Evaluation of a Parent Education Program Emphasizing Responsive Parenting and Mindfulness: An Inclusive Randomized Controlled Trial

Effect of recreational sport and physical activity participation on well-being during early parenthood: a randomized controlled trial

BACKGROUND

Parents with children in the home may benefit considerably from sport participation, given the high levels of physical inactivity and psychosocial distress among this group. The purpose of this study was to evaluate the effectiveness of team sport participation on mental health (primary outcome) as well as other secondary psychosocial outcomes compared to an individual physical activity condition and a "date night" control condition among parents with young children (under the age of 13).

METHODS

A three-arm parallel design single blinded randomized controlled trial compared the team sport (n = 58), individual physical activity (n = 60), and control condition (n = 66) over three months. Well-being variables (short-form-12, satisfaction with life scale, parental stress scale, relationship assessment scale, family inventory version II) were assessed at baseline and post-randomization at 6 weeks and 3 months. Rolling recruitment began in winter 2016 until spring 2023. Analyses were conducted using generalized linear mixed models.

RESULTS

Team sport participation resulted in improvements in mental health and increased relationship satisfaction compared to the other conditions. Team sport participation also showed improvements in lowering parental stress and increasing family emotional expressiveness compared to the control condition. All conditions improved satisfaction with life, lowered stress, increased relationship satisfaction, benefited family health/competence and lowered family conflict over time.

DISCUSSION

The findings extend prior observational research by demonstrating team sport participation may be a viable activity to recommend for parents of young children, who are typically challenged by lower well-being, stress, and social isolation from other adults.

REGISTERED TRIAL

The clinical trial is registered with the National Library of Medicine at the National Institutes of Health registration ID is NCT02898285.

Effect of authentic leadership and mindfulness educational program on nursing managers' competencies: a quasi-experimental study

BACKGROUND

Authentic leadership is an emerging perspective in leadership that focuses on leaders' values and beliefs. while the mindfulness perspective permits nurse managers to be fully present, aware of themselves and their impact on others, and aware of their reactions in stressful situations. so, authentic leadership and mindfulness if combined create nurse managers who have clearer, more focused thinking, and a growth mindset that help subordinates improve and grow. as well as mindfulness-based interventions help them to improve interpersonal relationships with patients and colleagues, and to take better care of themselves and others.

AIM

The present study aims to; explore the effect of authentic leadership and mindfulness educational program on nursing managers' competencies in hospital.

METHODS

A quasi-experimental design (Quantitative pre-, post-, and follow-up design) was used to conduct the study at Shirbeen General Hospital, Egypt. The study subjects consist of a purposive sample of 70 nurse managers and 226 nurses. Three tools used for data collection consisted of; the authentic leadership questionnaire, the five Facet Mindfulness Questionnaire, and the managerial competencies of Nurse Managers. Data analysis was performed using SPSS version 20, Qualitative categorical variables were compared using the chi-square test. A significant level value was considered when the p-value ≤ 0.05, and Cohen's d was used to measure the effect size which indicated there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores.

RESULTS

The current study revealed that there were significant differences between nurse managers' knowledge, authentic leadership, mindfulness, and managerial competencies (P = 0.001) pre-, post-, and after 3 months of the program. As determined by Cohen's d test, there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores.

CONCLUSION

The educational program about authentic leadership and mindfulness had a positive effect on nurse managers' managerial competencies.

TRIAL REGISTRATION NUMBER (TRN)

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University, Egypt (code number: NUR 13/3/2022-11).

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents

BACKGROUND

Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes.

OBJECTIVES

To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents.

SEARCH METHODS

We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field.

SELECTION CRITERIA

We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance.

DATA COLLECTION AND ANALYSIS

We followed standard Cochrane procedures.

MAIN RESULTS

Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence).

AUTHORS' CONCLUSIONS

Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.

Mindfulness Intervention Improves Coping and Perceptions of Children's Behavior among Families with Elevated Risk

Mindfulness-informed interventions (MIIs) are increasingly common but have not been extensively studied among families with elevated levels of risk (e.g., those involved in child protective services and/or receiving financial assistance). These families often experience high rates of stressors that can impact coping strategies, interpersonal dynamics, and relationships. Given that mindfulness has been shown to promote health and wellbeing, this study used a sample from two pilot randomized controlled trials to test the extent to which a mindfulness-informed intervention improved coping strategies and perceptions of children's behavior among 53 families with elevated risk. A principal components analysis with a direct oblimin rotation revealed that cognitive-emotion coping strategies could be characterized by three factors: positive adaptation, negative adaptation, and positive refocusing. Intention-to-treat analysis indicated significant group by time differences, with intervention participants demonstrating improvements in positive refocusing coping, positive adaptation coping, and perceptions of children's behavior problems compared to participants in the waitlist control group. No significant differences were found for negative adaptation coping strategies. Findings provide preliminary support for the benefits of mindfulness training in a sample generally underrepresented in the mindfulness intervention literature.

Sequencing drinking events and use of punitive, nonpunitive, and positive parenting behaviors with ecological momentary assessment

BACKGROUND

The relationship between alcohol use and parenting is primarily predicated on use of both past year drinking and parenting behaviors, making it difficult to develop prevention and intervention efforts that target alcohol-related maltreatment. Here, we assess the sequencing of parenting behaviors in relation to alcohol use (e.g., whether punitive parenting and alcohol use occur simultaneously).

METHODS

Using Ecological Momentary Assessment, a convenience sample of parents was asked to take three brief surveys daily (at 10 a.m., 3 p.m., and 9 p.m.) for 14 days. If the parent was with the focal child, they were asked to identify whether they had used one of six randomly assigned parenting behaviors (punitive, nonpunitive, or positive). Alcohol use was queried at the 9 p.m. survey on days 7 and 14. Logistic multilevel models were used to analyze the data.

FINDINGS

Parents reported less nonpunitive parenting during the time in which they reported drinking, and less positive parenting behaviors on the morning after the drinking occurred.

CONCLUSIONS

Parents may be less attentive to children's behavior while drinking, or they may be less inclined to find that behavior needing correction. Drinking may reduce the likelihood of positive parenting the next day if parents are feeling hungover or have negative aftereffects from drinking. These parents may want to explicitly have another adult provide caregiving duties during the drinking event or plan drinking when it is less likely to cause the least amount of harm (e.g., when children are in bed).

Parenting Programme Structure, Potential Barriers, and Facilitators: A Scoping Review

Becoming a parent is a challenging transition, and stress factors may arise. This scoping review aims to map, from the literature, the structure, potential barriers, and facilitators to be considered when conducting a parenting programme for parents of children up to 3 years old. It followed the JBI methodology and included studies with parents of children up to 3 years old (Participants), studies about parenting programme structure, its potential barriers, and facilitators (Concept) in the healthcare or community setting (Context). Qualitative and/or quantitative study designs and grey literature publications between 2016 and 2021 were eligible. The search was performed in three stages in CINAHL Plus with Full Text, MEDLINE with Full Text, and PubMed databases. It was also conducted in OpenGrey, ProQuest, Portuguese Open Access Scientific Repository, and Google Scholar. Fourteen articles were selected. The following aspects were identified regarding parenting programmes: benefits; structuring elements to be considered; facilitating factors and possible barriers to its development, and measurement instruments to assess the programme. Parenting programmes are important ways to contribute to a healthy, sustainable, and resilient society. It should be adapted to individuals, groups, and communities. They add value to parents, children, and society and should be carefully adapted to the group's needs.

Thirteen-Year Outcomes of a Randomized Clinical Trial of Early Preventive Care for Very Preterm Infants and Their Parents

OBJECTIVE

To evaluate 13-year outcomes of a randomized controlled trial of preventive care (VIBeS Plus) for infants born very preterm and their parents and examine whether possible effects of intervention varied by family social risk.

STUDY DESIGN

Families were randomized to an intervention arm (n = 61) or a standard care arm (n = 59). The intervention was delivered at home by psychologists and physiotherapists over the infants' first year, focusing on infant development and parental mental health. At 13 years corrected age, cognitive, motor, and behavioral outcomes, and parental mental health were assessed. Primary estimands were between-group mean differences, estimated using multiple imputed regression models.

RESULTS

Follow-up included 81 surviving children (69%). There was little evidence of benefits of the intervention for IQ, attention, executive functioning, working memory, and academic skills regardless of level of social risk. Specifically, mean differences in adolescent cognitive outcomes ranged from -2.0 units (95% CI, -9.9 to 5.9) in favor of standard treatment to 5.1 units (95% CI, -2.3 to 12.5) favoring the intervention. A group-by-social risk interaction was observed only for adolescent motor outcomes, with mean differences favoring the intervention for those at higher social risk (balance, 4.9; 95% CI, 1.3-8.5; total motor, 3.2; 95% CI, 0.3-6.2), but not those at lower social risk (balance, -0.3; 95% CI, -2.4 to 1.9; total motor, 0.03; 95% CI, -1.9 to 2.0). Mean differences in adolescent behavior and parental mental health ranged from -6.6 (95% CI -13.8, 0.5) to -0.2 (95% CI, -1.9 to 1.4) and -1.8 (95% CI, -4.1 to 0.6) to -1.7 (95% CI, -4.3 to 1.0), respectively, indicating a pattern of fewer symptoms in the intervention group.

CONCLUSIONS

Benefits of the intervention persisted for adolescent behavior, with better motor outcomes observed in those from socially disadvantaged families. Replication with larger samples, multiple informant reports, and assessment of quality of life-related outcomes is warranted.

TRIAL REGISTRATION

http://www.anzctr.org.au/: ACTRN12605000492651.