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Vallotton CD, Decker KB, Kwon A, Wang W, Chang T. Quantity and Quality of Gestural Input: Caregivers’ Sensitivity Predicts Caregiver-Infant Bidirectional Communication Through Gestures. INFANCY 2016. [DOI: 10.1111/infa.12155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vallotton C, Mastergeorge A, Foster T, Decker KB, Ayoub C. Parenting Supports for Early Vocabulary Development: Specific Effects of Sensitivity and Stimulation through Infancy. INFANCY 2016; 22:78-107. [PMID: 28111526 DOI: 10.1111/infa.12147] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Growing recognition of disparities in early childhood language environments prompt examination of parent-child interactions which support vocabulary. Research links parental sensitivity and cognitive stimulation to child language, but has not explicitly contrasted their effects, nor examined how effects may change over time. We examined maternal sensitivity and stimulation throughout infancy using two observational methods - ratings of parents' interaction qualities, and coding of discrete parenting behaviors - to assess the relative importance of these qualities to child vocabulary over time, and determine whether mothers make related changes in response to children's development. Participants were 146 infants and mothers, assessed when infants were 14, 24, and 36 months. At 14 months, sensitivity had a stronger effect on vocabulary than did stimulation, but the effect of stimulation grew throughout toddlerhood. Mothers' cognitive stimulation grew over time, whereas sensitivity remained stable. While discrete parenting behaviors changed with child age, there was no evidence of trade-offs between sensitive and stimulating behaviors, and no evidence that sensitivity moderated the effect of stimulation on child vocabulary. Findings demonstrate specificity of timing in the link between parenting qualities and child vocabulary which could inform early parent interventions, and supports a reconceptualization of the nature and measurement of parental sensitivity.
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Wan MW, Brooks A, Green J, Abel K, Elmadih A. Psychometrics and validation of a brief rating measure of parent-infant interaction. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1177/0165025416631835] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the psychometrics of a recently developed global rating measure of videotaped parent-infant interaction, the Manchester Assessment of Caregiver–Infant Interaction (MACI), in a normative sample. Inter-rater reliability, stability over time, and convergent and discriminant validity were tested. Six-minute play interactions were blind-rated by trained coders in 147 healthy mother-infant dyads at 3–10 months postpartum using the MACI; 51% were re-assessed 4 or 7 months later. Infant cognitive functioning, language and temperament, parent-reported infant warmth and invasion, parental mood, and the parent’s own recalled experiences of being parented were measured. We report the internal psychometrics of the MACI, evidence of stability as predicted, and inter-rater reliability. MACI caregiver sensitive responsiveness showed convergent validity with parental state of mind (mood at 3–4 months; report of own childhood care and overprotection), while MACI infant affect (but not the caregiver scales) was associated with parent-rated infant warmth. All MACI scales showed discriminant validity with concurrent cognitive and language developmental status, and most temperament dimensions. In conclusion, the MACI demonstrates utility, reliability and preliminary validity data in a normative sample, which complements previous work using the MACI. Follow-up is needed to test predictive validity. The findings inform further improvements to the tool, and may guide those looking for a relatively brief way to examine the global qualities of parent, infant and dyadic interaction.
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Montirosso R, Casini E, Borgatti R, Urgesi C. Relationship Between Maternal Sensitivity During Early Interaction and Maternal Ability in Perceiving Infants' Body and Face. INFANCY 2016. [DOI: 10.1111/infa.12129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Rosario Montirosso
- 0-3 Centre for the at - Risk Infant Scientific Institute IRCCS Eugenio Medea
| | - Erica Casini
- 0-3 Centre for the at - Risk Infant Scientific Institute IRCCS Eugenio Medea
| | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit - Scientific Institute; IRCCS Eugenio Medea
| | - Cosimo Urgesi
- Department of Human Sciences; University of Udine and Scientific Institute; IRCCS Eugenio Medea
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Ji ES, Lundeen SP, Lee J. Effect of prenatal Qi exercise on mother-infant interaction and behavioral state. J Child Health Care 2015; 19:504-12. [PMID: 24619991 DOI: 10.1177/1367493514522575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the effects of prenatal Qi exercise on mother-infant interaction and the behavioral state of the infant. A prospective, quasi-experimental design was used in 70 healthy pregnant women of more than 18 weeks of gestation. Pregnant women in the intervention group received 90 minutes of prenatal Qi exercise twice a week for 12 weeks. Prenatal Qi exercise group's Nursing Child Assessment of Feeding Scale scores was higher in mother's sensitivity to cues, responses to distress, socioemotional growth fostering, and cognitive fostering and for children in responsiveness. There was no significant difference in Anderson Behavioral State Scoring System scores between groups. The results suggested that prenatal Qi exercise is a valuable approach to positively influence mother-infant interaction postdelivery.
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Affiliation(s)
- Eun Sun Ji
- Konkuk University Glocal Campus, Republic of Korea
| | | | - Jia Lee
- Kyung Hee University, Republic of Korea
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Bell AF, Carter CS, Steer CD, Golding J, Davis JM, Steffen AD, Rubin LH, Lillard TS, Gregory SP, Harris JC, Connelly JJ. Interaction between oxytocin receptor DNA methylation and genotype is associated with risk of postpartum depression in women without depression in pregnancy. Front Genet 2015; 6:243. [PMID: 26257770 PMCID: PMC4508577 DOI: 10.3389/fgene.2015.00243] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/02/2015] [Indexed: 01/23/2023] Open
Abstract
Postpartum depression (PPD) affects up to 19% of women, negatively impacting maternal and infant health. Reductions in plasma oxytocin levels have been associated with PPD and heritability studies have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR) has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of PPD and that such variability may be central to predicting risk. This case-control study is nested within the Avon Longitudinal Study of Parents and Children and included 269 cases with PPD and 276 controls matched on age group, parity, and presence or absence of depressive symptoms in pregnancy as assessed by the Edinburgh Postnatal Depression Scale. OXTR DNA methylation (CpG site -934) and genotype (rs53576 and rs2254298) were assayed from DNA extracted from blood collected during pregnancy. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of elevated symptoms of PPD with genotype, methylation, and their interaction adjusted for psychosocial factors (n = 500). There was evidence of an interaction between rs53576 and methylation in the OXTR gene amongst women who did not have depression prenatally but developed PPD (p interaction = 0.026, adjusted for covariates, n = 257). Those women with GG genotype showed 2.63 greater odds of PPD for every 10% increase in methylation level (95% CI: 1.37, 5.03), whereas methylation was unrelated to PPD amongst "A" carriers (OR = 1.00, 95% CI: 0.58, 1.73). There was no such interaction among women with PPD and prenatal depression. These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of PPD.
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Affiliation(s)
- Aleeca F. Bell
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, ChicagoIL, USA
| | - C. S. Carter
- Kinsey Institute and Department of Biology, Indiana University, BloomingtonIN, USA
| | - Colin D. Steer
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - Jean Golding
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - John M. Davis
- Department of Psychiatry, University of Illinois at Chicago, ChicagoIL, USA
| | - Alana D. Steffen
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, ChicagoIL, USA
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois at Chicago, ChicagoIL, USA
| | - Travis S. Lillard
- Department of Psychology, University of Virginia, CharlottesvilleVA, USA
| | - Steven P. Gregory
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of BristolBristol, UK
| | - James C. Harris
- Department of Psychiatry and Behavioral Sciences, Developmental Neuropsychiatry, Johns Hopkins University School of Medicine, BaltimoreMD, USA
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Lam-Cassettari C, Wadnerkar-Kamble MB, James DM. Enhancing Parent-Child Communication and Parental Self-Esteem With a Video-Feedback Intervention: Outcomes With Prelingual Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2015; 20:266-74. [PMID: 25819293 PMCID: PMC4450156 DOI: 10.1093/deafed/env008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/23/2015] [Indexed: 05/08/2023]
Abstract
Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent-child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child (Mage = 2 years 8 months) completed three sessions of video interaction guidance intervention. Families were assessed in spontaneous free play interactions at pre and postintervention using the Emotional Availability (EA) Scales. The Rosenberg Self-esteem Scale was also used to assess parental report of self-esteem. Compared with nontreatment baselines, increases were shown in the EA subscales: parental sensitivity, parental structuring, parental nonhostility, child responsiveness, and child involvement, and in reported self-esteem at postintervention. Video-feedback enhances communication in families with prelingual DHH children and encourages more connected parent-child interaction. The results raise implications regarding the focus of early intervention strategies for prelingual DHH children.
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Webb R, Ayers S. Cognitive biases in processing infant emotion by women with depression, anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review. Cogn Emot 2014; 29:1278-94. [DOI: 10.1080/02699931.2014.977849] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cents RAM, Kok R, Tiemeier H, Lucassen N, Székely E, Bakermans-Kranenburg MJ, Hofman A, Jaddoe VWV, van IJzendoorn MH, Verhulst FC, Lambregtse-van den Berg MP. Variations in maternal 5-HTTLPR affect observed sensitive parenting. J Child Psychol Psychiatry 2014; 55:1025-32. [PMID: 24484301 DOI: 10.1111/jcpp.12205] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the genetic determinants of sensitive parenting. Two earlier studies examined the effect of the serotonin transporter polymorphism (5-HTTLPR) on sensitive parenting, but reported opposite results. In a large cohort we further examined whether 5-HTTLPR is a predictor of observed maternal sensitivity and whether observed child social fearfulness moderates the effect of 5-HTTLPR on maternal sensitivity. METHODS The population-based cohort consisted of 767 mother-child dyads. Maternal sensitivity was repeatedly observed at the child's age of 14 months, 36 months and 48 months. Sensitivity was coded using the Ainsworth's rating scales for sensitivity and cooperation and the revised Erickson rating scales for Supportive presence and Intrusiveness. Child social fearfulness was observed using the Stranger Approach episode of the Laboratory Temperament Assessment Battery at 36 months. RESULTS Repeated measurement analyses showed a consistent main effect of maternal 5-HTTLPR on sensitivity; mothers carrying the S-allele were more sensitive toward their children (p = .005). This effect was not explained by the child's 5-HTTLPR genotype. We found no evidence that child social fearfulness moderated the effect of 5-HTTLPR on sensitivity. CONCLUSIONS This study suggests that variations in maternal 5-HTTLPR genotype appear to be involved in the etiology of parenting behavior. The observed effects of this genetic variation are consistent with the notion that parenting may have a genetic component, but large studies are needed to find the specific small molecular effects.
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Affiliation(s)
- Rolieke A M Cents
- The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
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Bell AF, Erickson EN, Carter CS. Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood. J Midwifery Womens Health 2014; 59:35-42: quiz 108. [PMID: 24472136 PMCID: PMC3947469 DOI: 10.1111/jmwh.12101] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Emerging research raises questions that synthetic oxytocin during childbirth may alter the endogenous oxytocin system and influence maternal stress, mood, and behavior. Endogenous oxytocin is a key component in the transition to motherhood, affecting molecular pathways that buffer stress reactivity, support positive mood, and regulate healthy mothering behaviors (including lactation). Synthetic oxytocin is widely used throughout labor and postpartum care in modern birth. Yet research on the implications beyond labor of maternal exposure to perinatal synthetic oxytocin is rare. In this article, we review oxytocin-related biologic pathways and behaviors associated with the transition to motherhood and evidence supporting the need for further research on potential effects of intrapartum oxytocin beyond labor. We include a primer on oxytocin at the molecular level.
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Reichmuth K, Embacher AJ, Matulat P, Am Zehnhoff-Dinnesen A, Glanemann R. Responsive parenting intervention after identification of hearing loss by Universal Newborn Hearing Screening: the concept of the Muenster Parental Programme. Int J Pediatr Otorhinolaryngol 2013; 77:2030-9. [PMID: 24182601 DOI: 10.1016/j.ijporl.2013.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Parents of newborns with hearing loss (HL) identified by Universal Newborn Hearing Screening (UNHS) programmes wish for educational support soon after confirmation and for contact with other affected families. Besides pedaudiological care, a high level of family involvement and an early start of educational intervention are the best predictors for successful oral language development in children with HL. The implementation of UNHS has made it necessary to adapt existing intervention concepts for families of children with HL to the needs of preverbal infants. In particular, responsiveness has proven to be a crucial skill of intuitive parental behaviour in early communication between parents and their child. Since infants with HL are being fitted earlier with hearing devices, their chances of learning oral language naturally in daily communication with family members have noticeably improved. OBJECTIVES The Muenster Parental Programme (MPP) aims at empowering parents in communicating with their preverbal child with HL and in (re-)building confidence in their own parental resources. Additionally, it supplies specific information about auditory and language development and enables exchange with other affected parents shortly after the diagnosis. CONCEPT The MPP is a responsive parenting intervention specific to the needs of parents of infants with HL identified by UNHS or through other indices and testing within the first 18 months of life. It is based on the communication-oriented Natural Auditory Oral Approach and trains parental responsiveness to preverbal (3-18 months) infants with HL. The MPP has been developed for groups of 4-6 families and comprises six group sessions (without infants), two single training sessions with video feedback, and two individual counselling sessions. At the age of 24-30 months, an individual refresher training session is offered to the parents for adapting their responsiveness to the current verbal level of the child via dialogic book reading. The programme also benefits parents of paediatric cochlear implant (CI) candidates preimplantation and postimplantation. CONCLUSIONS The MPP is evidence-based (see Glanemann et al., this volume) and meets the current need for effective family-centred educational intervention after UNHS.
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Affiliation(s)
- Karen Reichmuth
- Clinic for Phoniatrics and Pedaudiology, University Hospital Muenster, Germany.
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James DM, Wadnerkar-Kamble MB, Lam-Cassettari C. Video feedback intervention: a case series in the context of childhood hearing impairment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2013; 48:666-678. [PMID: 24165363 DOI: 10.1111/1460-6984.12039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Recent research shows that parental sensitivity can explain a significant and unique amount of growth in speech and language outcomes in children with cochlear implants. In this intervention study we explored the impact of an intervention designed to support parental sensitivity on children's communication development. AIMS This study tests the effect of a complex intervention in the context of childhood hearing impairment using a case study design of three families. Propositions for each case were made using parental report of the child's development in an attempt to identify change in outcome measurements that were not likely to be due to general development in the child or a halo effect from the intervention. METHODS AND RESULTS Multiple pre- and post-intervention measures were taken. Outcome measures were mother-child contingencies to vocal utterances, emotional availability and an assessment of early communication in the child. Results for each case showed that improvements in some outcome measurements were found after the intervention and were maintained at follow-up. CONCLUSIONS & IMPLICATIONS Taking account of developmental change in intervention studies with children is challenging. Single-subject intervention studies can be designed to allow research interventions to be tailored to meet families' specific needs. Video interaction guidance may support pre-linguistic communicative development in children with hearing impairment.
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Affiliation(s)
- Deborah M James
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK; NIHR Nottingham Biomedical Research Unit in Hearing, University of Nottingham, Nottingham, UK
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Goodman JH, Guarino AJ, Prager JE. Perinatal dyadic psychotherapy: design, implementation, and acceptability. JOURNAL OF FAMILY NURSING 2013; 19:295-323. [PMID: 23562990 PMCID: PMC4144803 DOI: 10.1177/1074840713484822] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Maternal postpartum depression (PPD) and mother-infant relationship dysfunction have reciprocal effects on each other and thus an integrated approach that addresses both problems simultaneously may lead to improved outcomes. This study aimed to determine the feasibility, acceptability, and preliminary efficacy of a new intervention, Perinatal Dyadic Psychotherapy (PDP), for the early treatment of maternal PPD. PDP is designed to promote maternal mental health and facilitate optimal mother-infant relationships via (a) a supportive, relationship-based, mother-infant psychotherapeutic component, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. This paper describes the pilot use of PDP with six acutely depressed postpartum women. Nurses delivered the intervention over eight home visits. Results indicate that PDP is a feasible, acceptable, and safe intervention with this population. All participants achieved remission of depression with significant reduction of depression and anxiety symptoms, suggesting that PDP is a promising treatment for PPD.
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Affiliation(s)
- Janice H Goodman
- MGH Institute of Health Professions School of Nursing, Boston, MA 02129, USA.
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Perou R, Elliott MN, Visser SN, Claussen AH, Scott KG, Beckwith LH, Howard J, Katz LF, Smith DC. Legacy for ChildrenTM: a pair of randomized controlled trials of a public health model to improve developmental outcomes among children in poverty. BMC Public Health 2012; 12:691. [PMID: 22917446 PMCID: PMC3534341 DOI: 10.1186/1471-2458-12-691] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 08/17/2012] [Indexed: 11/30/2022] Open
Abstract
Background One in five Americans under age 18 lives in a family below the Federal poverty threshold. These more than 15 million children are at increased risk of a wide variety of adverse long-term health and developmental outcomes. The early years of life are critical to short- and long-term health and well-being. The Legacy for ChildrenTM model was developed in response to this need and marries the perspectives of epidemiology and public health to developmental psychology theory in order to better address the needs of children at environmental risk for poor developmental outcomes. Methods/design The Legacy for ChildrenTM group-based parenting intervention model was evaluated as a pair of randomized controlled trials among low-income families in Miami and Los Angeles. The study was designed to allow for site-stratified analysis in order to evaluate each model implementation separately. Evaluation domains include comprehensive assessments of family, maternal, and child characteristics, process outcomes, and prospective programmatic cost. Data collection began prenatally or at birth and continues into school-age. Discussion The societal costs of poor developmental outcomes are substantial. A concerted effort from multiple sectors and disciplines, including public health, is necessary to address these societal concerns. Legacy uses a public health model to engage parents and promote overall child well-being in families in poverty through rigorous evaluation methodologies and evidence-based intervention strategies. This study collects rich and modular information on maternal and child outcomes, process, and cost that will enable a detailed understanding of how Legacy works, how it can be refined and improved, and how it can be translated and disseminated. Taken together, these results will inform public policy and help to address issues of health disparities among at-risk populations. Trial registration NCT00164697
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Affiliation(s)
- Ruth Perou
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
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Holland ML, Yoo BK, Kitzman H, Chaudron L, Szilagyi PG, Temkin-Greener H. Mother-child interactions and the associations with child healthcare utilization in low-income urban families. Matern Child Health J 2012; 16:83-91. [PMID: 21127953 DOI: 10.1007/s10995-010-0719-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies have demonstrated that low-income families often have disproportionately high utilization of emergency department (ED) and hospital services, and low utilization of preventive visits. A possible contributing factor is that some mothers may not respond optimally to their infants' health needs, either due to their own responsiveness or due to the child's ability to send cues. These mother-child interactions are measurable and amenable to change. We examined the associations between mother-child interactions and child healthcare utilization among low-income families. We analyzed data from the Nurse-Family Partnership trial in Memphis, TN control group (n = 432). Data were collected from child medical records (birth to 24 months), mother interviews (12 and 24 months postpartum), and observations of mother-child interactions (12 months postpartum). We used logistic and ordered logistic regression to assess independent associations between mother-child interactions and child healthcare utilization measures: hospitalizations, ED visits, sick-child visits to primary care, and well-child visits. Better mother-child interactions, as measured by mother's responsiveness to her child, were associated with decreased hospitalizations (OR: 0.51; 95% CI: 0.32, 0.81), decreased ambulatory-care-sensitive ED visits (OR: 0.65, 95% CI: 0.44, 0.96), and increased well-child visits (OR: 1.55, 95% CI: 1.06, 2.28). Mother's responsiveness to her child was associated with child healthcare utilization. Interventions to improve mother-child interactions may be appropriate for mother-child dyads in which child healthcare utilization appears unbalanced with inadequate primary care and excess urgent care. Recognition of these interactions may also improve the care clinicians provide for families.
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Affiliation(s)
- Margaret L Holland
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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Ji ES, Han HR. The Effects of Qi Exercise on Maternal/Fetal Interaction and Maternal Well-Being During Pregnancy. J Obstet Gynecol Neonatal Nurs 2010; 39:310-8. [DOI: 10.1111/j.1552-6909.2010.01135.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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