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.     

Externalizing Behaviors among Children of HIV Seropositive Former and Current Drug Users: Parent Support Network Factors as Social Ecological Risks

Children affected by their parents’ dual drug use and HIV/AIDS face considerable challenges to their psychosocial development, including parent dysfunction and foster care placement. While HIV/AIDS may increase parents’ mobilization of social support, their drug use may restrict who is available to help them, with potential implications to the adjustment of their children with whom they remain in contact. This study sought to identify dually affected children’s living situations, and parent and parent’s support network factors as correlates of children’s externalizing problem behaviors. An urban community sample of 462 HIV seropositive, current or former drug-using parents were queried about their children aged 5–15 years old. One hundred ninety-four children were reported by 119 parents. The outcome was children’s externalizing behaviors of ever having been suspended or expelled from school, criminal-justice system involvement, or illicit drug or heavy alcohol use. Independent variables included kin and drug users in parent’s support network. Generalized estimating equations were used to adjust for the potential correlation of children of the same parent. Among parents, 63% were mothers, 57% current opioid or cocaine users, 85% were African American, 35% had AIDS or CD <200, and 53% had high depressive symptoms (CES-D ≥ 16); median age was 38. Among children, median age was 12; 23% lived with the nominating parent, 65% with other family, and 11% in non-kin foster care. While only 34% of parents reported child custody, 43% reported daily contact with their child, and 90% reported high emotional closeness. Parents reported externalizing behaviors among 32% of the children. Logistic regression indicated that externalizing behavior was positively associated with parent’s physical limitations and proportion of illicit drug users in parent’s support network. A significant interaction was found indicating that the effect of parent’s support network-level drug use was greater for children living with versus not living with the parent. The model adjusted for parent’s current drug use and depressive symptoms, which were not significant. Results indicate that while only a minority of these dually affected children lived with the parent, the parents’ physical limitations and embeddedness in drug using support networks, particularly if living with their children, was associated with the children’s maladjustment. It is plausible that these factors interfere with parenting, expose the children to conflict or adverse social influences, or obligate children to assume caregiving for their parent. While dually affected children’s contact with their parents may have important benefits, results suggest it presents ongoing needs for intervention with the children, their parents, and caregivers. Knowlton, Wissow, and Latkin are with the Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA; Buchanan is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Pilowsky is with the Departments of Epidemiology and Psychiatry, Columbia University, New York, NY, USA.     

Factors that Influence Children’s Responses to Peer Victimization

Children’s responses to peer victimization are associated with whether the victimization continues, and its impact on adjustment. Yet little longitudinal research has examined the factors influencing children’s responses to peer victimization. In a sample of 140 late elementary school children (n = 140, Mean age = 10 years, 2 months, 55% female, 60% Caucasian), the role of social, emotional, and cognitive factors on children’s responses to peer victimization over time were examined. Broadly, children’s emotional reactivity and peer victimization experiences predicted changes in the ways participants thought about peer victimization over time, and children’s sense of control, attitudes toward the use of aggression, and problem solving predicted changes in participants’ coping responses over the course of the school year.     

Camp Okizu: Preliminary Investigation of a Psychological Intervention for Siblings of Pediatric Cancer Patients

This research was conducted at a summer camp for siblings of children with cancer. The camp is designed to address emotional problems, provide peer interaction and validation, and bolster siblings' self-esteem. Standardized measures assessing posttraumatic stress, anxiety, quality of life, and self-esteem were administered to 77 siblings (ages 6-17) prior to attending camp and again 3 months after camp. From pre- to post-camp, the siblings reported statistically significant decreases in symptoms of posttraumatic stress and anxiety, and statistically significant improvements in quality of life and self-esteem. These preliminary findings are encouraging and suggest the value of camp as a psychological intervention and provide a model for other pediatric cancer facilities designing intervention programs for siblings.     

Childhood Stressors and Coping Actions: A Comparison of Children and Parents’ Perspectives

At a time when many children and families are faced with enormous daily life hassles and major stressful events, it is crucial to understand issues pertaining to childhood stress and coping. The present study examined children and parents’ perceptions of childhood stressors and children’s coping actions. Findings reveal that children report higher stress levels than parents. The stressors identified by children range from peer related stressful situations such as being laughed at to internal factors such as lack of control, and major life events such as death of a loved one. Children and parents report a large range of coping actions with three predominant themes—cognitive, social, and emotional coping strategies. Implications for practice are discussed. This research was supported by a General University Research Program Grant from the University of Delaware.     

Responding to Peer Victimization: A Sense of Control Matters

Peer victimization is a salient stressor for children, and the ways children respond to peer victimization is thought to influence whether the victimization increases or decreases over time. In a sample of middle school students (n = 311, 89% Caucasian, 57% female, mean age = 10.8 years, SD = .70), the current study examined social and cognitive factors that predicted children’s coping responses over time. Findings indicated that appraised control moderates the associations between social and cognitive factors and coping responses. For example, appraised control reduced the likelihood of avoidant responses, especially when children had attitudes supporting the use of aggression. Findings suggest that increasing children’s sense of control when responding to bullies will not have uniformly positive effects however. Thus, interventions must also take care to promote more positive responses while empowering children.     

Eating Disorders and Disturbance in Children and Adolescents With Cystic Fibrosis

Although perceived social support is associated with positive outcomes and chronic illness, summer camps strive to provide social support to children and families, no measures of perceived support across settings and about illness-specific issues exist. The current study provides an initial validation of a new measure for children with cancer and their siblings, the Children's Assessment of Perceived Social Support, which assesses perceived support from individuals in the home and summer camp settings and about cancer and non–cancer-related issues. The results indicate the measure has adequate validity and reliability and that perceived support across settings and individuals may differ.     

Oncology Summer Camp: Benefits of Social Comparison

In this study, we examined social comparison, perceived self-competence, and social isolation among 34 adolescents with cancer who attended an oncology summer camp. Participants completed questionnaires on the first and last day of camp. The results indicate that adolescents felt more similar to camp peers than home peers and that these peer comparisons were related to social acceptance, physical appearance, global self-worth, and loneliness. The results of this study demonstrate that disease-specific summer camps provide adolescents with a community of similar peers who are an appropriate comparison group for self-evaluation. In turn, these social comparisons are related to improved psychosocial outcomes. The benefit of social comparison at an oncology camp should not be overlooked by researchers and health care professionals who plan, staff, and refer children to these programs.     

Mothers’ Socialization of Emotion Regulation: The Moderating Role of Children’s Negative Emotional Reactivity

During the toddler period, children begin to shift from being primarily dependent on parents to regulate their emotions to managing their emotions independently. The present study considers how children’s propensity towards negative emotional arousal interacts with mothers’ efforts to socialize emotion regulation. Fifty-five low income mothers and their 2-year-old children completed observational assessments measuring mothers’ socialization of emotion regulation, children’s reactivity propensity, and children’s emotion regulation. Children’s propensity towards negative reactivity significantly interacted with mothers’ use of physical soothing. That is, mothers with less reactive children who used more soothing had children who were more likely to use interactive, distraction-based regulatory behaviors during a frustration situation. Theoretical and child care implications of the finding are discussed.     

Conflict as social interaction: Building relationship skills in child care settings

Learning the skills to build relationships is an important part of child development. Good relationship skills in childhood lay the foundation for healthy adult relationships. Young children’s relationships are characterized by a high degree of conflict, as children learn the cognitive skills of taking another’s perspective, thinking in terms of multiple attributes and anticipating the consequences of their actions. Children who learn to resolve conflicts successfully become more popular and interact with other children more frequently and for longer periods of time as they grow older, thus practicing interpersonal skills more frequently and consolidating their advantage. This project looks at the conflicts in which young children engage in group care settings. The aim is to understand the children’s meanings of conflict by observing their behavior in context. Understanding the meanings of conflict for children can inform caregivers’ strategies for guiding their behavior and for developing effective conflict resolution strategies in children.     

Oncology Summer Camp: Benefits of Social Comparison

In this study, we examined social comparison, perceived self-competence, and social isolation among 34 adolescents with cancer who attended an oncology summer camp. Participants completed questionnaires on the first and last day of camp. The results indicate that adolescents felt more similar to camp peers than home peers and that these peer comparisons were related to social acceptance, physical appearance, global self-worth, and loneliness. The results of this study demonstrate that disease-specific summer camps provide adolescents with a community of similar peers who are an appropriate comparison group for self-evaluation. In turn, these social comparisons are related to improved psychosocial outcomes. The benefit of social comparison at an oncology camp should not be overlooked by researchers and health care professionals who plan, staff, and refer children to these programs.     

Residential Staff’s Changing Attitudes Toward Parents of Children in their Care: Rationale and Healing Effects on Children,Parents, and Staff

A pilot project in Israel, regarding parent’s involvement in their children’s education in residential care was evaluated. The dual goals were changing staff’s attitudes toward parents, and empowering parents. During the school year, parents were invited to participate in bi-weekly dynamic group workshops in the residence (parents only and parents–children), and to 3–4 “Family Days,” in addition to sharing special parent–child summer camps. Results indicate considerable success: children, parents, and staff felt that the project had improved their ability to deal successfully with their everyday challenges, with parents viewing themselves as having been most rewarded.

Evaluation of a family camp intervention for children with a heart transplant and their families

Given the arduous course of heart transplantation and follow-up care, recipients and their families face complex challenges and stressors warranting supportive interventions. This study explored the impact of a family camp as an intervention of education and social support for pediatric transplant recipients and their families. A total of 49 individuals participated in this evaluation, including eight children and nine youth with heart transplants, five siblings, 19 parents, and 13 health care providers. Participants ranked and described the 3-day family camp experience. Analysis of pre/post intervention measures on knowledge, social support, and coping revealed statistically significant improvements in knowledge, social support, self-esteem, and psychological stability. Satisfaction surveys revealed the camp to be an important resource for education, family fun, and peer support among transplant recipients, their families, and the health care team. Implications and recommendations are offered for clinical and community practice.     

Delayed or Forgone Care and Dissatisfaction with Care for Children with Special Health Care Needs: The Role of Perceived Cultural Competency of Health Care Providers

To better understand if reported delayed/forgone care and dissatisfaction with care for children with special health care needs (CSHCN) are associated with the parent’s perception of health care providers’ cultural competency. National survey. Fifty United States and the District of Columbia yielding 750 families per state and District of Columbia with CSHCN ≤ 18 years participated in the 2005–06 National Survey of CSHCN. Outcome measures were delayed/forgone care in the past 12 months (yes or no) and dissatisfaction (very dissatisfied to very satisfied). Demographic/clinical characteristics and the parent’s perception of health care providers’ cultural competency were examined. Perception of cultural competency was defined by questions related to time spent with child, respect for family values, listening to the family, sense of partnership, and information provided. Delayed/forgone care and dissatisfaction with care were associated with perceived health care provider cultural competency. Parents whose children were older, whose children’s condition affected their ability to do things, whose interviews were not conducted in English, and were from certain racial and ethnic groups reported more delayed or forgone care and were more dissatisfied with their children’s health care. Delayed/forgone care and dissatisfaction with care were associated with perceived cultural competency of health care providers. This did not appear to differ consistently by racial or ethnic group. Further research using more refined instruments and longitudinal designs is needed to assess the effects of health care providers’ cultural competency and other cultural factors on the delayed/forgone care for CSHCN and on the dissatisfaction with care of parents with CSHCN.     

Encouraging the development of social competence in young children

To help children develop social competence, teachers need to understand differences between popular and unpopular children, know how to assess social competence, and employ techniques which aid the development of children's social skills. In general, popular children have developed skills and strategies which allow them to interact with their peers in various situations. Unpopular children engage in behaviors which are detrimental to peer interaction. Their behaviors and lack of skills increase the likelihood of peer rejection. Knowing how to interact with peers successfully is vitally important, for research shows that early popularity is associated with later positive outcomes, while early unpopularity is associated with later negative outcomes. To identify children who are rejected, neglected, or popular, teachers can employ several methods, including sociometric ratings and rankings, the picture nomination technique, informal observations, and checklists such as the California Preschool Competency Scale. Teachers can also utilize several techniques to improve children's social skills. Such techniques include, among others, reinforcement through praise, structuring the social and physical environment to encourage positive interaction, providing time for free play, and enhancing children's self esteem.     

Child pedestrians: The role of parental beliefs and practices in promoting safe walking in urban neighborhoods

The purpose of this study was to describe parents’ child pedestrian safety practices, knowledge, risk perceptions, and beliefs. We surveyed 732 parents from four elementary schools in urban neighborhoods that differed in income, and child pedestrian injury risks. Findings indicated that most parents taught their children street safety. Few (16%) knew basic pedestrian safety facts; 46% believed children younger than 10 years could safely cross streets alone; 50% believed a child pedestrian crash was likely. Parents in lower income neighborhoods reported the highest rates of unpleasant walking environments and concerns about drug dealers, crime, violence, and trash. We conclude that education should focus on children’s risk, developmental capabilities, and supervision needs. Promoting physical activity in urban neighborhoods, especially lower income ones, must address concerns about the physical and social environment.     

Time trends in exposure to environmental tobacco smoke and parental educational level for 6-year-old children in Germany

The aim of the study was to investigate the association between exposure to environmental tobacco smoke of 6-year-old children and parental educational level in Germany under the changing socioeconomic conditions after reunification. Logistic regression was used to examine the relationship between tobacco smoke exposure of children (current environmental tobacco smoke, maternal smoking during pregnancy, environmental tobacco smoke during the first 3 years of the child’s life) and the determinants parental educational level, time and region. In Germany, the risk of environmental tobacco smoke exposure among 6-year-old children was strongly associated with parental educational level (odds ratio: ≥2 ‘low’/‘middle’ versus ‘high’ parental educational level). In West Germany, environmental tobacco smoke exposure generally exhibited a decreasing trend of about 20%. In contrast, in East Germany the environmental tobacco smoke exposure was only decreasing for children of parents with higher education. The gap between low and high parental educational level with respect to current children’s tobacco smoke exposure has increased from 1991 to 2000 in East Germany. A considerable fresh increase of maternal smoking during pregnancy could be observed around 1991 in both parts of Germany. In East Germany, the transition from a socialist economic system to a market economy after reunification might in part explain the increased gap of tobacco smoke exposure between children of parents with lower and higher educational levels.     

The Effect of Parental Immigration Authorization on Health Insurance Coverage for Migrant Latino Children

Objective: To examine if immigration authorization among parents is associated with health insurance coverage for migrant Latino children. Data Source: A cross-sectional household survey of 300 migrant families for which one child, aged <13 years, was randomly selected. Results: Most children lacked insurance (73%) and had unauthorized parents (77%). Having an authorized parent or parental stay of more than 5 years in the US were each positively associated with children’s health insurance coverage [OR: 4.9; 95% CI: (2.7–8.7) and [OR = 6.7; 95% CI: (3.8–12.0), respectively]. The effect of parental authorization did not persist in multivariable logistic regression analysis; however, more than 5 years of parental stay in the US remained associated with children’s insurance coverage [OR = 4.8; 95% CI (1.8–12.2)], regardless of parental authorization. Conclusion: Increased parental familiarity with US health and/or social services agencies, rather than parental authorization status, is important to obtaining health insurance for migrant children. Efforts to insure eligible migrant children should focus on recently arrived families.     

Adjustment among Mothers Reporting Same-Gender Sexual Partners: A Study of a Representative Population Sample from Quebec Province (Canada)

We examined the well-being of mothers and non-mothers reporting exclusive opposite-gender sexual partners (OG), same-gender sexual partners (SG), or both (BI) in a representative sample of 20,773 participants (11,034 women) 15-years-old or older from the population of Quebec province in Canada. Participants completed a self-administered questionnaire and SG and BI women (n = 179) were matched to a sample of OG women (n = 179) based on age, income, geographical area, and children (having at least one 18-year-old or younger biological or adopted child at home). We assessed social milieu variables, risk factors for health disorders, mental health, and quality of mothers’ relationship with children. The findings indicated a sexual orientation main effect: Mothers and non-mothers in the SG and BI group, as compared to their OG controls, were significantly less likely to live in a couple relationship, had significantly lower levels of social support, higher prevalence of early negative life events, substance abuse, suicide ideation, and higher levels of psychological distress. There were no Sexual Orientation X Parenthood status effects. The results further indicated that sexual orientation did not account for unique variance in women’s psychological distress beyond that afforded by their social milieu, health risk factors, and parenthood status. No significant differences were found for the quality of mothers’ relationship with children. SG-BI and OG mothers with low levels of social integration were significantly more likely to report problems with children than parents with high levels of social integration. We need to understand how marginal sexualities and their associated social stigma, as risk indicators for mothers, interact with other factors to impact family life, parenting skills, and children’s adjustment.     

Ancillary Benefits for Caregivers of Children with Asthma Participating in an Environmental Intervention Study to Alleviate Asthma Symptoms

Providing care for children with asthma can be demanding and time-intensive with far-reaching effects on caregivers’ lives. Studies have documented childhood asthma symptom reductions and improved asthma-related quality of life (AQOL) with indoor allergen-reducing environmental interventions. Few such studies, however, have considered ancillary benefits to caregivers or other family members. Ancillary benefits could be derived from child health improvements and reduced caregiving burden or from factors such as improved living environments or social support that often accompanies intensive residential intervention efforts. As part of the Boston Healthy Public Housing Initiative (HPHI), a longitudinal single-cohort intervention study of asthmatic children, we examined trends in caregivers’ quality of life related to their child’s asthma (caregiver AQOL) using monthly Juniper Caregiver Asthma Quality of Life Questionnaires (AQLQ) for 32 primary caregivers to 42 asthmatic children aged 4 to 17 years. Longitudinal analyses were used to examine caregiver AQOL trends and their relationship to the child’s AQOL, then to consider additional predictors of caregiver AQOL. Caregiver AQLQ improved significantly over the course of the study with overall improvements significantly correlated with child AQOL (p = 0.005). However, caregiver AQOL improved most in the months before environmental interventions, while children’s AQOL improved most in the months following. Time trends in caregiver AQOL, controlling for child AQOL, were not explained by available social support or caregiver stress measures. Our findings suggest potential participation effects not adequately captured by standard measures. Future environmental intervention studies should more formally consider social support and participation effects for both children and caregivers