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Richardson HL, Damashek A. Examining the Use of a Brief Online Intervention in Primary Care for Changing Low-Income Caregivers' Attitudes Toward Spanking. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20409-NP20427. [PMID: 34802302 DOI: 10.1177/08862605211054101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is a robust and growing literature base indicating that spanking is a common, but potentially problematic, discipline strategy. Goals: Using a randomized controlled trial design, this study examined whether participation in a brief online program, Play Nicely, would result in favorable changes in caregivers' attitudes toward spanking. The study also examined whether the intervention was equally effective for participants of color (POC) and White participants, and it assessed caregivers' perceptions of the program's cultural sensitivity. Methods: Participants were 52 caregivers from 1- to 5-year-old children who were visiting a pediatric clinic. Participants were enrolled and randomly assigned to either engage in the Play Nicely online program (n = 21) or view a control condition website (n = 31) in a clinic exam room. Results: There was not a statistically significant difference between the treatment and control groups' scores on attitudes toward spanking (ATS) at post-test (F (1, 49) = 1.515, p = 0.224), but a small between-group effect size was detected (d = 0.20). Within the treatment condition, desired changes in ATS scores were significantly higher among White participants than POC (t (17) = -2.125, p = 0.049), but there was not a significant difference in reported perceptions of Play Nicely's cultural acceptability between White participants and POC (t (19) = 0.469, p = 0.644). Conclusions: Findings suggest a need for further investigation of Play Nicely's impact on caregivers' ATS with a larger sample to clarify the program's utility as a potential population-based tool for parent education and violence prevention. Additional research is needed to identify sociocultural factors that may moderate the effects of spanking interventions for families across diverse racial backgrounds.
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Affiliation(s)
| | - Amy Damashek
- Department of Psychology, Western Michigan University, Kalamazoo, MI, USA
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Williamson AA, Okoroji C, Cicalese O, Evans BC, Ayala A, Harvey B, Honore R, Kratchman A, Beidas RS, Fiks AG, Power TJ, Mindell JA. Sleep Well! An adapted behavioral sleep intervention implemented in urban primary care. J Clin Sleep Med 2021; 18:1153-1166. [PMID: 34910624 DOI: 10.5664/jcsm.9822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To describe the adaptation, feasibility, and initial outcomes of Sleep Well!, an intervention for early childhood insomnia and insufficient sleep, designed for families from lower-socioeconomic status (SES) backgrounds presenting to large metropolitan primary care sites. METHODS Fifteen caregiver-child dyads (caregivers: 92.3% mothers; 80.0% Black; 53.3% ≤125% US poverty level; children: 73.3% female; 86.7% Black; M age = 3.0 years) participated this multi-method, single-arm trial. A family advisory board of caregivers (N = 4) and a clinician advisory board of sleep experts, primary care clinicians, and psychologists (N = 13) provided intervention feedback throughout the pilot. Most adaptations were related to intervention delivery methods, with some related to sleep strategies. At post-intervention, caregivers completed surveys on intervention acceptability and cultural humility (primary outcomes) and completed semi-structured interviews. Caregivers also reported on child sleep pre- and post-intervention. RESULTS Thirteen (86.6%) families completed Sleep Well! and 12 (80.0%) completed pre- and post-intervention measures. Caregivers reported strong intervention acceptability and cultural humility. There were pre-to-post reductions in child sleep problems, bedroom electronics, sleep onset latency, and night awakening frequency and duration. Nighttime sleep duration and overall insufficient sleep also improved. Qualitative data also showed strong intervention acceptability and perceived flexibility, with few participation barriers. CONCLUSIONS A brief, early childhood behavioral sleep intervention delivered in primary care with families from primarily lower-SES and/or racially minoritized backgrounds is feasible to implement, with strong retention rates, acceptability, and perceptions of cultural humility. Child sleep improvements are positive, and warrant replication in a randomized controlled trial.
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Affiliation(s)
- Ariel A Williamson
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Amanda Ayala
- Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Rachel Honore
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Amy Kratchman
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Rinad S Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA.,Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia, PA
| | - Alexander G Fiks
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas J Power
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jodi A Mindell
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Saint Joseph's University, Philadelphia, PA
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Evaluation of a Safe Sleep Training for Home Visitors and Their Clients. J Clin Psychol Med Settings 2021; 29:477-488. [PMID: 34378161 DOI: 10.1007/s10880-021-09811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Sleep-related deaths are a common preventable cause of death, and such deaths occur disproportionately in families of color. Home visitors provide families with education about infant safe sleep guidelines; however, families face many barriers to engaging in safe sleep practices. This study evaluated the efficacy of a program to train home visitors to talk to clients about infant safe sleep using Motivational Interviewing and cultural sensitivity. We examined the effects of the intervention on home visitors' (n = 23) knowledge, MI skill use, and cultural sensitivity using a single group pre-post design. We also examined home visiting clients' (n = 78) knowledge, attitudes, and behaviors using a quasi-experimental design. Home visitors were primarily female (97%), had a college degree (86%), and were primarily white (50%) or African American (43%). The home visiting clients were all female and were primarily African American (43%) and Caucasian (36%). Most clients (59%) earned less than 30,000 dollars per year. Home visitors showed significant improvement in MI skill use and cultural sensitivity from pre- to post-test. Regarding client outcomes, our results indicate a significant group by time interaction when predicting changes in client knowledge such that the treatment group showed larger gains than the control group. There were no significant differences between groups when predicting changes in client attitudes or behavior. MI may be an effective technique for home visitors to help increase families' safe sleep knowledge. Additional research is needed to examine whether such training can translate to changes in families' safe sleep behavior.
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Oh S, Shillingford-Butler A. The Client Assessment of Multicultural Competent Behavior (CAMCB): Development and Validation. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1080/07481756.2020.1745651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Piercy FP. On maps, shapeshifting, and my syllabus: family therapies today. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:1-4. [PMID: 25615812 DOI: 10.1111/jmft.12108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Fred P Piercy
- Marriage and Family Therapy Doctoral Program, Department of Human Development, Virginia Tech, Blacksburg, VA 24060.
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