Social support, family functioning and parenting competence in adolescent parents

Associations between teacher-parent relationships and preschool children's social behavior problems-the chain mediating roles of work-family conflict and parenting self-efficacy

In the Chinese cultural context, the collaborative interaction characteristics among three key entities - families, kindergartens, and communities - and the mechanisms of their correlation with preschool children's social behavior problems have not been fully understood yet. Based on ecological systems Theory and social support theory, this study aimed to examine the correlation between parent-teacher relationships and preschool children's social behavior problems in Chinese kindergartens, as well as the mediating role of parents' work-family conflict and parenting self-efficacy. Structural equation modeling was used to test the research hypotheses based on a questionnaire survey of 1,784 parents of preschool children. The main findings of this study are as follows: (1) Parents' perceived positive parent-teacher relationships are negatively correlated with preschool children's social problems. (2) Parents' work-family conflict and parenting self-efficacy mediate the relationship between parent-teacher relationships and preschool children's social behavior problems; (3) Parents' work-family conflict and parenting self-efficacy play a chain mediating role in the influence of the parent-teacher relationship on preschool children's social behavior problems. Taken together, the results collectively further elucidate the correlation between parent-teacher relationships and preschool children's social behavior problems, while also discussing other relevant factors pertaining to children's social behavior problems. Theoretically, this study expands the understanding of how external environmental resources interact with home and family education. Practically, this research indicates that governments, early childhood education institutions, and workplaces need to strengthen their support for family education of preschool children. The findings contribute to promoting a multi-faceted co-operation aimed at enhancing the quality of early childhood education and fostering the social adaptability and holistic development of preschool children.

Factors affecting parental role adaptation in parents of preterm infants after discharge: a cross-sectional study

Background

Parenting a preterm infant can be incredibly challenging and stressful, particularly in the first year after discharge. Desirable parental role adaptation leads to appropriate parenting behaviors and parent-infant interaction, which are essential to child health and development.

Aim

To investigate the level of parental role adaptation and its influencing factors among parents of preterm infants in the first year after hospital discharge according to Belsky's parenting process model among parents of preterm infants in the first year after hospital discharge.

Methods

A cross-sectional study design was adopted using convenience sampling. Data were collected using the Parental Role Adaptation Scale (PRAS) in parents with preterm infants, the Perceived Social Support Scale (PSSS), the Coping Adaptation Processing Scale (CAPS-15), and a sociodemographic questionnaire. Descriptive statistics, non-parametric tests, Spearman correlation analyses, and multivariate linear regression were used to analyze the data.

Results

In total, 300 Chinese parents were included in the analysis. In the multivariate analysis, first-time parent (p = 0.003), master's degree and above (p = 0.042), coping adaptation processing (p = 0.000), residence location (towns: p = 0.019, city: p = 0.028), monthly family income (6000-10,000: p = 0.000, >10,000: p = 0.000), and perceived social support (p = 0.001) were all significant predictors of parental role adaptation and collectively accounted for 56.8% of the variation in parental role adaptation of parents with preterm infants (F = 16.473, p < 0.001). Coping adaptation processing mediated the relationship between perceived social support and parental role adaptation (95% bootstrap CI = 0.022, 0.130).

Conclusion

Chinese parents of preterm infants experience a moderate level of parental role adaptation when their child is discharged from the hospital to home. Parents who are not first-time parents, have master's degrees or above, live in towns or cities, have higher coping and adaptation abilities, have high monthly family income, and greater perceived social support have a higher level of parental role adaptation. Healthcare providers should pay more attention to parents with low socioeconomic status and encourage them to improve their coping and adaptation abilities and to utilize their formal and informal social support networks.

Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China

OBJECTIVE

China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum.

METHODS

A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics.

RESULTS

The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet.

CONCLUSION

The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.

Parenting experiences and outcomes among former adolescent mothers: A mixed methods study

The purpose of this explanatory sequential mixed methods study was to examine parenting outcomes and experiences over time among marginalized adolescent mothers enrolled in randomized clinical trials (RCT) between 2002 and 2016 testing Minding the Baby® (MTB), an early home visiting program. The quantitative phase examined associations between measures of maternal experiences and parenting outcomes from 71 participants 2-8 years since RCT completion. MTB mothers reported less hostile parenting and fewer child behavior problems. The sequential qualitative phase involved interviews with a subsample (n = 31) and revealed six themes about their personal and parenting maturation. Through integration of quantitative and qualitative data, we generated metainferences, revealing a nuanced understanding of participants' experiences. Integrated findings revealed the complex personal and parenting experiences among former adolescent mothers during their developmental phases of emerging and early adulthood. Findings inform clinical and research approaches to promote personal growth and positive parenting outcomes over time among women who began childbearing in adolescence.

Parenting knowledge and parenting self-efficacy of mothers with borderline personality disorder and depression: "I know what to do but think I am not doing it"

Borderline personality disorder (BPD) is a complex mental health condition often associated with previous childhood adversity including maladaptive parenting. When becoming a parent themselves, mothers with BPD have difficulties with various parenting cognitions and practices, but unknown is whether they have appropriate knowledge of sensitive parenting. This study explored whether differences in parenting knowledge or self-efficacy are specific to BPD or also found in mothers with depression, and whether symptom severity or specific diagnosis better explain parenting perceptions. Mothers with BPD (n = 26), depression (n = 25) or HCs (n = 25) completed a Q-sort parenting knowledge task and a parenting self-efficacy questionnaire. Results showed mothers with BPD had the same knowledge of sensitive parenting behaviors as mothers with depression and healthy mothers. Self-reported parenting self-efficacy was lower in mothers with BPD and depression compared with healthy mothers, with symptom severity most strongly associated. A significant but low correlation was found between parenting self-efficacy and knowledge. Findings suggest that mothers with BPD and depression know what good parenting is but think they are not parenting well. Mental health difficulties are not associated with parenting knowledge, but symptom severity appears to be a common pathway to lower parenting self-efficacy. Future interventions should test whether reduction of symptom severity or positive parenting feedback could improve parenting self-efficacy.

Development and Psychometric Testing of the Fathers' Self-Efficacy Scale for Newborn Care

PURPOSE

Fathers' involvement in newborn care positively affects both work sharing between parents, newborn quality of life, and the relationship between father and newborn. However, there is no valid and reliable measurement tool to evaluate fathers' self-efficacy levels for newborn care. This study aimed to develop the fathers' self-efficacy scale for newborn care (FSSNC) and to examine its psychometric properties.

METHODS

This study is an instrument development and validation study. After a comprehensive literature review, expert opinion, and pilot application stages, an item pool was developed. For validity and reliability analyses, data were collected between March and December 2022 from 442 individuals, including fathers with newborn babies and expectant fathers whose partners are pregnant. Validity assessments included content, exploratory and confirmatory factor analyses, and convergent validity. The scale was also evaluated for its internal consistency, and two-half-test reliability. In this study, the STROBE checklist was used as a guideline.

RESULTS

The final version of the scale consisted of three subdimensions (hygiene, safety, and nutrition). The total number of items is 17. Confirmatory factor analysis results confirm the results of exploratory factor analysis. There was a strong correlation between the scale score and the participants' self-assessment score.

CONCLUSIONS

The study demonstrates that the FSSNC was a valid, reliable, and user-friendly measurement tool used to evaluate fathers' self-efficacy regarding hygiene, safety, and nutrition in newborn care.

Perception and experience of relatives of pregnant teenagers: A qualitative study in the North and Northeast departments of Haiti

Teenage pregnancy remains a global problem because of its consequences for the teenager, her child, her family, and society. In Haiti, this type of pregnancy burdens the family economy. In addition, the adolescent fertility rate is still high, despite efforts to reduce it. This article aims to analyze the perception and experiential experience of relatives of pregnant adolescents in Haiti. A qualitative study design based on Dewey's social survey was conducted. Data were collected from 17 relatives (partners, parents, guardians, and others) of pregnant adolescents in Haiti's North and Northeast departments. These data were analyzed using thematic analysis. According to the results, teenage pregnancy is seen as a disaster or a social problem in Haiti. It leads to many psychosocial and economic difficulties for the relatives, who are the only source of economic and social support for pregnant adolescents. Considering the vulnerability of relatives, policies, and interventions aimed at reducing the negative consequences of teenage pregnancy should consider this group of individuals.

Development and validation of a parental competence questionnaire in the paediatric hospital emergency setting (ECP-U)

OBJECTIVE

To develop and validate a parental competence questionnaire for parents of children seeking care in hospital emergency departments.

METHODS

An instrumental study of the development of an assessment questionnaire was carried out in three phases: 1) review of relevant measures and item generation, 2) content validity evaluation, 3) psychometric evaluation. Exploratory factor analysis was performed to examine the factorial structure. Internal consistency was evaluated using ordinal alpha. Hypothesis testing was determined between the resulting factors, the Parental Stress Scale and the State-Trait Anxiety Inventory.

RESULTS

The participants were 270 parents of children aged 0-14 years old from a referral hospital in Valencia (Spain). An 18-item questionnaire was developed, comprising five factors that explain 53.0% of the variance: 1) "emotional management and expression", 2) "passive social support", 3) "parental agency", 4) "basic needs and care" and 5) "active social support". The internal consistency for the different factors was modest (>0.70). A negative correlation between the Parental Stress Scale and the parental competence questionnaire was found for most of the factors.

CONCLUSIONS

This questionnaire on parental competence in the hospital emergency department (ECP-U) is a useful and simple self-report instrument for assessing the parental competence of parents with children in the emergency department.

PRACTICAL IMPLICATIONS

The resulting questionnaire is of practical value to both healthcare professionals and researchers in this field. It can be administered quickly in clinical practice and used to identify parents' levels of parental competence and refer those with difficulties to appropriate support services.

Factor structure and validity of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U)

OBJECTIVE

To confirm the structure and examine the psychometric properties of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U).

METHODS

An instrumental validation study of the ECP-U questionnaire and an examination of its psychometric properties were carried out.

RESULTS

The participants were 260 mothers and fathers seeking care in the paediatric emergency department of a hospital in Valencia (Spain) with children aged 0 to 14 years old. The five-factor structure of the ECP-U was confirmed with excellent statistical fits. Second-order models and a more parsimonious four-factor structure with adequate but marginal fits are proposed. With the exception of the "parental agency" factor (in both models examined) and the "active social support" factor (in the original five-factor structure), the internal consistency of the different factors was modest (≥ 0.70). A negative correlation was found between the Parental Stress Scale and the ECP-U for most factors.

CONCLUSIONS

Validity and reliability analyses indicate that the ECP-U is an instrument with modest psychometric properties.

IMPLICATIONS FOR PRACTICE

The ECP-U is an instrument that can be used by future researchers to identify different levels of parental competence in paediatric hospital emergency departments. This will enable help to be given to families with parenting issues and problems. The underlying concern is to reduce the number of frequent users and "Non-Urgent Presentations" to paediatric emergency departments due to low parental competence.

The Effect of Virtual Education in Parenting Skills on the Parenting Sense of Competence in First-time Mothers with a 0-2-year-old Baby: A Quasi-experimental Study

Background

Parental competence is a key aspect of parenting. Since they have no previous experience of having a baby, first-time mothers should acquire certain skills to be competent enough in caring for their baby. The present study aimed to investigate the effect of virtual education in parenting skills on the parenting competence of first-time mothers with a 0-2-year-old baby.

Methods

This quasi-experimental study was conducted through convenience sampling; 72 first-time mothers were selected from 12 healthcare centers, 62 of whom met the criteria for entering the study, and divided into an experimental (n=31) and a control (n=31) group. The mothers in the experimental group received virtual education in parenting skills in six sessions, each lasting 10 minutes for two weeks. The data were collected using a demographics questionnaire and Gibaud-Wallston's parenting sense of competence scale. Sense of competence was assessed in three stages: before, immediately after, and one month after the completion of the intervention. The collected data were analyzed using SPSS v. 22 at a significance level of less than 0.05.

Results

Results showed a statistically significant increase in the experimental group's parenting competence mean score immediately and one month after the intervention (P<0.001). There was a statistically significant difference between the mean scores of the study groups as measured immediately after (P=0.043) and one month after the intervention (P<0.001).

Conclusion

Virtual education of parenting skills could have a positive impact on the mothers' parenting competence. It is suggested that first-time mothers should be educated in parenting skills on a face-to-face basis in maternity wards and online after discharge.

The association between perceived social support and parenting self-efficacy among parents of children aged 0-8 years

Strengthening social support has been recognized as a potentially effective strategy to enhance parenting self-efficacy, but empirical evidence is limited. This study examined the association between perceived social support and parenting self-efficacy.Data of 647 parents of children aged 0-8 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Data were collected between October 2017 and December 2019. Multivariable linear regression models were used to examine the association between social support and parenting self-efficacy. The mean age of the participants was 33.8 years (SD = 4.9); 94.9% mothers. At the start of the study, 15.1% parents perceived low to moderate social support. Parents who experienced lower levels of social support at the start of the study reported lower parenting self-efficacy at follow-up (β: 0.13; 95% CI: 0.05, 0.21), independent of potential socio-demographic confounders. Experiencing an increase in perceived social support during the study period was associated with an increase in parenting self-efficacy (β: 0.15; 95% CI: 0.10, 0.21). Our findings indicate perceived social support is associated with parenting self-efficacy among parents of children aged 0-8 years. Future longitudinal studies need to confirm our findings and may examine which social support interventions are effective in strengthening parenting self-efficacy.

A Longitudinal Mixed-Methods Characterization of Family Support from Adolescence to Young Adulthood in Autism and Other Developmental Disabilities

Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.

Isolation: The experience of adolescent motherhood in Laos

Background

Teenage pregnancy is a persistent public health problem with pervasive socio-economic consequences, particularly in in low- and middle-income countries, often related to low social participation and low economic security. The experiences of adolescent pregnancy and motherhood have seldom been described from a personal point of view. This study aimed to gain insights into how adolescent mothers in Laos experience their motherhood, how they perceive their situation and try to cope with it.

Methods

This qualitative study was undertaken with 20 pregnant adolescents and young mothers living in peri-urban areas in two of the 18 provinces in Laos. Data were collected during 20 semi-structured interviews and two focus group discussions (n = 10). Digital recordings were transcribed verbatim, summarised and thematically analysed using an inductive analysis and exploratory approach.

Results

The most common theme was that the young mothers experienced exclusion individually, socially and in relation to official systems. In only two cases was the pregnancy intended. All were determined to be good mothers, but were overwhelmed and unsure how to overcome structural barriers to educational, social and economic participation.

Conclusion

Participants revealed that their adolescent pregnancy was tied to losses of past and future aspirations, and believed that working to prevent unintended adolescent pregnancy is worthwhile, but also advised that community support structures would help young women in their position.

Funcionalidad Familiar de Adolescentes Asistentes a control prenatal. Cartagena 2021

Introducción: El embarazo en la adolescencia tiende a presentar repercusiones personales, sociales, educativas y psicológicas en la madre y en el hijo. Es por ello por lo que el apoyo de la familia y su funcionalidad resultan cruciales. Objetivo: Determinar el nivel de funcionalidad familiar existente en las familias de las adolescentes gestantes asistentes a controles prenatales en tres instituciones de salud de Cartagena-Colombia durante 2021. Materiales y Métodos: Estudio descriptivo, de corte transversal, y asociación. La población estuvo constituida por 780 adolescentes gestantes que asisten a controles prenatales en dos instituciones. Se determinó una muestra de 185 adolescentes gestantes, seleccionadas mediante muestreo probabilístico. Fue aplicado instrumento sociodemográfico y APGAR familiar. Resultados: Las gestantes participaron de la institución A (50,81%) y de la institución B (44,32%), se trató de adolescentes bachilleres (58,92%), que conviven en unión libre (51,35%), en familias nucleares de origen (32,97%) y sus familias devengan ingresos entre 1 – 2 salarios mínimos (48,11%). El embarazo actual no fue planeado, y a los controles prenatales asisten con la mamá (31,35%), la pareja (27,57%) o solas (22,16%). La funcionalidad normal fue la más frecuente (99,46%), y se presentó asociación (p ≤ 0,05) con las instituciones, con la tipología familiar de naturaleza monoparental conformada y con el acompañamiento a los controles prenatales. Conclusión: Se determinó un nivel de funcionalidad familiar normal en las familias de las adolescentes gestantes asistentes a controles prenatales en dos instituciones de salud de Cartagena.

Influence of home chaos on preschool migrant children's resilience: A moderated mediation model

Increasing attention has been drawn to the development of preschool migrant children's resilience recently. Resilience refers to the positive internal strengths and qualities of individuals in adverse situations, and is an essential psychological quality for preschool migrant children to cope with adversity. Home chaos as a risk factor, has an important impact on the development of individual's resilience, but the specific mechanisms under which home chaos works have yet to be explored, especially for preschool migrant children. Based on resilience model theory, 3,135 preschool migrant children and their families were surveyed and a moderated mediating effect mode was constructed to test the effect of home chaos on preschool migrant children's resilience. The results showed that after controlling for gender and age, home chaos significantly and negatively predicted preschool migrant children's resilience. Family resilience played a mediating role in the relationship between home chaos and preschool migrant children's resilience. Meanwhile, social support positively moderated the mediating effects of family resilience. The findings of this study suggested that low home chaos was conducive to promoting family resilience, which in turn fostered children's resilience, and that social support could play its protective role in weakening the negative effects of home chaos and this had certain guiding implications for the development of resilience in preschool migrant children.

Readiness for Hospital Discharge After a Cesarean Section and Associated Factors Among Chinese Mothers: A Single Centre Cross-Sectional Study

Purpose

Knowledge of the readiness for hospital discharge can help health care professionals accurately determine the patients' discharge time. However, few studies were on the readiness for discharge and its related factors among mothers with cesarean sections. Thus, this study aims to examine the readiness for hospital discharge and its associated factors among Chinese mothers with cesarean sections.

Patients and Methods

A single-centre cross-sectional study was conducted from September 2020 to March 2021 in Guangzhou, China. Three hundred thirty-nine mothers with cesarean sections completed the questionnaires on demographic and obstetric characteristics, readiness for hospital discharge, quality for discharge teaching, parenting sense of competence, family function, and social support. Multiple linear regression analysis was used to identify independent factors influencing readiness for hospital discharge among mothers with cesarean sections.

Results

The total score of readiness for hospital discharge was 136.47 ± 25.29. The quality of discharge teaching, parenting sense of competence, number of cesareans, family function, and attending antenatal classes were independent factors influencing the readiness for hospital discharge (P < 0.05) among mothers with cesarean sections.

Conclusion

The readiness for hospital discharge of mothers with cesarean sections need to be improved. Improving the quality of discharge teaching, parenting sense of competence, and family function may help improve the readiness for hospital discharge of mothers with cesarean sections.

Psychosocial Resources Predicting Maternal and Paternal Positive Parenting and Lower Child Abuse Risk

Young children have the highest victimization rates of physical abuse in their first year of life, making up nearly half of all child abuse-related fatalities. More effective prevention is needed to reduce child victimization, yet many risk reduction models rely on problematic inclusion criteria, only intervene after maltreatment has occurred, or focus only on mothers. More proactive prevention models that promote positive parenting practices early in the transition to parenthood could be key to reducing child maltreatment. The current study sought to assess how both mothers' and fathers' psychosocial resources (e.g., emotion regulation, coping, and social support) and empathy can predict positive parenting and predict lower child abuse risk across time in a cross-lagged model. Parenting and abuse risk were examined prenatally, through the transition into parenthood, until children were 4 years old. First time mothers and their partners were recruited in the third trimester of pregnancy and assessed again when children were 6 months, 18 months, and 4 years old. Separate path models for mothers and fathers analyzed whether psychosocial resources and empathy at earlier timepoints predicted their positive parenting and lower abuse risk by the time children were age 4. Findings demonstrated that mothers' earlier empathy predicted later positive parenting and earlier positive parenting predicted later empathy. Fathers' lower prenatal abuse risk predicted greater subsequent empathy. Both mothers' and fathers' psychosocial resources and empathy at earlier timepoints predicted later positive parenting. Parents' psychosocial resources can be integral assets in positive, effective parenting approaches both concurrently and longitudinally. Mothers' and fathers' resources are an important point of intervention prior to and during the transition into parenthood to support healthier families that would confer benefits to child functioning.

Socio-demographic characteristics associated with perceived social support among parents of children aged 0-7 years: the CIKEO study

BACKGROUND

Social support has been associated with numerous positive outcomes for families' health, wellbeing and empowerment. This study examined which socio-demographic characteristics are associated with perceived social support among parents of children aged 0-7 years.

METHOD

Cross-sectional data of 1007 parents of children aged 0-7 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Social support was assessed with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to examine associations between socio-demographic characteristics and perceived social support.

RESULTS

The mean age of the participants was 34.1 years (SD = 5.1); 92.9% were mothers. The multivariable regression model showed that fathers (β: -0.15, 95% CI: - 0.22, - 0.08), parents with a low educational level (β: -0.12, 95% CI: 0.18, - 0.06), parents with a low income (β: -0.10, 95% CI: - 0.19, - 0.01), unemployed parents (β: -0.14, 95% CI: - 0.20, - 0.07), and parents of older children (β: -0.07; 95% CI: - 0.13, 0.00) perceived lower levels of social support. Interaction analyses showed that parents with a migration background and a low educational level were particularly susceptible to perceiving lower levels of support (β: -0.34, 95% CI: - 0.52, - 0.15).

CONCLUSION

Fathers, parents with a low educational level, parents with a low income, unemployed parents, parents of older children, and parents with both a migration background and a low educational level are at increased risk of perceiving lower levels of social support.

IMPLICATIONS

We recommend to develop, implement and evaluate intervention strategies to strengthen perceived social support among the abovementioned subgroups of parents, in order to improve families' health, wellbeing and empowerment.

TRIAL REGISTRATION

NTR7607 in the Netherlands trial registry.

A prospective study on the association between social support perceived by parents of children aged 1-7 years and the use of community youth health care services

Aim

This study examined the association between social support perceived by parents of children aged 1-7 years and the use of additional community youth health care services.

Methods

Data of 749 parents of children aged 1-7 years, gathered in the CIKEO cohort study in the Netherlands, were analyzed. Social support was assessed with the Multidimensional Scale of Perceived Social Support. Data on the use of additional community youth health care services during a period of 1.5 years were obtained from the electronic records of participating youth health care organizations. Multivariable logistic regression models were used to examine the association between perceived social support and the use of additional youth health care services and to explore moderation by the parent's educational level.

Results

The mean age of the responding parents was 33.9 years (SD = 5.1); 93.6% were mothers. Parents who perceived low to moderate levels of social support had 1.72 (95% CI: 1.11, 2.66) times higher odds of using one or more additional youth health care services during the study period compared to parents who perceived high levels of social support at baseline. This association was independent of predisposing factors, but not independent of need factors (p > 0.05). Furthermore, the association was moderated by the educational level of the parent (p = 0.015). Among parents with a high educational level, low to moderate levels of perceived social support at baseline were associated with 2.93 (95% CI: 1.47, 5.83) times higher odds of using one or more additional youth health care services during the study period independent of predisposing and need factors. Among parents with a low or middle educational level the association between perceived social support and use of additional youth health care services was not significant.

Conclusion

Our findings provide evidence that low to moderate levels of perceived social support are associated with a higher use of additional community youth health care services among parents of children aged 1-7 years, especially among high educated parents. Recommendations for policy and practice are provided.

Apoyo social percibido por mujeres gestantes de Santa Marta, Colombia: un análisis comparativo

Introducción: El apoyo social percibido durante la gestación es importante para la salud mental perinatal. Sin embargo, poco se conoce sobre estas variables en la población colombiana. Objetivo: Comparar el apoyo social percibido según variables sociodemográficas, ginecobstétricas y afecto positivo en mujeres gestantes de Santa Marta, Colombia. Materiales y métodos: Participaron 40 mujeres entre 19 y 41 años (M=26.48; DE=5.03), que se encontraban en su tercer trimestre de embarazo, beneficiarias de un programa de promoción de la lactancia materna exclusiva. Las participantes diligenciaron una ficha de información sociodemográfica y ginecobstétrica, la Escala Multidimensional de Apoyo Social Percibido (α=0.88) y una subescala de la Escala de Afectos Positivos y Negativos (α=0.82). Se aplicó la prueba U de Mann-Whitney para los análisis estadísticos comparativos y se siguieron los lineamientos éticos en investigación con humanos. Resultados: 67% de las participantes fueron de estrato socioeconómico bajo, 87.5% tenía pareja, 67.5% contaba con estudios superiores, 42.5% tenía trabajo y 47.5% eran madres primerizas. Las mujeres de estrato socioeconómico alto percibieron mayor apoyo social por parte de sus amigos (p=0.01). El apoyo social familiar fue significativamente más alto en las madres primerizas (p=0.01) y en las que reportaron mayor afecto positivo (p=0.03). Por último, el apoyo social por parte de personas significativas fue mayor cuando era el primer embarazo de la mujer (p=0.02). Conclusión: Se encontraron diferencias significativas en algunas dimensiones del apoyo social percibido según el estrato socioeconómico, ser madre primeriza y el afecto positivo. Se recomienda realizar otros estudios con mayor tamaño muestral. Como citar este artículo: Thomas-Hilarión Whitne Dayana, Fuentes-Vanegas Laura Vanessa, Gallo-Barrera Yeison David, Ramos-De la Cruz Ediltrudis. Apoyo social percibido por mujeres gestantes de Santa Marta, Colombia: un análisis comparativo. Revista Cuidarte. 2022;13(3):e2448. http://dx.doi.org/10.15649/cuidarte.2448      

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.

Ten years later: Satisfaction with intimate relationships and parenthood of young people aging out of residential care

BACKGROUND

Care leavers, young people who have aged out of residential or foster care, experience many challenges during their transition to adulthood. However, there is relatively little research on care leavers' intimate relationships. Their parenthood has been explored to a greater extent, but mostly qualitatively.

OBJECTIVE

This study focused on Israeli care leavers a decade after leaving care and explored various factors associated with satisfaction with both intimate relationships and parenthood.

METHODS

One-hundred-and-fifty-two young people participated in the study ten years after leaving care. Toward the end of their 20s, 74.3% were either married or had stable intimate relationships, and 40.1% were parents. To assess satisfaction with intimate relationships and parenthood, two hierarchical regressions were conducted that examined the cumulative contribution of background factors (care variables and traumatic life events), personal characteristics (self-esteem, mental distress, and alcohol use) and social support.

RESULTS

Satisfaction with intimate relationships was associated with higher income, fewer traumatic life events, and higher self-esteem. Gender moderated the association of traumatic life events with satisfaction with intimate relationships. Satisfaction with parenthood was associated with fewer traumatic events throughout care leavers' lives; it was also associated with lower levels of mental distress and alcohol use and with higher levels of satisfaction with intimate relationships. Gender moderated the association of mental distress with satisfaction with parenthood.

CONCLUSIONS

Ten years after leaving care, care leavers' backgrounds (i.e., their traumatic life events) were strongly associated with their situation as adults. Other risk factors such as alcohol use and mental distress were especially relevant to care leavers' satisfaction as parents, demanding longitudinal interventions. Further exploration of the role of gender in satisfaction with intimate relationships and parenthood is needed.

Marital Satisfaction and Perceived Family Support in Families of Children with Autistic Spectrum Disorder: Dyadic Analysis

Background: Raising children with autism spectrum disorder (ASD) causes tremendous stress for parents that may lead to marital conflict and relationship dissatisfaction. Many factors are associated with parent relationships including severity of autistic behaviors and social support. This study aimed to investigate whether severity of autistic behaviors, perceived family support, and complementarity of interpersonal styles between husbands and wives predicted couple satisfaction among the parents of children with ASD. Method: Seven hundred ninety-seven parent dyads of children aged 7–14 years old with ASD participated in the study. Measurements used included couple satisfaction index, perceived family support using the Multidimensional Scale of Perceived Social Support, inter-personal style using the inventory of interpersonal problems, the ABC autism checklists as well as sociodemographic and related factors. The Actor Partner Interdependence Model estimated by multilevel modeling was used for analysis. Results: Perceived family support was relevant in married couples regarding their marital relationship, but the effects on husbands and wives differed. Husbands’ relationship satisfaction was predicted by how they perceived being supported by family. The severity of autistic behaviors predicted relationship satisfaction but only actor effect. Negative prediction of interpersonal complementarity on couple satisfaction was observed. In addition, time spent on raising children had a negative impact on the quality of the relationship. Partner effect of time spent was observed among women. Conclusion: Dyadic analysis using an actor–partner independence model confirmed perception of family support predicts relationship satisfaction among parents of children with ASD in addition to the severity of autistic behaviors and time spent caring for children. Complementarity of individual interpersonal style had no effect on couple satisfaction. This research suggests implications for interventions regarding building skills that elicit support from family members.

Parenting Stress During COVID-19 Lockdown: Correlates with Family and Child Factors

In response to the COVID-19, a 76-day city-wide strict lockdown was imposed in Wuhan, China. This study aimed to document the family’s psychological status during the lockdown and test the role of family functioning, children’s mental health, child-parent relationship as well as parenting time during pandemic on parenting stress. The results showed that nearly 18% of the children exhibited clinical-level mental health problems. The children’s mental health and child-parent conflict fully mediated general family functioning’s impact on parenting stress. The change in childcaring time moderated the effect of the children’s mental health problems and child-parent conflict on parenting stress. Findings indicated that, during COVID-19 lockdown, children’s mental health and child-parent conflict contributed to parenting stress. More childrearing time would reduce the impact of children’s mental health on parenting stress.

Socio-demographic, maternal, and infant characteristics associated with early childhood development delays among children of young mothers in Brasília, Brazil

Background

Holistic attention to adolescent health is needed to sustain the benefits of investment in early childhood development. Any such interventions must make sure to address the needs of adolescent and young adult parents. This study explored the social and demographic maternal variables associated with risk of early childhood development (ECD) delay for children of young mothers in Brazil.

Methods

Cross-sectional secondary data analysis was done using data from young mothers (aged 13–24) and their children (aged 0–2), collected from community health centers in Brasília, Brazil, between 2017–2018. The Denver Developmental Screening Test II was used to assess risk of ECD delay outcomes. Descriptive analyses were conducted across the full sample and sub-groups of adolescent (13–19) and young adult (20–24) mothers. Multivariable logistic regressions based on theory modelling approach were conducted for the full sample to examine the associations between maternal age and risk of ECD delay, adjusted for a battery of household, maternal, pregnancy, and infant variables.

Results

Risk of ECD delay was found in 17.39% (N = 76) of the children who participated (N = 437). No significant differences in risk of ECD delay were found for children of adolescent mothers compared to children of young adult mothers. Across the full sample, 60.36% (N = 236) of mothers were living in poverty, 73.17% (N = 319) had 9 or more years of education, and 86.14% (N = 373) were not working outside the home at time of data collection. Furthermore, 90.11% (N = 392) did not identify as head of their household and 73.68% (N = 322) were primiparous. Socially-mediated factors such as lower maternal educational attainment, unemployment, and lack of household support were associated with increased risk of ECD delays for children under age 2. Adjusted logistic regression identified multiparity as an independent maternal factor associated with increased risk of ECD delay (AOR = 2.51; 95% CI, 1.23–5.13).

Conclusions

Multiparity was the only independent maternal factor associated with ECD delay among children under 2 years old. Other socio-demographic factors relevant to young mothers may influence ECD delays. Ensuring sustained, concurrent attention to children’s and young parent’s developmental needs may improve multi-generational health outcomes.

Maternal self-efficacy and emotional well-being in Chilean adolescent mothers: the relationship with their children's social-emotional development

Background

Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being.

Methods

A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships.

Results

A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation.

Conclusions

The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.

The Presence of Meaning in Parenthood, Perceived Social Support, and Happiness of Mothers Living in Hong Kong: A Comparative Study on Younger and Older Mothers

This study investigates whether and how mothers’ meaning of parenthood and their perceived social support interact and are associated with their happiness. Similarities and differences in these areas between younger and older mothers are also explored. A total of 1292 Chinese mothers were recruited from different Hong Kong communities; 361 were 24 years of age and younger and were categorized as younger mothers, and 931 were older than 24 years of age and were categorized as older mothers. Multiple regression analyses were performed to discern direct and interaction effects. The results show that older mothers were happier than younger mothers and indicate that parental meaning and perceived social support had a positive effect on the happiness of both younger and older mothers. Notably, while the results reveal significant interaction effects between the meaning of parenthood and perceived social support from significant others and friends on the happiness of older mothers, these effects are not found among younger mothers. This study suggests that the social support young mothers receive from their significant others and friends does not amplify the association between their meaning of parenthood and happiness. These findings provide insights into the importance of synergizing social support and meaning-making among younger mothers.

Caregiver Social Capital and Supportive Relationships are Associated with Better Child Social-Emotional Development

This study examined how different domains of social capital and of social support among caregivers are associated with social-emotional development in children ages 4-6 and how caregiver depressive symptoms modify these associations. Using a stratified random sample of preschools, data included a cross-sectional study of 1147 child-caregiver pairs (543 girls) in a low-income municipality in Brazil. Crude and adjusted linear regression models revealed that all domains of social support and two domains of social capital were associated with less social-emotional development delay in children. Given a significant proportion of children in low- and middle-income countries do not meet developmental milestones, strengthening caregiver social capital and support in these settings may have the potential to improve child social-emotional development.

Vulnerabilities and Strengths of Pregnant Haitian Adolescents and their Families During Transition to Motherhood

BACKGROUND AND OBJECTIVE

Teenage pregnancy is considered a social and health problem because of its multifaceted consequences for pregnant teens, their family and society. The objectives of this article are 1) to describe the vulnerabilities encountered by pregnant teenagers and their relatives throughout the time of transition from pregnancy to motherhood and 2) to identify the strengths that are mobilized by these individuals during this period.

METHODS

The qualitative data collection and analysis methodology was based on John Dewey's Social Inquiry. Participants were recruited from nine health institutions in the North and Northeast departments of Haiti. Data were collected through individual semi-structured interviews, which were audiotaped, transcribed, and exported for coding after verification and validation. The data were analyzed using the thematic analysis of Paillé and Mucchielli.

RESULTS

A total of 50 interviews were conducted with 33 pregnant teenagers (aged 14 - 19 years) and 17 relatives. This research identified vulnerabilities and strengths experienced by the adolescent participants and their relatives during the motherhood transition.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

The experiences, challenges, and vulnerabilities associated with the teenage-motherhood transition and the needs of pregnant teens, partners, and parents were identified in this study. The results indicated that more attention must be given to psychosocial and material support programs for pregnant adolescents and their loved ones during the motherhood transition and after-childbirth period. When logically and effectively implemented, the study results and suggested recommendations can be used as tools for reaching local and global public-health initiatives in Haiti.

Relationship between social support and parenting sense of competence in puerperal women: Multiple mediators of resilience and postpartum depression

BACKGROUND

Maternal role competence is an important marker of achievement in the role of the mother, but parenting sense of competence (PSOC) among puerperal women is not high. Psychosocial factors, particularly social support, postnatal depression and resilience, have been identified as significant predictors of maternal role competence. However, information is limited regarding the mechanisms through which these psychosocial factors affect maternal role competence.

OBJECTIVE

To evaluate the multiple mediators of resilience and postpartum depression (PPD) in the relationship between social support and PSOC in puerperal women.

METHODS

A cross-sectional study was performed in a tertiary general hospital in Yangzhou, China. A total of 234 puerperal women at 6-8 weeks after birth completed the socio-demographic questionnaires, Social Support Rating Scale, Connor-Davidson Resilience Scale, Edinburgh Postnatal Depression Scale, and PSOC Scale.

RESULTS

Resilience and PPD mediated the relationship between social support and PSOC. The mediation effect of resilience and PPD and the total mediation effect were significant, individually accounting for 22.96, 21.70, and 44.65%, respectively, of the total effect. Moreover, pairwise contrast between the two indirect effects was not significant. The difference between the two pathways suggests that resilience and PPD play different roles in the relationship between social support and PSOC.

CONCLUSIONS

This study showed that social support may exert its effects on PSOC in puerperal women with multiple mediators of resilience and PPD. This therefore highlights potential intervention targets to improve PSOC.

Parental, child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0-7 years old: the CIKEO study

BACKGROUND

A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE.

OBJECTIVE

To investigate factors associated with PSE in parents of children aged 0-7 years old, and to explore whether the associations were different between mothers and fathers.

METHODS

We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE.

RESULTS

Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (- 2.05, 0.87), and 0.23 (- 0.46, 3.29), respectively.

CONCLUSIONS

A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care.

TRIAL REGISTRATION

Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

Parental Worrying, Family Functioning, and Quality of Life During the COVID-19 Pandemic

BACKGROUND

The 2019 novel coronavirus pandemic has affected many aspects of American life with reported increases in parental anxiety and adverse health outcomes among children. However, it is unknown how family functioning and parental anxiety may be associated with child health outcomes during this pandemic.

OBJECTIVES

Explore associations among parental worrying, family functioning, and the health-related quality of life (HRQoL) of middle and high school-aged children in the United States during the 2019 novel coronavirus pandemic.

METHODS

Ninety-three parent-child dyads were recruited via snowball sampling through WhatsApp messenger from December 2020 to February 2021 in this exploratory cross-sectional study. Each family completed a series of self-report measures, including the General Functioning Scale-Family Assessment Device and Worry Domaine Questionnaire for parent respondents and the KIDSCREEN-10 for child respondents. A hierarchical regression analysis was performed to examine effects of parental worrying and family functioning on the HRQoL of middle and high school-aged children.

RESULTS

Lower levels of parental worrying and better family functioning predicted better child HRQoL, while parental worrying was associated with worse family functioning. The relationship between family functioning and child HRQoL did not differ by levels of parental worrying. Increased child age and parental education were associated with worse child HRQoL.

DISCUSSION

The high socioeconomic status sample reported healthy family functioning during the 2019 novel coronavirus pandemic. Family functioning appears to improve child HRQoL consistently, even as parental worrying increases or decreases, although increased worrying would likely decrease family functioning and child HRQoL. The inverse relationships of parental educational attainment with family functioning and child HRQoL are surprising; they may be due to pandemic circumstances and the nature of the sample being high socioeconomic status families with middle and high school-aged children.

Feinberg M. “A Little Bit Closer”: A Mixed Method Analysis of the Effect of the COVID-19 Pandemic on the Lives of Adolescent Parents

Using a Family Stress Model framework, we used quantitative and qualitative methods to investigate the impact of the pandemic on Latinx pregnant and parenting adolescents and their families. Participants were 406 adolescents (ages 14–19) in the southwestern U.S. who participated in a school-based relationship education program for pregnant and parenting adolescents. In the quantitative analysis, we compared self-reported mental health (depressive symptoms, worry, parental stress), coparental relationships (conflict and communication), and parenting of adolescents who participated prior to the pandemic ( N = 357; 83.6% female; 84.7% Latinx) with those who participated during the pandemic ( N = 49; 74.6% female; 87.8% Latinx). Unexpectedly, the pandemic-period cohort reported fewer depressive symptoms, less parental stress, more frequent coparental communication, and more positive coparental communication and conflict management than the pre-pandemic cohort. For the qualitative analysis, we conducted focus groups and individual interviews with 21 adolescent parents (95.2% female; 90.5% Latinx) from the pandemic-period cohort and analyzed the data using thematic analysis. Participants reported many negative effects of the pandemic including increased economic and health stress, yet also discussed reduced pressure with school and more time with family members. These findings have important implications for enhancing the well-being of adolescent parents and their children after the pandemic.

Direct and Indirect Associations between Family Residential Mobility, Parent Functioning, and Adolescent Behavioral Health

Residential mobility and caregiver social support are two key factors influencing adolescents' and their caregivers' health status. However, few studies have examined whether these factors vary across developmental periods. The present study therefore adopted a life course perspective to investigate the longitudinal effects of residential mobility and caregiver social support on a range of individual health outcomes (i.e., caregiver depression, adolescent internalizing problems, and adolescent externalizing problems) among families exposed to disadvantaged social and economic conditions. Data were obtained from the Longitudinal Studies in Child Abuse and Neglect, and 425 children and their caregivers who completed the age 12, 14, 16, and 18 interviews were included in this study. Structural equation modeling was conducted to test the measurement and structural models. The results showed that greater residential mobility was significantly associated with higher levels of caregiver depression, which in turn led to more adolescent internalizing and externalizing problems. Alternatively, higher levels of caregiver social support mitigated the levels of caregiver depression, which in turn resulted in fewer adolescent internalizing and externalizing problems. Highly mobile children and their caregivers were found to be vulnerable to several negative health outcomes and in high need of mental and behavioral health support and services. These findings inform important policy and practice implications on social support for mobile caregivers to address their children's behavioral problems.

Psychosocial factors and health practices in pregnancy: A cross-sectional study

AIM

The aim of this study was to investigate psychosocial, demographic and obstetric factors that affect health practices in pregnancy.

METHODS

This cross-sectional study was conducted with pregnant women selected by using random sampling in a public hospital in Turkey. The pregnant women (n = 383) completed the Health Practices Questionnaire in Pregnancy, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Multidimensional Scale of Perceived Social Support. Multiple linear regression was used to examine predictors of participation in health practices. The variables were subjected to multiple linear regression analysis to estimate the effect of each independent variable (depression, anxiety, perceived social support, age, educational level, gestational week and parity) on the dependent variable (health practices).

RESULTS

Depression and anxiety were not significantly related to gestational health practices. The multiple linear regression model showed that inadequate social support, low education level, early gestational week and high parity were significant predictors of nonengagement in favourable health practices during pregnancy.

CONCLUSIONS

Pregnant women with inadequate social support and specific demographic and obstetric characteristics are less likely to participate in gestational health practices. This study suggests that more attention should be paid to these groups to improve the health practices of pregnant women.

Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model

Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.

Effectiveness of psychosocial support provided by midwives and family on preventing postpartum depression among first-time adolescent mothers at 3-month follow-up: A randomised controlled trial

AIMS AND OBJECTIVES

To evaluate the effectiveness of a midwife-family provided social support programme (MFPSS programme) for first-time adolescent mothers on preventing postpartum depression (PPD) at 3-month postpartum.

BACKGROUND

Adolescent mothers with lack of social support are a high-risk group for increasing the development of PPD. Interventions designed to promote social support and provided to mothers following childbirth have a more effective role in preventing PPD.

DESIGN

The Consolidated Standards of Reporting Trials (CONSORT) guidelines for a single-blinded randomised controlled trial were conducted.

METHODS

Forty-two adolescent mothers were randomly assigned to 4-week MFPSS programme plus routine care (n = 21) and routine care only (n = 21). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), rates and severity at baseline, post-test, 6-week and 3-month postpartum follow-ups. Repeated measures ANOVA and Cohen's d were used to analyse the data.

RESULTS

At the last follow-up, 20 (95.24%) participants remained in each group. Data were analysed based on 40 adolescent mothers. After the intervention, the mean EPDS scores in the intervention group were significantly lower than the same scores in the control group at post-test, 6-week and 3-month postpartum follow-ups. Similarly, the rates and severity of PPD in the intervention group were also lower than the control group at post-test, 6-week and 3-month postpartum follow-ups.

CONCLUSION

Psychosocial support interventions designed to incorporate support from midwives and family members is an effective intervention for preventing PPD in first-time adolescent mothers and the preventive effect is sustained for up to 3-month postpartum.

RELEVANCE TO CLINICAL PRACTICE

Midwives or nurses could apply the MFPSS programme to nursing care for adolescent mothers and family members by adding health information about PPD and promoting social support.

CLINICAL TRIAL REGISTRATION

The trial was registered with Thai Clinical Trials Registry (TCTR). The trial registration number is TCTR 20190206004.

The Influence of Four Constructs of Social Support on Pregnancy Experiences in Group Prenatal Care

Objective: This study aimed to identify the influence of the four constructs of social support on positive pregnancy experiences in CenteringPregnancy, a group prenatal care (GPNC) model. Methods: Using a qualitative descriptive design, semi-structured interviews were conducted with 11 women who had participated in at least 6 of 10 GPNC sessions at a family practice medicine residency. Participants were asked to describe their experiences in GPNC. Results: Using a standard content analysis, four constructs of social support (emotional, informational, instrumental, and appraisal) were identified through three major themes: (1) informational support, offered by peers in GPNC settings, promotes learning and prepares women for motherhood; (2) emotional and appraisal support, offered by peers in GPNC, improves emotional well-being and helps women build lasting, supportive connections with peers, and (3) emotional, informational, instrumental, and appraisal support work in tandem to create positive relationships between women and health care providers. Conclusion: Social support provided a means to a positive prenatal health care experience that facilitated the attainment of new knowledge and the formation of positive relationships with health care providers and peers. The findings of this study can provide health care providers with a framework to examine and enhance their practice and care of women in the perinatal period.

A Strategic Program for Risk Assessment and Intervention to Mitigate Environmental Stressor-Related Adverse Pregnancy Outcomes in the Indian Population

The Problem: Global environmental stressors of human health include, but are not limited to, conflict, migration, war, natural disasters, climate change, pollution, trauma, and pandemics. In combination with other factors, these stressors influence physical and mental as well as reproductive health. Maternal stress is a known factor for adverse pregnancy outcomes such as preterm birth (PTB); however, environmental stressors are less well-understood in this context and the problem is relatively under-researched. According to the WHO, major Indian cities including New Delhi are among the world's 20 most polluted cities. It is known that maternal exposure to environmental pollution increases the risk of premature births and other adverse pregnancy outcomes which is evident in this population.

Response to the Problem: Considering the seriousness of this problem, an international and interdisciplinary group of researchers, physicians, and organizations dedicated to the welfare of women at risk of adverse pregnancy outcomes launched an international program named Optimal Pregnancy Environment Risk Assessment (OPERA). The program aims to discover and disseminate inexpensive, accessible tools to diagnose women at risk for PTB and other adverse pregnancy outcomes due to risky environmental factors as early as possible and to promote effective interventions to mitigate these risks. OPERA has been supported by the Worldwide Universities Network, World Health Organization (WHO) and March of Dimes USA.

Addressing the Problem: This review article addresses the influence of environmental stressors on maternal-fetal health focusing on India as a model population and describes the role of OPERA in helping local practitioners by sharing with them the latest risk prediction and mitigation tools. The consequences of these environmental stressors can be partially mitigated by experience-based interventions that build resilience and break the cycle of inter- and-transgenerational transmission. The shared knowledge and experience from this collaboration are intended to guide and facilitate efforts at the local level in India and other LMIC to develop strategies appropriate for the jurisdiction for improving pregnancy outcomes in vulnerable populations.

Engaging Expectant and Parenting Adolescents: Lessons from the Massachusetts Pregnant and Parenting Teen Initiative

INTRODUCTION

Programs supporting adolescent parents have been shown to increase socio-economic opportunities and promote healthy child development for young families, but retaining young parents is challenging. The Massachusetts Pregnant and Parenting Teen Initiative (MPPTI) offers case management and linkages to community and clinical services to young families. We examine engagement strategies identified by MPPTI participants and staff members in relation to participant retention by program site to identify potential strategies for increasing program engagement.

METHODS

We employed a mixed-methods approach incorporating quantitative data on program participant characteristics and program retention by site with qualitative data from staff and participant interviews and focus groups.

RESULTS

Key program engagement strategies identified by both MPPTI staff and youth participants were social-emotional supports, staffing model, and concrete supports. We found significant differences in program retention by site; the two sites with the highest levels of program retention offered all engagement strategies identified.

DISCUSSION

Quantitative data on program retention coupled with qualitative data from staff and youth interviews suggests that in our program, there may be an association between the engagement strategies identified and levels of program retention.

Care of Adolescent Parents and Their Children

Teen pregnancy and parenting remain important public health issues in the United States and around the world. A significant proportion of teen parents reside with their families of origin, which may positively or negatively affect the family structure. Teen parents, defined as those 15 to 19 years of age, are at high risk for repeat births. Pediatricians can play an important role in the care of adolescent parents and their children. This clinical report updates a previous report on the care of adolescent parents and their children and addresses clinical management specific to this population, including updates on breastfeeding, prenatal management, and adjustments to parenthood. Challenges unique to teen parents and their children are reviewed, along with suggestions for the pediatrician on models for intervention and care.

Pediatric and adolescent gynecology through a global lens

Girls and adolescents, aged 0-19 years make up almost 30% of the world's female population yet their specific healthcare needs often slip between the gaps of pediatrics and adult women's health. Pediatric and adolescent gynecology is the clinical field that endeavors to address the reproductive health needs of this age group. The environment and psychosocial well-being, social determinants of health, have direct bearing on reproductive health, affecting menstrual cycles, menstrual hygiene, and risks for unintended pregnancy and sexually transmitted infections. This narrative review will highlight common gynecologic conditions of adolescents, especially where diagnosis and management are distinct from adult women. It will also present preventive health strategies to improve reproductive health through vaccination, improved access to hygiene supplies and contraception.

Factors associated with parenting self-efficacy: A systematic review

Aims

To provide an overview of the parental, child, and socio‐contextual factors related to general parenting self‐efficacy (PSE) in the general population.

Design

Systematic review.

Data sources

Medline Ovid, Web of Science, Embase, and PsycINFO Ovid were systematically searched for studies published between January 1980‐June 2020.

Review Methods

Studies were included if they described associations between factor(s) and PSE among parents of children aged 0–18 years old in the general population, and published in an English language peer‐reviewed journal. Studies with participants from specific populations, studies describing the development of instruments for PSE, qualitative studies, reviews, theses, conference papers and book chapters were excluded. Belsky's process model of parenting guided the data synthesis.

Results

Of 3,819 articles, 30 articles met the inclusion criteria. Eighty‐nine factors were identified. There was evidence of associations between child temperament, maternal parenting satisfaction, parenting stress, maternal depression, household income, perceived social support and PSE. Evidence was inconsistent for an association of educational level, parity, number of children in the household and PSE in mothers. There was no evidence of an association for child gender, age, marital status and PSE in both mothers and fathers; ethnicity, age, employment status in mothers; household income in fathers; and educational level, parenting fatigue in parents.

Conclusion

A range of factors studied in relation to PSE was identified in this systematic review. However, the majority of the factors was reported by one or two studies often implementing a cross‐sectional design.

Impact

There is some evidence for an association between some potentially modifiable factors and PSE in the general population, this information may be used by health and social professionals supporting child health and well‐being. Future longitudinal studies are recommended to study parental, child and socio‐contextual factors associated with PSE to inform the development of intervention strategies.

Social networking sites: Can midwives and nurses working with adolescent mothers harness their potential value?

AIM

This paper aims to discuss social networking sites as potentially salutogenic, culturally relevant extensions to maternity care provision for adolescent mothers.

BACKGROUND

Studies report that online networking may enhance social capital, a concept linked to enhanced well-being, particularly for marginalized individuals. Improving outcomes for adolescent mothers is an ongoing global strategy; thus, this paper has relevance for all professionals involved in their care.

DESIGN

This is a discussion paper.

DATA SOURCES

This paper draws on the authors' research and is supported by literature and theory. Key terms and Boolean operators were used to identifiy English-language papers published in January 1995 to January 2019 in nine databases and Google Scholar databases.

IMPLICATIONS FOR NURSING

Despite limited evidence specific to adolescent mothers, contextual studies suggest that social networking sites may enhance well-being. Nurses and midwives need to understand adolescent mothers' use of online networks to aid development of innovative, health-enhancing care strategies using adolescent-familiar modalities.

CONCLUSION

This paper highlights the need for further research regarding the value of professional engagement in online networks to enhance an adolescent's transition to motherhood.

Maternal-child nursing care for adolescent mothers: health education

OBJECTIVES

to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care.

METHODS

this is an action research based on diagnosis, intervention and apprehension stages.

RESULTS

the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game's first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version.

FINAL CONSIDERATIONS

the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.

Disentangling levels of mother-infant neuroendocrine attunement and longitudinal relations with maternal risk and protective factors

Scientific understanding of mother-infant HPA axis attunement has been limited by discrepant methods for assessing attunement that often conflate different levels of association. We sought to refine the conceptualization of attunement by investigating whether mother-infant cortisol attunement exists as coupling of response trajectories within an acute stress episode, separate from shared developmental patterns and/or overall dyadic similarity in cortisol levels, and whether the degree of attunement depends on within- or between-dyad differences in maternal risk and protective factors. We examined these questions using a longitudinal study with mother/infant salivary cortisol during dyadic stressors at 6, 12, and 18 months postnatal. A three-level hierarchical linear model showed that sample-wide associations between mother and infant cortisol were not significant at any level, suggesting normative lack of attunement; however, there was significant variability in degree of attunement across dyads. Concurrent levels of family resources and social support satisfaction predicted lower mother-infant cortisol attunement within the session, and overall (mean) parenting stress predicted the opposite. Follow-up analyses showed this was typically due to an increase in infants' (but not their mothers') within-session cortisol response slopes with increasing support and decreasing stress. Implications for the role of mother-infant cortisol attunement in intergenerational stress transmission are discussed.

Measurement of Parenting Self-efficacy Among Female HIV-Affected Caregivers in Uganda

OBJECTIVES

Parenting self-efficacy has been associated with positive parenting behaviors, fewer parental mental health problems, less family dysfunction, and better child development outcomes. The parenting sense of competence (PSOC) scale is commonly used to measure parenting self-efficacy in high-resource settings. This study sought to examine the factor structure, internal consistency, and convergent construct validity of the PSOC in a sample of predominantly HIV-infected women in Uganda.

METHODS

Using data from 155 HIV-affected caregivers who participated in a randomized controlled trial of a parenting intervention, two and three factor models of a 16-item translated version of the PSOC were tested using confirmatory factor analysis. Multivariable regression models were used to examine relationships between parenting confidence (operationalized using the best-fitting PSOC model), caregiver mental health symptoms (depression and anxiety), social support, family dysfunction, and family wealth, after adjusting for covariates.

RESULTS

Neither the two- nor three-factor models of the PSOC demonstrated adequate model fit; however, adequate model fit was demonstrated for a one-factor model that included only items from the PSOC efficacy subscale. Cronbach's alpha was 0.73 for this subscale. Correlates of parenting self-efficacy in this sample included caregiver depression, family dysfunction, and family wealth, but not caregiver anxiety or social support.

CONCLUSIONS FOR PRACTICE

These findings lend support for future use of the PSOC efficacy subscale among HIV-affected caregivers of children in low-resource settings such as rural Uganda.