Introducing Parenting Support in Primary Care: Professionals’ Perspectives on the Implementation of a Positive Parenting Program

Journal of Prevention - While positive parenting programs are an initiative aligned with the Family-Centered Care model and the Council of Europe’s Recommendation on Positive Parenting,...     

Factors Affecting Students’ Evaluation in a Community Service-Learning Program

A community service-learning curriculum was established to give students opportunities to understand the interrelationship between family and community health, the differences between community and hospital medicine, and to be able to identify and solve community health problems. Students were divided into small groups to participate in community health works such as home visits etc. under supervision. This study was designed to evaluate the community service-learning program and to understand how students’ attitude and learning activities affected students’ satisfaction. The results revealed that most medical students had a positive attitude towards social service and citizenship but were conservative towards taking the role to serve people in the community. Students had achieved what they were required to learn especially the training in communication skills and ability to identify social issues. Students’ attitude towards social service did not affect their opinions on the quality of the program and subjective rating on their achievement. The quality of the program was related to the quality of learning rated by the students.     

Does Social Support Predict Pregnant Mothers’ Information Seeking Behaviors on an Educational Website?

We examine how social support (perceived support and support from a spouse, or committed partner) may influence pregnant women’s information seeking behaviors on a pregnancy website. We assess information seeking behavior among participants in a trial testing the effectiveness of a web-based intervention for appropriate gestational weight gain. Participants were pregnant women (N = 1,329) recruited from clinics and private practices in one county in the Northeast United States. We used logistic regression models to estimate the likelihood of viewing articles, blogs, frequently asked questions (FAQs), and resources on the website as a function of perceived social support, and support from a spouse or relationship partner. All models included socio-demographic controls (income, education, number of adults and children living at home, home Internet use, and race/ethnicity). Compared to single women, women who were married or in a committed relationship were more likely to information seek online by viewing articles (OR 1.95, 95 % CI [1.26–3.03]), FAQs (OR 1.64 [1.00–2.67]), and blogs (OR 1.88 [1.24–2.85]). Women who felt loved and valued (affective support) were more likely to seek information by viewing articles on the website (OR 1.19 [1.00–1.42]). While the Internet provides a space for people who have less social support to access health information, findings from this study suggest that for pregnant women, women who already had social support were most likely to seek information online. This finding has important implications for designing online systems and content to encourage pregnant women with fewer support resources to engage with content.     

What Affects Attendance and Engagement in a Parenting Program in South Africa?

Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. Studies in high-income countries show varying results regarding whether more disadvantaged families are equally engaged in parenting interventions. In low- and middle-income countries (LMICs), almost nothing is known about the patterns of participation in parent training. This paper examines group session attendance and engagement data from 270 high-risk families enrolled in the intervention arm of a cluster-randomized controlled trial in South Africa. The trial evaluated a 14-week parenting intervention aiming to improve parenting and reduce maltreatment by caregivers. The intervention was delivered in 20 groups, one per study cluster, with 8 to 16 families each. Overall, caregivers attended 50% of group sessions and children, 64%. Using linear multilevel models with Kenward-Roger correction, we examined child and caregiver baseline characteristics as predictors of their attendance and engagement in the group sessions. Variables examined as predictors included measures of economic, educational, and social and health barriers and resources, as well as family problems and sociodemographic characteristics. Overall, the study yielded no evidence that the level of stressors, such as poverty, was related to attendance and engagement. Notably, children from overcrowded households attended on average 1.2 more sessions than their peers. Our findings suggest it is possible to engage highly disadvantaged families that face multiple challenges in parenting interventions in LMICs. However, some barriers such as scheduling, and alcohol and substance use, remain relevant.     

Do Maternal Caregiver Perceptions of Childhood Obesity Risk Factors and Obesity Complications Predict Support for Prevention Initiatives Among African Americans?

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children’s positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers’ support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers’ support for prevention initiatives. Methods A convenience sample of maternal caregivers (N?=?129, ages 22–65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers’ support for prevention strategies. Results Caregivers’ perceptions of childhood obesity risk factors were moderate (M?=?3.4; SD?=?0.64), as were their perceptions of obesity-related health complications (M?=?3.3; SD?=?0.75); however, they perceived a high level of support for prevention strategies (M?=?4.2; SD?=?0.74). In the regression model, only health complications were significantly associated with caregiver support (β?=?0.348; p?<?0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.     

Mothers’ Beliefs about Knowledge, Child Development, and Parenting Strategies: Expanding the Goals of Parenting Programs

This study examined the relationship between mothers’ beliefs about knowledge (epistemology) and conceptions of child development and parent-child communication strategies. One hundred twenty mothers of preschool-aged children completed the Ways of Knowing measure and Parent Communication Strategies Interview; a subset of 38 also completed the Concepts of Development Questionnaire. Analyses revealed that mothers with more complex understanding of knowledge have less categorical and more multi-faceted conceptions of child development and are more likely to endorse parenting strategies that are less authoritarian and more cognitively challenging for children. Editor’s Strategic Implications: Prevention programs designed to promote constructive parenting should foster parents’ epistemological development (which guide beliefs and practices) rather than dwell on individual parent behaviors. The authors continue to develop the promising practice of tailoring interventions on the basis of parents’ personal belief systems (see also Burns & Bond, 2004).     

Effectiveness of a Sexual Education Program for Mothers of Young Adults with Intellectual Disabilities on Mothers’ Attitudes Toward Sexual Education and the Perception of Social Support

Healthy sexual development is possible only through effective sexual education, which could be provided by families. Lack of sexuality training could lead to inappropriate behavior in children and they could face problems such as exclusion from the society and sexual abuse. The purpose of the present study was to scrutinize the effect of a Sexuality Education Program for Mothers of Young Adults with Intellectual Disabilities (SEPID) on the attitudes of mothers toward the sexuality education of their children and their perceptions of social support. The present research employed an empirical pretest–posttest model with control group. Study participants included 44 mothers who were randomly assigned to experimental (n = 22) and control (n = 22) groups. The SEPID program was conducted at the seminar hall located in the second floor of a café where individuals with intellectual disabilities work and it was conducted in four 1-h sessions. Study data were tested with ANOVA and ANCOVA methods. Findings demonstrated that SEPID changed the attitudes of mothers toward the sexuality education of their children in a positive direction and improved their perceptions of social support. Social validity findings showed that the mothers were satisfied with the program.     

Young First-Time Mothers’ Parenting of Infants: The Role of Depression and Social Support

Maternal and Child Health Journal - This study examines the contributions of social support and depressive symptoms on sensitive parenting behaviors, parenting attitudes and parenting stress among...     

What Does Attending Early Childhood Program Mean for Child Health in India?

The health impact of attending early childhood development programs in developing countries remains largely unknown. In this study, we focus on the health consequences of attending preschool programs in India. Using a unique longitudinal dataset, we allow for heterogeneity in the impact of preschool across the distribution of health outcomes while controlling for time‐invariant unobservables. We detect unique temporal variation in the effect of preschool attendance – growth of preschool attendees is slower than non‐attendees in various parts of the distributions of several anthropometric measures when evaluated in the early years between ages 1 and 5. This effect is likely to reverse in the longer term at age 8. The early years' adverse effect can be explained in part by over‐attendance in the form of long daily hours, excessive attendance days, and early entry. The findings are insensitive to nutritional incentives like free meals provided in public schools. The growth‐retarding effect remains robust for weight‐for‐age z‐scores, implying that the impact of preschool attendance is not only heterogeneous, but differs across dimensions of health status. Our study highlights the need for strengthening the delivery of childhood programs in developing countries in order to prevent adverse health effects in the critical years. Copyright © 2016 John Wiley & Sons, Ltd.     

Commonality of Risk Factors for Mothers’ Poor Oral Health and General Health: Baseline Analysis of a Population-Based Birth Cohort Study

Maternal and Child Health Journal - Objective The association between and commonality of risk factors for poor self-rated oral health (SROH) and general health (SRGH) among new mothers has not been...     

Acculturation,Parent–Child Acculturation Differential,and Chronic Disease Risk Factors in a Mexican-American Population

Acculturation is typically defined in terms of individual responses to a dominant culture. In the present study, we examined the effects of different levels of acculturation among family members. Specifically, we looked at the health and risk behavior in Mexican-American children as related to a variety of psychosocial predictors, especially the differences in orientation toward Mexican- and Anglo-American cultures between them and their parents. Mother and child pairs (n = 106) noted their orientation toward both Anglo and Mexican cultures. Children’s dietary and sedentary behaviors, tobacco and alcohol use (and susceptibility to use), and depressive symptoms were also measured. Males were more likely to be sedentary and consume higher levels of total fat and saturated fat, whereas girls reported higher levels of depression. Anglo-oriented youth consumed lower levels of calories from fat but also more alcohol than did their Mexican-oriented counterparts. The latter was particularly the case among those children who were relatively more Anglo oriented than were their parents. Parent–child acculturation differential in terms of the differences in Mexican orientation, in comparison, predicted susceptibility to tobacco use. However, the sum of the absolute values of these two differences predicted only lifetime alcohol use, and in a counter-intuitive direction. This familial measure of acculturation shows some promise, but additional formative research is needed to operationalize this construct.     

Correlates of Prenatal Parenting Expectations in new Mothers: Is Better Self-Efficacy a Potential Target for Preventing Postnatal Adjustment Difficulties?

The extent to which a mother’s prenatal expectations are realistic or unrealistic has been associated with postnatal adjustment in first-time mothers. This cross-sectional study investigated the associations with prenatal parenting expectations to determine what makes them more or less realistic. A mediational model was developed to explain the relationships between family and social support, maternal adjustment (i.e., depression, anxiety, worry, stress, and happiness), parenting self-efficacy, and prenatal expectations. We recruited 255 first-time expectant mothers living in Brisbane, Australia. Using structural equation modeling, we found that higher levels of social and family support were associated with lower levels of maternal maladjustment, which in turn was related to higher parental self-efficacy. Finally, self-efficacy was a significant positive predictor of prenatal parenting expectations, implying that the more confident mothers are, the more realistic are their parenting expectations during pregnancy. This was a fully mediated effect. Our findings are of particular relevance for the educational and counseling services offered to pregnant mothers. Specifically, they could assist health professionals in identifying mothers who may be prone to having unrealistic expectations and prepare them for the demands and challenges of having a new baby, which may prevent poor adjustment in the postnatal period.     

Patterns in Mothers’ Recollection of Health Care Providers’ Young Child Feeding Recommendations

ObjectiveCharacterize feeding guidance mothers recall receiving from their child's health care provider (HCP).DesignCross-sectional study of mothers participating in the 2017–2019 National Survey of Family Growth.ParticipantsUS mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years).Variables MeasuredWeighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics.AnalysisLogistic regression assessing the relationship between recall of feeding guidance and demographics.ResultsIn 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 ImplicationsMothers 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.     

Factors Affecting a Recently Purchased Handgun’s Risk for Use in Crime under Circumstances That Suggest Gun Trafficking

While many handguns are used in crime each year in the USA, most are not. We conducted this study to identify factors present at the time of a handgun’s most recent retail sale that were associated with its subsequent use in crime under circumstances suggesting that the handgun had been trafficked—purchased with the intent of diverting it to criminal use. Handguns acquired in multiple-gun purchases were of particular interest. Using data for 180,321 handguns purchased from federally licensed retailers in California in 1996, we studied attributes of the handguns, the retailers selling them, the purchasers, and the sales transactions. Our outcome measure was a handgun’s recovery by a police agency, followed by a gun ownership trace, conducted by the Bureau of Alcohol, Tobacco, Firearms and Explosives, that determined (a) that the recovery had occurred within 3 years of the handgun’s most recent purchase from a licensed retailer and (b) that the person who possessed the gun when it was recovered by police was not its most recent purchaser. Altogether, 722 handguns were recovered and had trace results that met the additional criteria. Handguns acquired in multiple-gun, same-day transactions were more likely to be traced than were single-purchase handguns (odds ratio [OR] 1.33, 95% confidence intervals [CI] 1.08 to 1.63). This was not the case for multiple-purchase handguns defined more broadly as multiple handguns purchased by one individual over any 30-day period as used in “one-gun-a-month” laws. Bivariate regressions indicated increased risk of a handgun being traced when it sold new for $150 or less (OR 4.28, 95% CI 3.59 to 5.11) or had been purchased by a woman (OR 2.02, 95% CI 1.62 to 2.52). Handguns sold by retailers who also had a relatively high proportion (≥2%) of purchases denied because the prospective purchasers were prohibited from owning firearms were more likely to be traced than were those sold by other retailers (OR 4.09, 95% CI 3.39 to 4.94). These findings persisted in multivariate analyses. Our findings suggest specific strategies for intervention to prevent gun violence.     

Is Timing of Enrollment Associated with Birth Outcomes? Findings from a Healthy Start Program in Kansas

Objective The Sedgwick County Healthy Babies Healthy Start (HBHS) program provides community-based services (including care coordination, interconception care and home visiting) aimed at reducing racial/ethnic disparities in poor birth outcomes. The purpose of this study is to assess the effectiveness of the Sedgwick County HBHS program by comparing the birth outcomes of program participants who enrolled prenatally and those who did not participate while pregnant. Methods In this retrospective cohort study, we used data drawn from the Sedgwick County HBHS program. The sample included 280 clients who were enrolled in the Sedgwick County HBHS program between September 2014 and December 2015. We performed logistic regression analyses to assess the associations between enrollee type (prenatal enrollee vs. interconceptional enrollee) and birth outcomes (low birth weight, preterm birth). Results The majority of the sample consisted of racial/ethnic minority women (32.1% non-Hispanic black, 31.8% Hispanic). After adjusting for covariates, women who enrolled in the Sedgwick County HBHS program prenatally were less likely than women who were not enrolled during pregnancy to have a preterm birth (OR 0.19, [CI 08, 0.43]) and deliver a low birth weight infant (OR 0.31, [CI 0.10, 0.97]). Conclusions for Practice Women, particularly minority women, who participate in the HBHS program experienced better birth outcomes than women who did not participate in the program during pregnancy. However, findings also suggest that interconceptional enrollees may stand to benefit from continued participation in the program.     

Enhancing Sensitivity in Adolescent Mothers: Does a Standardised,Popular Parenting Intervention Work with Teens?

This community pilot study was designed to evaluate a small group intervention, Right From The Start (RFTS), in terms of the benefits it provides to adolescent mothers specifically. The effectiveness of the programme was examined in the areas of maternal sensitivity, parenting confidence, parenting stress, and postnatal depression. RFTS has been found as effective as home-visiting in improving maternal sensitivity among adult mothers. This research aimed to study whether similar results could be obtained in a population of adolescent mothers. Eleven adolescent mothers participated in this group intervention, and four of them completed it entirely. Mothers were recruited through an early parenting centre where they were videotaped during a five-minute feeding session. Maternal sensitivity was coded pre and post intervention using the Nursing Child Assessment Satellite Training Parent Child Interaction scale. In addition, the Beck Depression Inventory, the Parenting Stress Index, and the Toddler Care Questionnaire were used. In a paired-samples, two-tailed t-test, overall maternal sensitivity significantly improved between pre and post group intervention (p = 0.048). Maternal depression, stress, and parental confidence did not show significant improvements post intervention. In conclusion, RFTS may be helpful to even very young mothers within some domains of parenting. Clinical implications and limitations are discussed. Further research is required before conclusions about the effectiveness of this programme can be generalised.     

Social Support for First-Time Chinese Mothers in Contexts of Provider–Recipient Relationships

This study examined the influence of social support on perceived stress and online support activities in two relationship contexts. In 2013, we surveyed 366 first-time mothers between the ages of 26 and 30 years from mainland China about their social support experiences with their mothers and mothers-in-law in regard to child rearing. Women who received higher levels of support from their mothers reported lower levels of perceived stress and higher levels of online support activities. Receiving support from mothers-in-law was not associated with either perceived stress or online support activities. The findings demonstrate the importance of considering relationship contexts when examining social support outcomes. Implications for future research on social support and interpersonal relationships are discussed.     

Genetic ‘Risk Carriers’ and Lifestyle ‘Risk Takers’. Which Risks Deserve our Legal Protection in Insurance?

Over the past years, one of the most contentious topics in policy debates on genetics has been the use of genetic testing in insurance. In the rush to confront concerns about potential abuses of genetic information, most countries throughout Europe and the US have enacted genetics-specific legislation for insurance. Drawing on current debates on the pros and cons of a genetics-specific legislative approach, this article offers empirical insight into how such legislation works out in insurance practice. To this end, ethnographic fieldwork was done in the underwriting departments of Belgian insurance companies. Belgium was one of the first European countries introducing genetics-specific legislation in insurance. Although this approach does not allow us to speak in terms of ‘ the causal effects of the law’, it enables us to point to some developments in insurance practice that are quite different than the law’s original intentions. It will not only become clear that the Belgian genetics-specific legislation does not offer adequate solutions to the underlying issues it was intended for. We will also show that, while the legislation’s focus has been on the inadmissibility of genetic discrimination, at the same time differences are made in the insurance appraisal within the group of the asymptomatic ill. In other words, by giving exclusive legal protection to the group of genetic risks, other non-genetic risk groups are unintendedly being under-protected. From a policy point of view, studying genetics-specific legislation is especially valuable because it forces us to return to first principles: Which risks deserve our legal protection in insurance? Who do we declare our solidarity with?