The role of parental self-efficacy in parent and child well-being: A systematic review of associated outcomes

Dyadic analyses on the prospective association between birth experience and parent-child-bonding: The role of postpartum depression, anxiety, and childbirth-related posttraumatic stress disorder

OBJECTIVE

Negative birth experiences are associated with postpartum mental health difficulties in parents. However, research considering the long-term impact of a negative birth experience on parent-child-bonding and the interdependence between parents is rare. This study aimed to investigate actor as well as partner effects for the association between parents' birth experience and parent-child-bonding and whether this association is mediated by postpartum psychiatric symptoms.

METHOD

A community sample of couples (N = 743) completed questionnaires during pregnancy, 2, and 14 months after birth.

RESULTS

Applying Actor-Partner Interdependence Mediation Models, structural equation modeling showed that parents' own negative birth experience predicted a poorer bond to their child 14 months postpartum. Compared to mothers, this association was twice as strong for partners and was mediated by symptoms of postpartum depression (mothers and partners), anxiety (partners), and childbirth-related posttraumatic stress disorder (mothers). Negative birth experiences of one parent were not related to the other parent's bonding with the child.

CONCLUSION

Results underline the importance of parents' positive birth experience for their postpartum mental health and secure bond to their child. The other parent's birth experience or postpartum mental health does not seem to affect one's own bond to the child in the long term.

Hospital healthcare experiences of children and young people with life-threatening or life-shortening conditions, and their parents: scoping reviews and resultant conceptual frameworks

BACKGROUND

Patient experience is a core component of healthcare quality. Patient-reported experience measures (PREMs) are increasingly used to assess this, but there are few paediatric PREMs. This paper reports the first stage of developing two such measures, one for children and young people (0-18 years) (CYP) with a life-threatening or life-shortening condition (LT/LSC), and one for their parents. It comprised parallel scoping reviews of qualitative evidence on the elements of health service delivery and care that matter to, or impact on, CYP (Review 1) and parents (Review 2).

METHODS

Medline and PsychINFO (1/1/2010 - 11/8/2020) and CINAHL Complete (1/1/2010 - 4/7/2020) were searched and records identified screened against inclusion criteria. A thematic approach was used to manage and analyse relevant data, informed by existing understandings of patient/family experiences as comprising aspects of staff's attributes, their actions and behaviours, and organisational features. The objective was to identity the data discrete elements of health service delivery and care which matter to, or impact on, CYP or parents which, when organised under higher order conceptual domains, created separate conceptual frameworks.

RESULTS

18,531 records were identified. Sparsity of data on community-based services meant the reviews focused only on hospital-based (inpatient and outpatient) experiences. 53 studies were included in Review 1 and 64 in Review 2. For Review 1 (CYP), 36 discrete elements of healthcare experience were identified and organized under 8 higher order domains (e.g. staff's empathetic qualities; information-sharing/decision making; resources for socializing/play). In Review 2 (parents), 55 elements were identified and organized under 9 higher order domains. Some domains were similar to those identified in Review 1 (e.g. professionalism; information-sharing/decision-making), others were unique (e.g. supporting parenting; access to additional support).

CONCLUSIONS

Multiple and wide-ranging aspects of the way hospital healthcare is organized and delivered matters to and impacts on CYP with LT/LSCs, and their parents. The aspects that matter differ between CYP and parents, highlighting the importance of measuring and understanding CYP and parent experience seperately. These findings are key to the development of patient/parent experience measures for this patient population and the resultant conceptual frameworks have potential application in service development.

The effects and process of the intervention "Individual Shantala Infant Massage" in preventive child healthcare to improve parent-child interaction: study protocol for a quasi-experimental study

BACKGROUND

Individual Shantala Infant Massage is an intervention that is offered by several Dutch Preventive Child Healthcare (PCH) organizations as optional preventive support, in addition to basic care as offered to all children. It targets vulnerable families and aims to enhance sensitive parenting and to reduce (effects of) parental stress. The intervention is carried out by a certified nurse. It consists of three structured home visits. Parents learn to massage their infant and receive parenting support. This study aims to investigate the effectiveness and the process of the intervention. The main hypothesis is that Individual Shantala Infant Massage leads to increased parental sensitive responsiveness, lower perceived and physiological parental stress, and improved child growth and development in the intervention group, compared to a control group where this intervention is not offered by PCH. Secondary research questions address effects on parenting confidence and parental concerns regarding the infant, the influence of background characteristics and the intervention process.

METHODS

The study is a quasi-experimental non-randomized trial. The aim is to include 150 infant-parent dyads in both the intervention and the control group. This takes into account possible attrition and missing data as 105 dyads with complete data per group are sufficient for analysis. All participants complete questionnaires at T0 (pre-test, child age between six-sixteen weeks), T1 (post-intervention, or ± four weeks after T0), and T2 (follow-up at five months). At T2, a hair tuft is cut from the parents' head to measure hair cortisol levels. Data on infant growth and development is obtained from PCH files. In the intervention group, additional data is collected to evaluate the intervention process: parents complete an evaluation questionnaire at T1, nurses keep semi-structured logbooks of intervention sessions and interviews are conducted with parents and professionals.

DISCUSSION

Study results can contribute to the evidence base of infant massage as applied in Dutch PCH, and can inform parents, PCH practitioners, policy makers and researchers both inside and outside the Netherlands on feasibility and effectiveness of the infant massage intervention as applied in this format and setting.

TRIAL REGISTRATION

ISRCTN registry: ISRCTN16929184. Date (retrospectively) registered: 29/03/2022.

Patients' well-being during the transition period after psychiatric hospitalization to school: insights from an intensive longitudinal assessment of patient-parent-teacher triads

BACKGROUND

The transition period after psychiatric hospitalization back to school is accompanied by various challenges, including a substantial risk for rehospitalization. Self-efficacy and self-control, as transdiagnostic variables and important predictors of coping with school demands, should be crucial factors for successful adaptation processes as well as an overall high well-being during school reentry. The present study therefore investigates how patients' well-being develops during this period, and how it is related to patients' self-control and academic self-efficacy, as well as parents' and teachers' self-efficacy in dealing with the patient.

METHODS

In an intensive longitudinal design, daily ambulatory assessment measures via smartphone were collected with self-reports from the triadic perspective of 25 patients (M_age = 10.58 years), 24 parents, and 20 teachers on 50 consecutive school days, starting 2 weeks before discharge from a psychiatric day hospital (mean compliance rate: 71% for patients, 72% for parents and 43% for teachers). Patients answered daily questions between five and nine o'clock in the evening about their well-being, self-control, academic self-efficacy and about positive and negative events at school, as well as parents and teachers about their self-efficacy in dealing with the patient.

RESULTS

Multilevel modeling revealed that on average, patients' well-being and self-control decreased during the transition period, with trends over time differing significantly between patients. While patients' academic self-efficacy did not systematically decrease over time, it did show considerable intra-individual fluctuation. Importantly, patients experienced higher well-being on days with higher self-control and academic self-efficacy as well as with higher parental self-efficacy. Daily teacher self-efficacy did not show a significant within-person relationship to daily patients' well-being.

CONCLUSIONS

Well-being in the transition period is related to self-control and self-efficacy of patients and their parents. Thus, addressing patients' self-control and academic self-efficacy, as well as parental self-efficacy, seems promising to enhance and stabilize well-being of patients during transition after psychiatric hospitalization. Trial registration Not applicable, as no health care intervention was conducted.

Assessing Maternal Attitudes: Development, Validation, and Psychometric Properties of the Mother-Child Reminiscing Scales

OBJECTIVE

Mother-child participation in conversations about past events in early childhood has an invaluable influence on child development. While previous studies have focused on the investigation of maternal styles of talking about the past, the role of maternal attitudes towards reminiscing has been overlooked. This paper presents two studies on the development and validation of two separate scales that assess maternal attitudes in mother-child conversations: the Maternal Attitudes Towards Mother-Child Reminiscing Scale (MCRS) and MCRS-Context.

DESIGN

In Study 1, we have investigated the factor structure of the MCRS (N = 312) and MCRS-Context (N = 278) with a sample of mothers whose children aged between 3 and 7. In Study 2, we aimed to test the factor structure obtained by exploratory factor analysis (EFA) in Study 1 using confirmatory factor analysis (CFA) and we have investigated the psychometric properties of the scales with a different sample of 223 mothers.

RESULTS

EFA and CFA results have suggested four theoretically consistent factors of the MCRS (interest, competency, satisfaction and difficulty) and a one-factor structure for the MCRS-Context (general positive attitudes in comparison to other mothers). To test construct validity, the relationships with related independent scales were investigated, indicating generally significant and theoretically expected correlations. The test/re-test, Cronbach alpha and composite reliability scores indicated acceptable internal consistency for both scales.

CONCLUSIONS

The findings of both studies provided evidence for the validity and reliability of these scales in evaluating maternal attitudes towards mother-child conversations. It is thought that the studies presented here will provide useful insight for future studies for understanding the link between maternal cognitions and reminiscing practices in mother-child conversations and the effect of that link on child development.

Effect of Educational Intervention Based on Self-Efficacy Theory on the Caring Behaviour of Mothers Who Have Children With Cancer

Self-efficacy, as one of the concepts of the empowerment model, plays a role in increasing caring behaviour. Accordingly, our study aimed to evaluate the effect of educational intervention based on self-efficacy theory on the caring behaviour of mothers who have children with cancer. This quasi-experimental study was conducted on all mothers (N = 86) of children with cancer undergoing chemotherapy who were referred to Bandar Abbas Children's Hospital. All mothers participated in 10 training sessions based on the four foundations of self-efficacy theory. The results indicated a significant increase in the mean score of mothers' self-efficacy at first and second follow-ups respectively by 10.2 and 10.9 after intervention (P < 0.001). Furthermore, the mean score of caring behaviour was increased after the intervention for the first and second follow ups by 24.6 and 25.9 from the baseline respectively (P < 0.001). The results of the present study indicated that an educational program for mothers increased their caring behaviour and self-efficacy with the increase of self-efficacy, mothers' caring behaviour was promoted. Authorities and practitioners are suggested to pay more attention to designing educational programs based on health models and theories.

'Parentbot - A Digital healthcare Assistant (PDA)': A mobile application-based perinatal intervention for parents: Development study

OBJECTIVE

To describe the development procedure of a mobile application-based parenting support program with integrated chatbot features entitled Parentbot - a Digital healthcare Assistant (PDA) for multi-racial Singaporean parents across the perinatal period.

METHODS

The PDA development process was guided by the combined information systems research framework with design thinking modes, and Tuckman's model of team development. A user acceptability testing (UAT) process was conducted among 11 adults of child-bearing age. Feedback was obtained using a custom-made evaluation form and the 26-item User Experience Questionnaire.

RESULTS

The combined information systems research framework with design thinking modes helped researchers to successfully create a PDA prototype based on end-users' needs. Results from the UAT process indicated that the PDA provided participants with an overall positive user experience. Feedback gathered from UAT participants was used to enhance the PDA.

CONCLUSION

Although the effectiveness of the PDA in improving parental outcomes during the perinatal period is still being evaluated, this paper highlights the key details of developing a mobile application-based parenting intervention which future studies could learn from.

PRACTICE IMPLICATIONS

Having carefully planned timelines with margins of delays, extra funds to resolve technical issues, team cohesion, and an experienced leader can facilitate intervention development.

How good do you think you are with computers? The link between teachers' perceived digital literacy, occupational efficacy, and psychological distress

The present study focused on teachers' perceived digital literacy, occupational self-efficacy, and psychological distress. Our sample included 279 Romanian teachers aged 20 to 66 (M = 31.92, SD = 11.72), with professional experience ranging from 1 to 46 years (M = 8.90). We tested a moderated mediated model, exploring occupational self-efficacy as a mediator of the relationship between perceived digital literacy (moderated by gender, controlling for age and professional experience) and psychological distress. Our findings suggested that higher levels of perceived digital literacy led to higher levels of occupational self-efficacy, which led to lower levels of psychological distress. Gender moderated this relationship, i.e., the observed indirect effects were significant for both genders, but the effects were stronger for male participants. We discuss our results concerning their practical implications for teachers' mental health and professional activity and the perspectives following the COVID-19 pandemic.

History of pediatric TBI hospitalization and current child-parent relationship quality in China

BACKGROUND

Long-term child-parent relationship quality following hospitalization for pediatric traumatic brain injury (TBI) remains poorly understood.

OBJECTIVE

We tested whether current child-parent conflict and closeness were related to the children's history of TBI-related experiences and contemporary child/family characteristics.

METHODS

The sample included 202 Chinese children (Boys: 60.4%) with a history of hospitalization for TBI. On average, the children were 11.2 years old (SD = 1.59) and sustained TBI at 8.5 years old (SD = 1.6). TBI-related data were obtained from hospital medical records. Parents provided data on child-parent closeness, child-parent conflict, and parental efficacy 2-4 years (M = 2.7, SD = 0.7) after discharge.

RESULTS

Forty-nine children (24.3%) had mild TBI, 139 (68.8%) had moderate TBI, and 14 (6.9%) had severe TBI. Surgical intervention occurred among 128 (63.4%) of the 202 children. Contemporaneous child and family characteristics explained 19% of the variance, history of surgery, length of hospitalization, and recovery status explained another 7%, and the interaction between length of hospitalization and parental efficacy explained another 4% in child-parent conflict. Contemporaneous child and family characteristics explained 29% of the variance, and TBI-related variables explained another 2% in child-parent closeness.

CONCLUSION

Post-TBI child-parent relationship was more associated with child/family characteristics than with TBI variables. Practitioners and families should be aware of the long-term challenges to child-parent relationship following hospitalization for pediatric TBI.

Intergenerational risk and resilience pathways from discrimination and acculturative stress to infant mental health

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers' exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related to more infant negative emotionality at approximately 12 months old (M = 12.6, SD = .75). In contrast, maternal report of parenting self-efficacy when infants were 6 months old was related to lower levels of infant negative emotionality. Further, higher levels of parenting self-efficacy mitigated the relation between acculturative stress and negative emotionality. Preconception and prenatal exposure to sociocultural stress may be a risk factor for poor offspring mental health. Maternal and child health researchers, policymakers, and practitioners should prioritize further understanding these relations, reducing exposure to sociocultural stressors, and promoting resilience.

Masters of Media: A longitudinal study of parental media efficacy, media monitoring, and child problematic media use across early childhood in the United States

The development of problematic media use in early childhood is not well understood. The current study examined long-term associations between parental media efficacy, parental media monitoring, and problematic media use across a three-year period of time during early childhood. Participants included 432 parents who reported on their own parenting and their child's use of problematic media once a year for three years (M age of child at Wave 1 = 29.68 months, SD = 3.73 months). Results revealed that early parental media efficacy predicted lower levels of child problematic media use over time. Restrictive media monitoring was also related to lower levels of child problematic media use over time. Additionally, general parental efficacy was related to parental media efficacy and lower child problematic media use, both at the cross-sectional and longitudinal levels. Discussion focuses on encouraging early parental media efficacy (and exploring other potential mechanisms) as a way to mitigate the development of problematic media use over time.

The association between parenting styles, maternal self-efficacy, and social and emotional adjustment among Arab preschool children

Parenting styles and parental self-efficacy are major factors that affect the overall adjustment of children. The current study examined parenting styles and maternal self-efficacy and their association with social-emotional adjustment among Arab preschool children living in Israel. Parenting Styles Questionnaire, Maternal Self-Efficacy Questionnaire, and Adjustment Questionnaire were administered to 420 Arabic-speaking mothers of 3- to 4-year-old children. After employing multiple regression analyses, the results indicated that parenting styles and the overall adjustment of children were significantly correlated. More precisely, a significant association between authoritative parenting style and higher levels of social-emotional adjustment among preschool children was found. Furthermore, maternal self-efficacy was significantly correlated to the overall adjustment of children. In this regard, higher maternal self-efficacy is associated with increased social-emotional adjustment among preschool children. The findings of our study show the applicability of these constructs found relevant across numerous cultures in a unique sample of Arab children living in Israel. Lastly, this study supports intervention programs that promote authoritative parenting style and parental self-efficacy in Arab communities.

Examining the relationship between parents' digital parenting self-efficacy and digital parenting attitudes

Digital resources have begun to be used frequently by both children and parents. Digital resources, which are used very frequently, have entered our lives more and more with the pandemic with the development of technology. Children are now regular users of smartphones and tablets, so children's early digital interactions have brought new concepts into parent-child relationships and the role of the parent. It is thought that it will be important to re-examine the self-efficacy and attitudes of digital parents in this regard and the factors affecting the family-child relationship. Digital parenting is explained as parental efforts and practices aiming at understanding, supporting, and regulating children's activities in digital environments. Accordingly, this study aims to examine the correlation between parents' digital parenting self-efficacy and digital parenting attitudes. The study group of this research consists of 434 parents whose children attend primary school living in different provinces of Turkey. In the research, "Demographic Information Form" and "Digital Parenting Self-Efficacy Scale" and, "Digital Parenting Attitude Scale" were used as data collection tools. Frequency, percentage, standard deviation, correlation, regression, multiple regression, and two-way analysis of variance statistical techniques were used in the analysis of the data. As a result of the research, it was concluded that the digital parenting self-efficacy and digital parenting attitude have a moderate correlation and some of the variables are important predictors on the digital parenting self-efficacy.

From seeing difficult behaviour to recognizing legitimate needs - A qualitative study of mothers' experiences of participating in a Circle of Security Parenting program in a public mental health setting

OBJECTIVE

Mental health challenges can interfere with caregivers' self-efficacy and their ability to engage with their children in developmentally appropriate ways. The goal of this study was to explore whether the intervention Circle of Security Parenting (COS-P) was experienced as a meaningful adjunct to psychological treatment.

METHOD

Individual qualitative semi-structured interviews were conducted with twelve female COS-P participants, exploring how taking part in COS-P had changed the way they related to themselves and others. Data were analyzed using a team-based, reflexive thematic analysis.

RESULTS

The analysis resulted in three main themes: (i) Connecting dots: A new perspective on one's past, (ii) Seeing oneself more clearly: Increased capacity to recognize and tend to own needs, and (iii) Gaining a map: Becoming a more competent parent.

CONCLUSION

Taking part in COS-P as an adjunct to psychological treatment positively impacted participants' sense of competence as mothers. They used the COS-P framework to make sense of their interaction with their child, enabling them to understand the child's behaviour and communication as expressing legitimate attachment needs. They also experienced that the course strengthened central psychological capacities, such as insight into their own developmental histories as well as increased self-awareness and self-care. Implications are discussed.

A randomized controlled trial of moderated online social therapy for family carers of first-episode psychosis patients in a specialist treatment setting

BACKGROUND

Family members, who provide the majority of informal care during the recovery period from first-episode psychosis (FEP), experience high levels of psychological distress. However, there is a lack of effective and accessible interventions for FEP carers.

OBJECTIVE

To determine the effectiveness of an online intervention ("Altitudes") in relation to the primary outcome of FEP-carer stress at 6 months follow-up.

METHODS

We conducted a cluster randomized controlled trial in which FEP carers were randomized to Altitudes combined with specialized treatment as usual (STAU) or STAU alone. In addition to questionnaires, we included multiple waves of intensive ecological momentary assessment (EMA) to measure carer stress and family outcomes in 164 carers of young (15-27 years) FEP patients.

RESULTS

Both groups improved over time on stress and a range of secondary outcomes, including mental health symptoms, self-efficacy, and expressed emotion with no group by time interactions. At 12 months there were significantly fewer visits to emergency departments by FEP patients in the Altitudes group (p = 0.022). Modelling of multiple EMA waves revealed that more time spent by carers with FEP patients predicted greater worry, expressed emotion, and adaptive coping.

CONCLUSIONS

Engagement and usability findings for Altitudes were positive. Further refinements to our online carer interventions may be needed to engage carers in purposeful skill development for improved management of stress and communication with the young person compared with existing specialist family interventions.

TRIAL REGISTRATION

ACTRN12616000968471.

The relationship between parental involvement and psychological adjustment among Chinese children with autism spectrum disorder in the transition from kindergarten to primary school: A chain-mediating model

Introduction

This study examined the impact of parental involvement on the psychological adjustment of children with autism spectrum disorder (ASD), and the role of parenting self-efficacy and parenting stress in the transition from kindergarten to primary school.

Methods

Using the questionnaires, we collected data from 237 Chinese parents of children with ASD.

Results

Mediation analyses showed that parental involvement partially promoted the psychological adjustment of children with ASD, which was reflected in the fact that parental involvement promoted children's prosocial behavior but did not reduce their emotional/behavioral problems. Mediation analyses also revealed the role of the mediator in parenting stress between parental involvement and the psychological adjustment of children. Additionally, the results suggested that parenting self-efficacy and parenting stress played a chain-mediating role in the association between parental involvement and psychological adjustment in children with ASD.

Discussion

These findings enhance our understanding of the mechanisms underlying the relationship between parental involvement and psychological adjustment in children with ASD in the transition from kindergarten to primary school.

Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study

BACKGROUND

Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia.

METHODS

Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children.

RESULTS

The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05).

CONCLUSIONS

Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.

How the home learning environment contributes to children's social-emotional competence: A moderated mediation model

Introduction

The home learning environment is the earliest contact learning environment in early childhood development, which plays an important role in the development of children's social-emotional competence. However, previous studies have not clarified the precise mechanisms by which the home learning environment influences children's social-emotional competence. Therefore, the purpose of the study is to explore the relationship between the home learning environment and its intrinsic structure (i.e. structural family characteristics, parental beliefs and interests, and the educational processes) and children's social-emotional competence, and whether gender plays a moderating role in the relationship.

Method

The study randomly selected a sample of 443 children from 14 kindergartens in western China. The Home Learning Environment Questionnaire and the Chinese Inventory of Children's Social-emotional competence scale were used to investigate the home learning environment and social-emotional competence of these children.

Results

(1) Structural family characteristics and parental beliefs and interests both had a significant positive predictive effect on children's social-emotional competence. (2) The educational processes fully mediate between structural family characteristics, parental beliefs and interests, and children's social-emotional competence. (3) Gender moderated the effect of the home learning environment on children's social-emotional competence. Gender moderates not only the indirect effects between parental beliefs and interests and children's social-emotional competence, but also the indirect effects between structural family characteristics and children's social-emotional competence. At the same time, gender also moderated the direct effects between parental beliefs and interests and children's social-emotional competence.

Discussion

The results emphasize the crucial role of the home learning environment in the development of children's early social-emotional competence. Therefore, parents should pay attention to the home learning environment and improve their ability to create a home learning environment that promotes the positive development of children's social-emotional competence.

First-time parents' experiences related to parental self-efficacy: A scoping review

Becoming a parent for the first time is a major transition, and parental self-efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first-time parents' experiences related to PSE in the transition to parenthood in the first-year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task-specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture-factors in society and the healthcare services; parents-processes within the parents; tasks-different parental tasks; support-parents' perceived support from professionals, peers, friends, family, and partner; and child-the child's well-being and feedback. This scoping review describes qualitative studies on first-time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate.

Assessing parents' self-efficacy beliefs before and during the COVID-19 pandemic in Greece

The aim of the present study is to establish the psychometric properties of the Self-Efficacy for Parenting Tasks Index-Toddler Scale (SEPTI-TS) in the Greek educational context and to examine changes in parenting self-efficacy over time. The Short Form of SEPTI-TS was used to evaluate parents' self-efficacy on four different domains: nurturance, discipline, play and routine. A sample of 159 parents of children aged from 3 to 5 years completed an online survey at two time periods before and during the COVID-19 pandemic. Results supported the proposed SEPTI-TS dimensionality (comparative fit index = .905, root-mean-square error of approximation = .053, standardised root mean square residual = .055). The results showed that the average parenting self-efficacy scores regarding discipline, play and routine were lower than parenting self-efficacy scores of those domains before the COVID-19 pandemic. Results also indicated that parents feel high self-efficacy for play with their children, whereas they perceive low self-efficacy for children's discipline. Good practices are discussed to address new challenges to Greek parents.

Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens.

Evaluating the Effectiveness of the Supportive Parenting App on Parental Outcomes: Randomized Controlled Trial

BACKGROUND

Adjusting to new or additional parenting responsibilities increases stress and affects parental well-being. Existing research has highlighted both parents' desire to receive more support. It has also been found that receiving sufficient social support enhances parenting outcomes. With the increasing popularity of mobile health apps, a Supportive Parenting App (SPA) intervention was developed to fulfill the support needs of parents during the perinatal period.

OBJECTIVE

This study aimed to examine the effectiveness of the SPA on parental outcomes during the perinatal period.

METHODS

A 2-group pretest and repeated posttest randomized controlled trial was conducted wherein 200 couples (N=400 mothers and fathers) were recruited from 2 public health care institutions in Singapore. Parents were randomly assigned to intervention (100/200, 50%) or control (100/200, 50%) groups. The SPA intervention consisted of a mobile app-based psychoeducation and peer support program to support parents from pregnancy to 6 months post partum. The outcome measures included postnatal depression, anxiety, parental bonding, parental self-efficacy, perceived social support, and parenting satisfaction. Data were collected at baseline (at >24 weeks of gestation-age of viability in Singapore) and at the first, second, fourth, sixth, ninth, and 12th month post partum. Linear mixed models were used to compare parental outcomes between the groups, and a linear mixed model for repeated measures was used to examine within-group changes.

RESULTS

Parents in the intervention group mostly showed better outcomes compared with those in the control group. Parents in the intervention group had higher perceived social support than those in the control group at the first (effect size=1.59, 95% CI 0.38-2.80; Cohen standardized effect size=1.31; P=.01), second (effect size=1.98, 95% CI 1.09-2.88; Cohen standardized effect size=2.21; P=.003), and fourth (effect size=2.57, 95% CI 1.62-3.51; Cohen standardized effect size=2.72; P=.048) months post partum. However, parents in the intervention group showed significantly poorer parental bonding (effect size=1.67, 95% CI 0.24-3.11; Cohen standardized effect size=1.16; P=.02). The other parental outcomes did not differ significantly between groups. The scores of mothers and fathers also differed significantly for all outcomes except parental self-efficacy.

CONCLUSIONS

Parents in the intervention group generally fared better, especially regarding perceived social support. However, the lack of statistical significance in most outcomes showed the limited effectiveness of the SPA intervention, which may be because of the COVID-19 pandemic. Parental differences in outcome scores suggest that mothers and fathers have different support needs; therefore, interventions should be tailored accordingly. Further improvements and evaluations are needed to examine the effectiveness of the SPA intervention in enhancing parental outcomes. Despite statistically insignificant results, limitations should be considered to further improve mobile health app-based interventions such as SPA, as they could serve as reliable and convenient sources of support for parents.

TRIAL REGISTRATION

Clinicaltrails.gov NCT4706442; https://clinicaltrials.gov/ct2/show/NCT04706442.

App-based support for parental self-efficacy in the first 1,000 days: A randomized control trial

Parental self-efficacy is key for guiding parents' interactions with their child and is an important target for early intervention. This study reports a pilot randomized control trial (RCT) of a parenting application (app) with 79 parents of children aged 0-6 months in the United Kingdom. The app includes 1,026 daily age-appropriate activities across eight areas of child development, using resources accessible at home. While controlling for pre-test scores, parents who used the parenting app (Treatment Group) had significantly higher parental self-efficacy, after the 4-week intervention period, compared to the Active Control Group. Partial correlation analyses indicated that higher frequency of self-reported use of the parenting app was associated with greater parental self-efficacy outcomes. This evidence establishes proof of concept that parenting apps can have significant benefits on parental self-efficacy in early childhood. Limitations to the interpretation and generalization of the findings, as well as directions for future research are discussed.

Preventive interventions for children of parents with depression, anxiety, or bipolar disorder: A quasi-experimental clinical trial

AIM

To investigate the effectiveness of preventive interventions for 8-17-year-old children of patients diagnosed with depression, anxiety, or bipolar disorder.

METHODS

Sixty-two families including 89 children received either the more extensive Family Talk Intervention (FTI; n = 35), the brief Let's Talk about Children (LTC; n = 16), or Interventions as Usual (IAU; n = 38) in routine care in adult psychiatry. Parent-rated questionnaire data were collected at baseline, after 6 and 12 months. We used growth curve models to investigate the effect of intervention on child mental health problems (SDQ-P Total Difficulties) and perceived parental control of child behaviour (PLOC-PPC).

RESULTS

Parents in the FTI and LTC groups, versus the IAU group, reported more favourable development in terms of preventing increase in child mental health problems with standardised intervention effects of d = -0.86 and -0.88 respectively, by study end, and reported improved perceived parental control, d = 1.08 and 0.71, respectively, by study end. No significant differences in effect were found when FTI and LTC were compared.

CONCLUSIONS

The results support continued use of FTI and LTC in adult psychiatry, and since LTC is a brief intervention, it might be useful as a minimum-level preventive intervention.

Parenting Sense of Competence: Psychometrics and Invariance among a Community and an At-Risk Samples of Portuguese Parents

Parenting sense of competence refers to parents' perception about their ability to perform the parenting role, one of the key dimensions in family dynamics. This construct is even more important in families at psychosocial risk, where the exercise of parenting can be more challenging. The Parenting Sense of Competence scale (PSOC) is a self-report measure that aims to assesses one's perceived efficacy and satisfaction with parenting. In this cross-sectional and instrumental study, we aimed to examine the psychometric properties of the PSOC among a Portuguese sample of community (n = 205) and at-psychological-risk (n = 273) parents. Participants completed the PSOC, the Enrich Marital Satisfaction Scale, the Parenting Stress Index, and the Parenting Alliance Inventory. Results from confirmatory factor analysis showed that a two-factor revised model obtained the best fit, with some items being removed. Our data confirmed that the PSOC has good psychometric properties, with acceptable reliability and validity and measurement invariance across the community and the at-risk samples. Findings of this psychometric exploration provided evidence that the PSOC is a reliable measure of easy application and interpretation for assessing the perceived competence of Portuguese parents.

Brain-Directed Care: Why Neuroscience Principles Direct PICU Management beyond the ABCs

Major advances in pediatric intensive care (PICU) have led to increased child survival. However, the long-term outcomes among these children following PICU discharge are a concern. Most children admitted to PICU are under five years of age, and the stressors of critical illness and necessary interventions can affect their ability to meet crucial developmental milestones. Understanding the neuroscience of brain development and vulnerability can inform PICU clinicians of new ways to enhance and support the care of these most vulnerable children and families. This review paper first explores the evidence-based neuroscience principles of brain development and vulnerability and the impact of illness and care on children's brains and ultimately wellbeing. Implications for clinical practice and training are further discussed to help optimize brain health in children who are experiencing and surviving a critical illness or injury.

Mental health in children of parents being treated by specialised psychiatric services

BACKGROUND

One in ten children have a parent diagnosed with a mental illness by specialised psychiatric services. Severe parental mental illness is a well-established risk factor for children's mental health problems, making the identification and support of these children a public health concern. This study investigated the mental health and family context of children of parents diagnosed with depression, anxiety, or bipolar disorder in this clinical setting.

METHODS

Parental reports on 87 children aged 8-17 years were analysed. The children's mental health was compared with that of a Swedish population-based sample. Multiple linear regression was used to investigate associations between child mental health and child gender, child age, parent symptoms and social status, family functioning, and perceived parental control. Furthermore, a cumulative risk index explored the effect of multiple risk factors on child mental health.

RESULTS

The children reportedly had significantly more mental health problems than did the population-based sample and about one-third had scores above the clinical cut-off. A significant multiple linear regression explained 49% of the variance in child mental health, with lower perceived parental control and younger child age being associated with more child mental health problems. With more reported risk factors, children reportedly had more mental health problems.

CONCLUSIONS

The results underline the importance of identifying a patient's children and assessing multiple relevant risk factors in the child's life. Furthermore, the results indicate that the needs of younger children and of patients in their parenting role are important to address.

Maternal self-efficacy development from pregnancy to 3 months after birth

The present study uses a prospective longitudinal study design to investigate the development of maternal self-efficacy in the transition phase to parenthood, drawing on a large sample of socially and/or culturally disadvantaged families (N = 292). Parity, maternal education, migration, informal and formal social support are considered as potential predictors. Results indicate that previous birth experience, being born abroad, and higher levels of formal and informal social support during pregnancy jointly predict higher levels of maternal self-efficacy three months after birth. First-time mothers and mothers born in Germany (where the study was conducted) benefit more from formal support than mothers with previous experience and mothers born outside of Germany. Overall, maternal self-efficacy increases significantly. Implications for prenatal maternal care are discussed.

Children with a rare congenital genetic disorder: a systematic review of parent experiences

BACKGROUND

Caring for a child with a chronic disease may be demanding and stressful. When a child has a rare condition, the impact of care on parents is amplified due to the rarity of the diagnosis. In order to address the lack of generalized and synthesized knowledge regarding parents' experiences of having a child with a rare genetic disorder, and give a holistic picture of these experiences, a systematic review of the available qualitative research was conducted.

METHODS

We performed a systematic review, including qualitative studies on parents of children with rare genetic disorders, published between 2000 and 2020.

RESULTS

The review included 33 qualitative studies. Findings were synthesized and categorized according to three main themes: Parents' experiences with health care, Responsibilities and challenges, and Factors promoting positive experiences in parents. The findings demonstrate that parents of children with rare genetic disorders share many common challenges, despite evident differences across conditions.

CONCLUSION

Coordinated care, and a more holistic approach in the follow up of children with rare genetic disorders is needed. International collaboration on research, diagnostics, producing scientific correct and understandable information available for health care professionals and lay people should be prioritized.

Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents

Background

Infant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, i.e. the caregiver’s ability to notice and interpret the child’s behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant’s behavioral cues.

Methods

This study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants’ behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors’ register.

Discussion

Results will provide evidence regarding the efficacy of UYB in promoting parenting competences. If proved effective, the study will represent a notable advance to initiating the UYB intervention as part of a better infant mental health strategy in Denmark. Conversely, if UYB is inferior to CAU, this is also important knowledge in regard to promoting parenting competence and infant mental health in a general population.

Trial registrationhttps://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00924-3.

Enhancing primary care psychology services with assistant psychologists in Ireland: An evaluation of output, throughput and stakeholder satisfaction

Primary care mental health services need to expand to assist the increased number of people reporting mild to moderate mental health difficulties. In Ireland, the primary care mental health service has been recently enhanced through the employment of Assistant Psychologists (AP) in primary care psychology. This paper provides an early and brief evaluation of the impact of the AP-enhanced model through a tripartite approach to evaluation which utilises measures of throughput, output and stakeholder satisfaction. We use data from two sources; Health service key performance indicators, and a routinely gathered minimal dataset of client measures. Results indicate that the numbers of clients seen in the period rose by 16%, that AP-delivered treatments are beneficial for clients with mild to moderate mental health difficulties, and more than 80% of clients reported being 'totally satisfied' with the care received. The data provide early evidence that the AP model is beneficial in meeting clients' needs across a range of presentations within the service admission criteria, and that the AP-enhanced model may offer a satisfactory solution to primary care needs. However, further data collection is required, and additional stakeholder input is necessary for a complete evaluation of the assistant psychologist model in primary care.

Effectiveness of mobile application-based perinatal interventions in improving parenting outcomes: A systematic review

Objective

Parents face many challenges during the perinatal period and are at risk for mental health issues, especially during the current coronavirus (COVID-19) pandemic. Mobile application-based interventions can help parents to improve their psychosocial well-being in a convenient and accessible manner. This review aims to examine the effectiveness of mobile application-based perinatal interventions in improving parenting self-efficacy, anxiety, and depression (primary outcomes), as well as stress, social support, and parent-child bonding (secondary outcomes) among parents.

Methods

Seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Thesis and Dissertations) were searched from their respective inception dates until August 2021. The Cochrane Risk of Bias-2 tool was used to conduct quality appraisals. Results were narratively synthesized due to the high heterogeneity of intervention and participant types.

Findings

A total of 6164 articles were retrieved from the seven electronic databases and citation searching. After excluding duplicate records and irrelevant titles/abstracts, 105 full texts were examined. Full-text screening excluded another 93 articles, leaving 12 included studies in this review. All studies were rated as having some concerns or a high overall risk of bias. Mobile application-based interventions were found to be feasible and promising in improving parents’ overall well-being post-intervention during the perinatal period. Further research would be needed to determine their long-term effects.

Key conclusions and implications for practice

Parental well-being was shown to improve using the following intervention components: educational resources on perinatal and infant care, psychotherapy, and support from peers and healthcare professionals. Hence, future interventions could aim to include these components and evaluate all inter-related parenting outcomes (parenting self-efficacy, stress, anxiety, depression, social support, and parent-child bonding). Parents could be provided with experiential learning exposure by using computer animations and virtual reality. Future research could be conducted on more fathers and parents from varied geographical regions.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Trauma-informed attitudes in residential treatment settings: Staff, child and youth factors predicting adoption, maintenance and change over time

BACKGROUND

Little is known about the benefits of implementing trauma-informed care (TIC) training programs for child welfare workers serving in out-of-home treatment settings, or about how staff, child and youth characteristics affect adoption of favorable attitudes towards TIC.

OBJECTIVE

This study aimed to understand how attitudes towards TIC changed over time for child welfare workers receiving training and monthly supervision sessions.

PARTICIPANTS AND SETTING

Child welfare workers (n = 429) serving juveniles mandated to protection or offender units (ages = 3-20 years), across 11 child protection agencies in Quebec, Canada.

METHODS

Participants completed the ARTIC-35 at pre-training, 6 months post-training, and 1 year follow-up. Multilevel mixed effect regression models were fit to examine outcomes for all subscales.

RESULTS

Participants reported small improvements in attitudes towards TIC at post-training and 1 year follow-up for subscales related to problematic child/youth behavior (β = 0.23-0.32, p's < 0.001). Multilevel modeling revealed that age group (adolescent), unit gender (boys) and legal mandate (offender) predicted higher pre-training TIC ratings for staff in management versus frontline positions across three subscales related to problematic child/youth behavior (β = 0.77-0.93, p's < 0.05) and two subscales related to trauma work and support needs (β = 0.66/0.84, p's < 0.05).

CONCLUSIONS

Results extend previous research demonstrating an association between TIC training and improved attitudes towards TIC over time, and highlight specific contexts in which frontline staff may experience more difficulty applying TIC-based principles than colleagues in management positions.

Supporting the Social-Emotional Well-Being of Elementary School Students Who Are Deaf and Hard of Hearing: A Pilot Study

PURPOSE

Children who are Deaf and Hard of Hearing (DHH), their parents, Teachers of the Deaf, and other community stakeholders were involved in co-designing a web-based resource to support students' social-emotional well-being. The resource was designed to provide families and teachers with strategies to enhance the social and emotional well-being of Grade 4-6 students who are DHH. This study reports outcomes of a pilot study of the web-based resource intervention.

METHOD

A pre-post pilot study was conducted to quantitatively examine reported anxiety, well-being, social relationships, school experience, student-teacher relationship, and parent and teacher self-efficacy. A total of 37 students, their parents (n = 37), and their classroom teachers (n = 40) participated in the intervention program and were provided access to the resource.

RESULTS

In total, 19 students, 22 parents, and 17 teachers completed both pre- and postsurvey measures. Paired t tests revealed that there was a statistically significant increase in parents' self-efficacy scores from pre- to posttest. Multivariate analysis of covariance revealed a significant association between parent use of the website and student-reported improved peer support and reduced school loneliness. No other statistically significant differences were found.

CONCLUSIONS

The use of a web-based resource codeveloped with students who are DHH, their parents, and teachers could potentially be beneficial for the well-being of students who are DHH as well as parents' self-efficacy. Further research is needed to confirm the benefits.

Building Self-Efficacy in Parenting Adult Children With Autistic Spectrum Disorder: An Initial Investigation of a Two-Pronged Approach in Role Competence

Previous studies on parenting adult children with ASD were scarce, and their intervention protocols mainly were derived from established work with children. Development of an applicable adult-oriented protocol and demonstration of its effectiveness is warranted. The present study outlined the development and evaluation of Core Autism Parenting Skills (CAPS), which targets to enhance parenting self-efficacy (PSE) intervention for adult children with ASD by addressing two intervention goals in parallel: acquisition of parenting skills and cultivating positive attributes. In CAPS, PSE is operationalised into four parent roles: to observe, reinforce, empathise, and accompany, each with requisite attributes, skills, and prescribed training. Twenty-seven parents with adult children with ASD (aged 16-37) were recruited. They completed measures assessing their PSE, competence in the four parent roles, and emotional well-being at pre-training, post-training and 2-month follow-up. The intervention was well-received by the participants and reported significant improvements in PSE, parent role competence at post-training and 2-month follow-up. The applicability of PSE and parent role competence in constructing effective parenting intervention for adult children with ASD was supported.

Parenting sense of competence and its predictors among primiparous women: a longitudinal study in China

BACKGROUND

Parenting sense of competence significantly affects the quality of parenting behaviours and healthy infant development. However, primiparous women without parenting experience may lack confidence and feel stress. This study aimed to explore the status of parenting sense of competence and identify its predictors among primiparous women.

METHODS

A longitudinal study design was used. Primiparous women were recruited by using a convenience sample from two women's and children's hospitals in two cities in China. All primiparous women completed questionnaires on demographic characteristics, infant characteristics, family function, and parenting sense of competence at 1 month postpartum. At 3 months postpartum, each women's parenting sense of competence was re-assessed. Generalised linear regression was applied to identify the predictors of parenting sense of competence at 3 months postpartum.

RESULTS

A total of 743 Chinese primiparous women were included in the analysis. The average parenting sense of competence score of the participants at 3 months postpartum was 70.18 (SD = 12.33). According to the generalised linear regression analysis, higher levels of parenting sense of competence at 3 months postpartum were significantly associated with older age (β = 0.13, P = 0.005), better family function (β = 0.37, P <  0.001), and higher levels of parenting sense of competence (β = 0.35, P <  0.001) at 1 month postpartum. In contrast, lower levels of parenting sense of competence at 3 months postpartum were associated with poorer self-rated economic status (β = - 0.16, P = 0.027), poorer infant health (β = - 0.26, P = 0.007), and mixed or formula feeding (β = - 0.11, P = 0.018) at 1 month postpartum.

CONCLUSIONS

Chinese primiparous women have a relatively good parenting sense of competence, but there is still room for improvement. Maternal age, economic status, family function, infant health, and feeding patterns were significant predictors. To improve their parenting sense of competence, more attention should be paid to primiparous women who are young, with poor economic status, having an unhealthy infant, and mixed or formula feeding. In addition, measures should also be taken during the early postpartum period to improve family function.

Parent-child conflict during homeschooling in times of the COVID-19 pandemic: A key role for mothers' self-efficacy in teaching

To contain the COVID-19 pandemic schools have been closed in many countries. Children stayed at home and were assisted by their parents with their schoolwork. Evidently, homeschooling puts extra demands on parents. We presumed that parents' sense of efficacy in teaching would play a key role in how they cope with this extra task of homeschooling. In particular, we hypothesized that parental characteristics (level of parental education and stress) and social contextual factors (household chaos and school support) would contribute to parents' teaching self-efficacy and that, in turn, a lower efficacy would result in more parent-child conflict during home schooling. Participants were 173 mothers of children in kindergarten or early elementary schools, who provided information for one of their children about interpersonal conflicts around schoolwork before and during school closure. Additionally, they reported on their self-efficacy in teaching, perceived stress during lockdown, home chaos, and school support. Path analyses indicated that mothers' perceived stress and household chaos were associated with a lower sense of efficacy in teaching, whereas school support, but not level of parental education, was related to a higher level of teaching self-efficacy. Higher levels of self-efficacy beliefs, in turn, were associated with a lower degree of mother-child conflict during schoolwork, even after controlling for prior levels of conflict. We discuss how the results of this study might be used to foster parents' self-efficacy in teaching and thereby decrease the amount of parent-child conflict during parents' support with schoolwork.

Impact of Parenting Style on Early Childhood Learning: Mediating Role of Parental Self-Efficacy

The current study examined the impact of parental style on early childhood learning, as well as the role of parental self-efficacy (PSE) as a mediating factor. In the domains of education and psychology, it is increasingly recognized that parents have a considerable impact on their children's learning and development. Purposive sampling was used and data was gathered over 3 months from school children's parents. Hypotheses were tested using smart partial least squares-structural equation modeling (PLS-SEM v3.2.8) software. The findings of the present study reveal that an authoritative parenting style is positively associated with learning outcomes among Chinese students. Moreover, the mediating role of parental self-efficacy has been tested and proved to be a potential mediator between parental style and children's learning outcomes. High PSE is linked to parents' adoption of a variety of optimum parenting practices throughout childhood, including maternal sensitivity and responsiveness to children's needs, warm and affectionate parental behavior, and monitoring. Hence, low PSE has been linked to coercive or harsh parenting as well as a proclivity to give up easily when faced with parental difficulties. In China, further study is needed on the relationship between parenting style, parental self-efficacy, and learning outcome. Future parenting programs could also focus on raising parents' understanding of the need for both parents' involvement in expressive activities and mentoring. This could help them boost their parenting self-efficacy even more. Lastly, the implications for parents, children, and teachers are discussed.

Workplace Support for Mental Health Workers Who Are Parents: A Feasibility Study

Background

Mental health workers are subject to high levels of occupational stress which is associated with poorer health and wellbeing and impaired patient outcomes. For individuals operating in high stress environments, reducing challenge at home, in particular around parenting, has been found to generalize into improvements in the professional domain. The present study sought to investigate the effectiveness and feasibility of brief targeted workplace intervention to support workers in terms of their parental role.

Design/Methodology

An uncontrolled evaluation of a series of three-session parenting-focused courses delivered to employees of a large Mental Health Trust. A pre-post-follow-up design was used to investigate effects on outcomes including parenting practice and experience, wellbeing, stress, and occupational self-efficacy. Intervention feasibility and acceptably was also evaluated.

Findings

Data from 15 participants who completed measures pre-post indicates the courses were associated with improved parenting practice and experience at a p < 0.005 level. Improvements were reported at 6-month follow up. Participant satisfaction and course acceptability was highly rated by 100% of participants.

Do Improvements in Maternal Mental Health Predict Improvements in Parenting? Mechanisms of the Mindful with Your Baby Training

Postpartum mental health symptoms are associated with parenting difficulties, which have negative consequences for child development. Interventions for young mothers should target their mental health problems and parenting difficulties. Mindful with Your Baby (MwyB) is an intervention for parents, with a baby, who experience (mental) health problems and/or stress or insecurity in parenting. This study seeks to replicate previous effects of MwyB regarding mindfulness, mindful parenting, maternal (mental) health (psychological distress, depressive mood, physical health complaints) and parenting outcomes (parenting stress, parental self-efficacy, bonding), and gain insight into the working mechanisms of the training. Mothers with babies aged 1–18 months (n = 61) completed questionnaires at waitlist, pretest, posttest, and 8-week follow-up. No significant differences were seen between the waitlist and pretest. Significant improvements in all outcomes were shown in the posttest (except for physical health complaints) and follow-up, compared to the pretest. Improvements in depressive symptoms and physical health complaints were dependent on improvements in mindfulness. Improvements in parental self-efficacy were dependent on improvements in mindful parenting. Improvements in some (mental) health and parenting outcomes seemed to be bidirectional. The results suggest that both mindfulness and mindful parenting are important for mothers who experience psychological distress and/or stress or insecurity in parenting their babies.

Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth

Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.

Changes in perceived parental self-efficacy after a Child-Centred Health Dialogue about preventing obesity

Aim

This randomised controlled trial evaluated changes in parental self‐efficacy and children's weight, after a Child‐Centred Health Dialogue about preventing obesity.

Methods

We randomly assigned 37 Child Health Centres in Skåne county Sweden to provide usual care or the dialogue intervention. They included centres from high and low socioeconomic areas. The outcomes were changes in parental self‐efficacy and any moderating effect on their children's body mass index 1 year later.

Results

The baseline data were based on 1115 mothers and 869 fathers representing 1197 children (52% females) aged 4 years (3.9–4.2) with a standardised body mass index (zBMI) of 0.1 ± 0.9. The participation rates at follow‐up, 1.1 ± 0.2 years after the intervention were 817 mothers and 508 fathers. Overall, parental self‐efficacy had decreased by the 1‐year follow‐up. There was a significant intervention effect on maternal self‐efficacy in promoting physical activity, however with unclear clinical relevance. Mothers' change in perceived self‐efficacy in promoting a healthy diet seemed to moderate the intervention effect on zBMI change in children with zBMI > 0 with −0.01 (95% CI: −0.025 to −0.001; p = 0.03).

Conclusion

Our study suggested a possible link between increased maternal self‐efficacy in promoting a healthy diet and a favourable development of zBMI.

Using Community Health Workers to Improve Health Outcomes in a Sample of Hispanic Women and Their Infants: Findings from a Randomized Controlled Trial

Introduction: The Maternal Infant Health Outreach Worker (MIHOW) program, an early childhood home visiting program, uses community health workers (CHWs) to improve health outcomes in underserved communities. Methods: This randomized clinical trial evaluated the impact of MIHOW's use of CHWs on selected maternal/infant outcomes up to 15 months postpartum. We hypothesized outcomes would be better among Hispanic women receiving MIHOW compared to a similar group of women eligible for MIHOW who received only a minimal education intervention (MEI). The study also expanded earlier research testing MIHOW's efficacy among Hispanic families using criteria set forth by federal guidelines. Women living in middle Tennessee enrolled during pregnancy (≤26 weeks gestation) and continued through 15 months postpartum. Results: Enrolled women (N = 132) were randomly assigned, with 110 women completing the study (MEI = 53; MIHOW = 57). Positive and statistically significant (p < .01) effects of MIHOW were observed on breastfeeding duration, safe sleep practices, stress levels, depressive symptoms, emotional support, referral follow through, parental confidence, and infant stimulation in the home. Conclusions: Findings provided strong evidence of the effectiveness of MIHOW for improving health outcomes in this sample. Using trained CHWs makes programs such as MIHOW a viable option for providing services to immigrant and underserved families.

Experiences of wellbeing and resilience among refugee mothers and families in Calgary during the COVID-19 pandemic, and the role of participation in HIPPY, a home visiting program

In order to provide meaningful and effective support to refugees in Canada during the COVID-19 pandemic, as well as during post-pandemic recovery efforts, it is critical to explore the experiences of refugee mothers and families during the pandemic, and to identify sources of resilience that can be leveraged to promote individual and household wellbeing. From November 2020 to June 2021, we conducted in-depth interviews with mothers from refugee backgrounds (n = 28) who resettled in Calgary, Alberta and are currently participating in the Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY) program. Interviews were conducted virtually using Microsoft Teams; we sought to better understand the pathways and barriers to wellbeing experienced by refugee mothers during the pandemic. The results indicate that the refugee mothers and families in our study experienced widespread disruptions to education and employment and increased motherhood burden, contributing to diminished wellbeing. Mental health was further impacted by heightened levels of worry, stress and social isolation, as well as intense fear pertaining to the spread of SARS-CoV-2. Some mothers reported experiencing barriers to accessing healthcare services and reliable health information during the pandemic. In the face of these challenges, the mothers demonstrated great resilience and identified tangible individual, household and extra-household factors and resources that supported them in coping with the impact of the COVID-19 pandemic. Additionally, our findings suggest that participation in HIPPY played a significant role in fostering the resilience of the participating mothers and families during the pandemic, speaking to the potential of home visiting intervention models in mitigating household hardship during current and future public health crises.

Adverse childhood experiences and maternal self-efficacy: Examining the mediating role of intimate partner violence and the moderating role of caste membership in rural India

Maternal self-efficacy (MSE) is associated with healthy functioning in mothers and children globally. Maternal exposure to adverse childhood experiences (ACEs) and intimate partner violence (IPV) is known to negatively impact MSE in high-income countries; however, the association has not been examined in low-and-middle-income countries, such as India, which face socioeconomic risks including poverty, illiteracy, and discrimination based on caste membership. The present study examines the mediating role of IPV in the association between ACEs (specifically-emotional, physical, and sexual abuse, neglect, household dysfunction, and discrimination) and MSE and tests caste membership as a moderator. A community-based, cross-sectional survey was performed with 316 mothers with at least one child between 0 and 24 months in a rural area in the North Indian state of Uttar Pradesh. A structural equation framework was used to test the moderated-mediation model. Results from the moderated-mediation model indicate that greater ACEs exposure was associated with lower MSE and this association was mediated by IPV exposure for low-caste but not high-caste mothers, even after controlling for wealth and literacy. These findings add to existing evidence on ACEs exposure as a significant burden for rural Indian mothers, negatively impacting parenting outcomes such as MSE. The critical role of caste membership is also highlighted, providing implications for future research.

Parental self-efficacy: Examining its mediating and reciprocally predictive roles in supportive emotion socialization

This longitudinal study examined the associations between child negative affect, parental self-efficacy (PSE), and parents' approaches to the provision of supportive socialization. It also investigated the bidirectionality between PSE, problem-focus socialization, and emotion-focus socialization across two time points separated by one year. Participants were 757 Hong Kong Chinese parents (47.4% fathers) of kindergarten children. At both time 1 and time 2, parents reported their PSE, problem-focus socialization, and emotion-focus socialization. Additionally, parents rated their child's negative affect at time 1. Results from the cross-lagged panel model revealed that, controlling for the effects of school's socioeconomic strata, child gender, parental age, and educational level, PSE at time 1 mediated the indirect links of child negative affect at time 1 with problem-focus (indirect effect: β = -.02, SE = .02, p < .05) and emotion-focus (indirect effect: β = -.02, SE = .01, p < .05) socialization at time 2 and that PSE (β = .10, SE = .06, p < .01) and problem-focus socialization (β = .15, SE = .03, p < .05) were reciprocally associated with each other. Findings underscored the role of PSE in understanding parental provision of supportive socialization and the co-development of belief about parenting and parenting behaviors.

Remote Intensive Group Behavioral Treatment for Families of Children with Selective Mutism

Selective mutism (SM) is a relatively rare, but highly interfering, child anxiety disorder characterized by a consistent failure to speak in certain situations, despite demonstrating fluent speech in other contexts. Exposure-based cognitive behavioral therapy and Parent-Child Interaction Therapy adapted for SM can be effective, but the broad availability and accessibility of such specialty care options remains limited. Stay-at-home guidelines to mitigate the spread of COVID-19 further limited the accessibility of office-based specialty care for SM. Building on separate lines of research supporting intensive treatments and telehealth service delivery models, this paper is the first to describe the development, preliminary feasibility, acceptability, and efficacy of a Remote Intensive Group Behavioral Treatment (IGBT) for families of young children with SM (N=9). Treatment leveraged videoconferencing technology to deliver caregiver training sessions, lead-in sessions, 5 consecutive daily IGBT sessions, and an individualized caregiver coaching session. Remote IGBT was found to be both feasible and acceptable. All families (100%) completed diagnostic assessments and caregiver-report questionnaires at four major study timepoints (i.e., intake, pre-treatment, post-treatment, 4-month follow-up) and participated in all treatment components. Caregivers reported high treatment satisfaction at post-treatment and 4-month follow-up and low levels of burden associated with treatment participation at post-treatment. Approximately half of participating children were classified as treatment responders by independent evaluators at post-treatment and 4-month follow-up. Although these pilot results should be interpreted with caution, the present work underscores the potential utility of using videoconferencing to remotely deliver IGBT to families in their natural environments.