Tailored, theory-based interventions are needed to improve communication between EHS staff and families. Clear policies on the application of Head Start oral health performance standards to EHS are warranted. Educational activities should address the needs and suggestions of EHS participants.Early childhood caries has emerged as a concern over the past few years because of its widespread and increasing prevalence, its inequitable distribution among preschool-aged children, and its negative consequences for children, their families, and public health programs.^1–4 Many barriers to obtaining dental care exist for young children in most parts of the United States, particularly children in low-income families, and treatment failure rates can be high for those with elevated risk factors.^5,6 Recent initiatives have explored innovative approaches to providing preventive and treatment services for these high-risk young children.^7,8The Head Start and Early Head Start (EHS) programs provide an excellent setting in which to develop and test oral health interventions for young children who are at high risk for early childhood caries.^9–11 Built on 30 years of Head Start experience, the EHS program began in 1995 and now consists of approximately 650 local programs serving more than 60 000 children.¹² Although EHS programs reach only about 10% of eligible children, they can play an important role in promoting the oral health of young children and families.EHS programs operate under a set of performance standards adopted from the long-standing Head Start program requiring that the oral health needs of children and their families be addressed.^5,13 Several of these standards relate to oral health activities and components such as oral examinations, access to oral health care, and preventive services provided directly to children.^5,14 Because EHS programs offer services for pregnant women and infants soon after birth, they can intervene at an opportune time to help reduce risk factors for oral disease and promote good oral health practices before the onset of disease. By the time children are old enough to enroll in Head Start, many are already on a trajectory of poor oral health that is difficult to change.⁵Creating a foundation for a lifetime of good oral health among EHS children requires a number of strategies.^11,15 Among others, these strategies include (1) delivering effective oral health promotion services in the classroom to instill healthy habits, (2) educating and motivating parents to take an active role in their children''s oral health, and (3) developing collaborative relationships within communities to ensure that EHS children have access to oral health care.Although EHS is well positioned to have an impact on the oral health of young children and families, little is known about the oral health activities of EHS staff. Most of the small number of dental studies that have been conducted have focused on Head Start, which targets children 3 to 5 years of age (EHS includes children up to the age of 3 years). Even in the case of the Head Start program, however, relatively little is known about program effectiveness.For example, the Task Force on Community Preventive Services, in an evaluation of the impact of early childhood development programs on health, concluded that there was insufficient evidence to determine the effectiveness of these programs in improving dental outcomes.¹⁶ Therefore, a large gap exists in our understanding of the oral health activities of EHS staff and the barriers that affect these activities, including characteristics of parents of enrolled children and pregnant women. We explored the oral health knowledge, attitudes, and activities of EHS staff members, parents, and pregnant women in relation to the oral health of EHS children, as well as their suggestions regarding future oral health educational interventions targeting EHS children.     

Evaluation of a nutrition education program for head start parents

This study investigated the effects of a parent education program on the nutrition-related behavior of Head Start parents and the dietary intake of their preschool children. Six New York City and five Maryland Head Start centers were assigned to either the treatment (nutrition education) or control group. Treatment group mothers received 13 weekly nutrition newsletters and were encouraged to attend four nutrition workshops addressing child nutrition, meal planning, food preparation, and food shopping. A total of 89 mothers in the treatment group and 82 mothers in the control group completed pre- and post-program interviews examining their children's food consumption and their nutrition-related behaviors. One to two months after the nutrition education program, Maryland treatment group parents reported that their children were consuming a significantly more diverse and high quality diet, and were consuming significantly more servings of selected nutritious foods than were children in the control group. There were no significant differences in the food consumption of New York treatment and control group children following the program. Treatment group parents from both Maryland and New York reported making more positive changes in their meal planning, food shopping, food preparation, and cooking practices than did their control group counterparts. Findings indicate that nutrition education programs can have a positive effect on Head Start parents' nutrition-related behaviors and can lead to improvements in the diets of children who have been eating fewer than the recommended number of servings of nutritious foods.     

Navigating disability and related services: stories of immigrant families

Cultural beliefs, values, language differences, and unfamiliar educational infrastructures and practices can impact immigrant parents’ capacity to support their children with disabilities in their new country. This study presents perspectives of disability and experiences with special education services based on interviews with eight immigrant parents of children with disabilities from four countries. Results indicate that the process for accepting, or not accepting, that their child has a disability differed across cultural contexts. Additionally, immigrant parents encounter diverse labelling practices and have varying levels of participation in special education services. Moreover, immigrant families who are refugees have differential access to services and a more limited cultural perspective of their heritage country than families who came to the USA directly from their heritage country. These results can assist professionals in rethinking policies and practices to more effectively establish partnerships with culturally and linguistically diverse families.     

The Head Start Tobacco Cessation Initiative: Using Systems Change to Support Staff Identification and Intervention for Tobacco Use in Low-Income Families

Tobacco use continues to be the leading cause of preventable illness and death in the United States. Remarkably, more than nine million preschool-aged children are exposed to secondhand smoke, resulting in increased rates of morbidity and mortality. Even more disturbing is that tobacco use is highest among people with the lowest levels of income and education. Thus, reaching these populations is a challenge facing tobacco control programs. This report describes an innovative pilot project implementing a systems change model that involves multiple stakeholders in integrating evidence-based cessation strategies into federal Head Start programs, which serve low-income adults and their children. The Tobacco Cessation Initiative was developed through a partnership between the American Legacy Foundation, the Mailman School of Public Health at Columbia University, and the Louisiana State University Health Sciences Center School of Public Health. The partnership developed guidelines to fit into the overall mission of Head Start by enabling participating sites to incorporate tobacco cessation identification and referral protocols into their existing infrastructures. This program allowed Head Start sites to incorporate, into their existing family services, protocols for user identification and referral; build partnerships with groups supporting tobacco cessation; link families to cessation services; and educate families about risks associated with exposure to secondhand smoke. Applying system strategies in non-clinical settings such as Head Start offers a way to improve the health and quality of life of preschool children at the highest risk for exposure to secondhand smoke.     

Estado de salud y frecuentación de los servicios sanitarios de los menores hijos de inmigrantes

ObjectiveTo provide empirical evidence to assess whether having immigrant parents is a source of variation in health status and in health services’ utilization among children.MethodThe analysis was based on the sample of children from the Catalan Health Survey, 2006. Modelling of health status and use of health services was developed from the specification of distinct probabilistic models.ResultsThe results indicate that the children of immigrants had a significantly fewer chronic diseases, while perceived health status, according to the self-evaluation of the parents or responsible person, was worse if both parents belonged to this group. Significant differences were found in the utilization of distinct health services.ConclusionsThe analyses developed suggest that parental origin leads to differences in the utilization of the various levels of the Spanish health system. While no widespread pattern of increased or decreased utilization of the whole system was identified, differences were found in the number of specialist visits and admissions. Statements of the child's perceived health status were influenced by immigrant families’ socioeconomic conditions, which probably affected outcomes.     

Caring for Children While Working in Agriculture—The Perspectiveof Farmworker Parents

ABSTRACT

Access to safe, off-farm childcare is often a challenge for farmworkers with young children and is likely to become an increasingly salient barrier as more agricultural workers migrate together with families and as the number of women entering the agricultural workforce increases. Agriculture is one of the most hazardous industries, and the presence of young children in the workplace puts them at risk. To better understand the current nature of childcare for farmworker families and the challenges to accessing services, this project facilitated in-person surveys with 132 parents in three communities in Florida. A convenience sample that intentionally targeted parents living and working in areas with limited access to Migrant and Seasonal Head Start facilities was used to recruit participants. Most participants reported childcare access as a challenge. They expressed a desire to work in an area based on childcare availability. These findings offer agribusiness leaders important data to consider. They also suggest that industry support of childcare may be an important workforce investment. Findings indicate that high quality, affordable off-farm childcare services could serve as a means for attracting farmworkers to regions currently experiencing labor shortages. Additional research is warranted to explore this subject in diverse geographic areas.     

Factors associated with intensiveness of use of child preventive health services in Taiwan: a comparative study between cross-cultural immigrant families and native-born families

Objectives: To compare intensiveness of use of child preventive health services (CPHS) between cross-cultural immigrant families and native-born families in Taiwan and to explore factors associated with differences in intensiveness of CPHS use.

Design: Cross-cultural immigrant families were defined as families where the mother was an immigrant from another southeast Asian country. In native-born families, both parents were Taiwanese-born. Data were collected from 318 immigrant mothers and 340 native-born mothers of children aged 7 years or younger in a cross-sectional survey in central Taiwan. A social determinants framework of health inequities was constructed, and ordinal logistic regression models were used to examine the effect of four domains of intermediary determinants on the relationship between family type and underuse of CPHS: CPHS-related factors, medical-related factors, maternal acculturation factors, and sociodemographic/socioeconomic characteristics.

Results: Cross-cultural immigrant families were less likely to intensively use CPHS than native-born families. This difference appeared to be mediated by the greater likelihood of having an older child or a lower educated father in cross-cultural families.

Conclusion: Findings of this study highlight the importance of promoting health behaviors and combating health inequities and social inequalities for cross-cultural immigrant families in Taiwan from a sociodemographic/socioeconomic and political context.     

Maternity care through the eyes of Southern European immigrant parents in Norway

ObjectiveTo explore Southern European immigrant mothers and fathers’ experiences of reproductive health services in Norway, and their perceptions of health providers’ beliefs and attitudes regarding pregnancy and childbirth.MethodWe employed a qualitative research methodology with two focus group discussions and 11 in-depth interviews with 4 fathers and 11 mothers from Italy, Spain, Portugal, and Greece, whose children were born in Norway. Thematic Analysis was conducted to identify and analyze patterns across the data.ResultsWe identified three themes as key elements in parents’ experiences: experiences with the coverage and organization of the Reproductive Health Services; relational experiences with health providers; and pregnancy and delivery as a culturally-shaped event. The immigrant parents experienced a clash between their expectations and the procedures and health facility environment encountered in Norway regarding check-ups, diagnosis tests, childbirth preparation courses, and health facilities. Informants perceived that the maternity care practices of the host country were underpinned by the health care providers’ cultural understandings of labor and pregnancy. Particularly, they experienced a less interventionist approach towards pregnancy and childbirth.ConclusionsThe experiences of immigrant parents provide relevant information to improve reproductive health services in a cross-cultural context. Inmigration brings new challenges that must be addressed from a perspective of cultural competence. These services should acknowledge diversity in cultural beliefs around childrearing and involve both fathers and mothers in decision-making.     

Navigating different cultural beliefs and practices to support immigrant preschoolers and their families: a Bakhtinian textual analysis on preschool teacher and administrator perspectives

ABSTRACT

Understanding different cultural beliefs and practices has become increasingly important for early childhood educators in the contemporary United States. This paper investigates how preschool teachers and administrators navigate different cultural discourses in classrooms that frequently go unidentified or ignored, and how they support children and parents from immigrant families. Preschool teachers and administrators play a vital role as moderators in contemporary early childhood education and care settings due to the increasingly diverse demographic and cultural landscape. Using a version of Bakhtinian textual analysis, we illustrate the complexities of navigating multiple sets of cultural beliefs and practices in early childhood classrooms, as well as the possible challenges of supporting children and parents from immigrant families. The paper makes visible tacit cultural values and attitudes that manifest in early childhood classrooms to explore the circulating discourses about cultural diversity in the midst of rising anxieties, ambivalence, and tensions around immigration.     

Working with a Head Start population with asthma: lessons learned

The Early Childhood Asthma Project involved asthma case identification in 35 Head Start centers in Detroit, MI, and attempted implementation of an intervention designed to help families manage a child's asthma more effectively. Surveys were distributed to the parents of all Head Start children (3408), and 2198 complete surveys were returned. Case detection found probable asthma in 30% of the children whose parent returned a sufficiently complete survey. Implementation of the intervention was unsuccessful in this setting. Obstacles to effective implementation included the sample's low participation and high attrition, limited involvement of Head Start personnel, factors related to the program approach, and the target population's beliefs about asthma.     

Predictors and behavioural outcomes of parental involvement among low-income families in elementary schools,United States

ABSTRACT

Parental involvement (PI) in their children’s schools has been shown to have a positive influence on the children’s behaviours and academic achievement. The purpose of this study was to examine predictors of PI and relations of PI in schools to child externalizing and internalizing behaviours. Data were from the fifth-grade wave of the Early Head Start Research and Evaluation Project, with 1354 fifth grade low-income children and parents. Results revealed that family conflict predicted child internalizing and externalizing and negatively predicted PI in schools. However, PI in schools partially reduced the negative effect of family conflict on both internalizing and externalizing. Parental warmth negatively predicted child externalizing behaviours, and positively predicted PI in school. Additionally, PI in schools further enhanced the positive effect of parental warmth in reducing externalizing behaviours. The study highlights home and parent characteristics that relate to low-income fifth-grade parents’ involvement in their child’s education and demonstrates the mediating role of PI in reducing behavioural problems of low-income children.