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Shapiro CJ, Hill-Chapman C, Williams S. Mandated Parent Education: Applications, Impacts, and Future Directions. Clin Child Fam Psychol Rev 2024; 27:300-316. [PMID: 38761324 PMCID: PMC11222221 DOI: 10.1007/s10567-024-00488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/20/2024]
Abstract
Mandated participation in parent education programs is a common practice across the United States for families who are undergoing divorce or who are involved in the child welfare or juvenile justice systems. Mandates to participate in parenting programs create substantial challenges for families, service providers, and service systems. Furthermore, the type and quality of the parenting services accessed vary widely, and their impacts need to be better understood. To address this need, an overview of the current state of the empirical literature on the impacts and outcomes of mandated parenting interventions for divorce and in child welfare and juvenile justice settings is provided, and suggestions to the field are offered to refine research related to mandated parenting programs. Given the challenges that mandated parenting programs pose, an alternative approach that views parenting through a public health lens is highlighted to build on the growing body of research on the impacts of population-wide applications of parenting support programs, and as a possible way to decrease the number of parents who are required to attend parenting programs. Opportunities to advance universal parenting support within a range of community settings, including primary care, early childhood education, and community mental health systems are offered. Gaps in knowledge regarding mechanisms of action of universal supports and impacts on the number of parents mandated to treatment are highlighted, and future directions for research in this area are suggested.
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Affiliation(s)
- Cheri J Shapiro
- Institute for Families in Society, College of Social Work, University of South Carolina, 1600 Hampton St., Suite 507, Columbia, SC, 29208, USA.
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Vallejo-Slocker L, Idoiaga-Mondragon N, Axpe I, Willi R, Guerra-Rodríguez M, Montserrat C, Del Valle JF. Systematic Review of the Evaluation of Foster Care Programs. PSYCHOSOCIAL INTERVENTION = INTERVENCION PSICOSOCIAL 2024; 33:1-14. [PMID: 38313691 PMCID: PMC10835188 DOI: 10.5093/pi2023a14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/23/2023] [Indexed: 02/06/2024]
Abstract
OBJETIVE The aim of this study was to conduct an exhaustive synthesis to determine which instruments and variables are most appropriate to evaluate foster care programs (foster, kinship, and professional families). This evaluation includes the children, their foster families, their families of origin, professionals, and foster care technicians. METHOD The systematic review included randomized, quasi-randomized, longitudinal, and control group studies aimed at evaluating foster care interventions. RESULTS A total of 86 studies, 138 assessment instruments, 18 constructs, and 73 independent research teams were identified. CONCLUSIONS (1) although the object of the evaluations was the children, the informants were usually the people in charge of their care; therefore, effort should be made to involve the children in a more participatory way; (2) psychosocial functioning, behavior, and parenting are transversal elements in most evaluations, while quality of life and coping are not sufficiently well incorporated; (3) practical instruments (brief and easy to apply and correct) that are widely used and carry scientific guarantees should be prioritized to ensure the comparability and reliability of the conclusions; and (4) progress should be made in the study of evaluation models for all forms of foster care, including foster, extended, and specialized families.
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Affiliation(s)
| | - Nahia Idoiaga-Mondragon
- University of the Basque Country Leioa Spain University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Inge Axpe
- University of the Basque Country Leioa Spain University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Rosalind Willi
- SOS Children's Villages International Innsbruck Austria SOS Children's Villages International, Innsbruck, Austria
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Tiberio SS, Pears KC, Buchanan R, Chamberlain P, Leve LD, Price JM, Hussong AM. An Integrative Data Analysis of Main and Moderated Crossover Effects of Parent-Mediated Interventions on Depression and Anxiety Symptoms in Youth in Foster Care. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1547-1557. [PMID: 36930405 DOI: 10.1007/s11121-023-01524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Without preventative intervention, youth with a history of foster care (FC) involvement have a high likelihood of developing depression and anxiety (DA) symptoms. The current study used integrative data analysis to harmonize data across four foster and kinship parent-mediated interventions (and seven randomized control trials) designed to reduce youth externalizing and other problem behaviors to determine if, and for how long, these interventions may have crossover effects on youth DA symptoms. Moderation of intervention effects by youth biological sex, developmental period, number of prior placements, and race/ethnicity was also examined. Youth (N = 1891; 59% female; ages 4 to 18 years) behaviors were assessed via the Child Behavior Checklist, Parent Daily Report, and Eyberg Child Behavior Inventory at baseline, the end of the interventions (4-6 months post baseline), and two follow-up assessments (9-12 months and 18-24 months post baseline), yielding 4830 total youth-by-time assessments. The interventions were effective at reducing DA symptoms at the end of the interventions; however, effects were only sustained for one program at the follow-up assessments. No moderation effects were found. The current study indicates that parent-mediated interventions implemented during childhood or adolescence aimed at reducing externalizing and other problem behaviors had crossover effects on youth DA symptoms at the end of the interventions. Such intervention effects were sustained 12 and 24 months later only for the most at-risk youth involved in the most intensive intervention.
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Affiliation(s)
- Stacey S Tiberio
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA.
| | - Katherine C Pears
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Rohanna Buchanan
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Patricia Chamberlain
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - Joseph M Price
- Department of Psychology, San Diego State University, San Diego, USA
| | - Andrea M Hussong
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, USA
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Evans R, MacDonald S, Trubey R, Noyes J, Robling M, Willis S, Boffey M, Wooders C, Vinnicombe S, Melendez-Torres GJ. Interventions targeting the mental health and wellbeing of care-experienced children and young people in higher-income countries: Evidence map and systematic review. Syst Rev 2023; 12:111. [PMID: 37393358 PMCID: PMC10315047 DOI: 10.1186/s13643-023-02260-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/26/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The mental health and wellbeing of care-experienced children and young people (i.e. foster care, kinship care, residential care) is poorer than non-care-experienced populations. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise the international evidence base for interventions targeting subjective wellbeing, mental health and suicide amongst care-experienced young people aged ≤ 25 years. METHODS For the first phase of the review, we constructed an evidence map identifying key clusters and gaps in interventions and evaluations. Studies were identified through 16 electronic databases and 22 health and social care websites, in addition to expert recommendations, citation tracking and screening of relevant systematic reviews. We charted interventions and evaluations with a summary narrative, tables and infographics. RESULTS In total, 64 interventions with 124 associated study reports were eligible. The majority of study reports were from the USA (n = 77). Interventions primarily targeted children and young people's skills and competencies (n = 9 interventions), the parental functioning and practices of carers (n = 26), or a combination of the two (n = 15). While theoretically under-specified, interventions were largely informed by theories of Attachment, Positive Youth Development, and Social Learning Theory. Current evaluations prioritised outcomes (n = 86) and processes (n = 50), with a paucity of study reports including theoretical descriptions (n = 24) or economic evaluations (n = 1). Interventions most frequently targeted outcomes related to mental, behavioural or neurodevelopmental disorders, notably total social, emotional and behavioural problems (n = 48 interventions) and externalising problem behaviours (n = 26). There were a limited number of interventions targeting subjective wellbeing or suicide-related outcomes. CONCLUSIONS Future intervention development might focus on structural-level intervention theories and components, and target outcomes related to subjective wellbeing and suicide. In accordance with current methodological guidance for intervention development and evaluation, research needs to integrate theoretical, outcome, process and economic evaluation in order to strengthen the evidence base. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020177478.
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Affiliation(s)
- Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Sarah MacDonald
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Rob Trubey
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Simone Willis
- Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
| | - Maria Boffey
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | | | - Soo Vinnicombe
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
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Salisbury MR, Roos LE, Horn SR, Peake SJ, Fisher PA. The Effectiveness of KEEP for Families of Children with Developmental Delays: Integrating FIND Video Coaching into Parent Management Training-Oregon Model: a Randomized Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1029-1040. [PMID: 35107694 DOI: 10.1007/s11121-022-01344-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/26/2022]
Abstract
Children with developmental delays or disabilities (DD) are at risk for self-regulation difficulties and behaviour problems compared to typically developing children. Intervening early is crucial to prevent long-term adjustment challenges across home and school contexts. Parenting has been identified as a malleable target of intervention for improving children's adaptive functioning across behavioural, emotional and cognitive domains. Although parent management training (PMT) is an identified best-practice, key questions remain about the critical components of interventions and how novel approaches like video feedback may offer additional benefits. Using a pre-test-post-test one group and superiority design, we evaluated the efficacy of two models of the Keeping Parents Trained and Supported (KEEP) preschool program with parent-only components among 175 families with children diagnosed or at-risk for DD. KEEP-P included core PMT (Oregon Model) methods and KEEP-V integrated KEEP with Filming Interactions to Nurture Development video coaching methods for enhancing developmentally supportive interactions. Intervention outcomes on children's behaviour problems and executive functioning, parenting stress and parent-child relationship quality were compared between groups. Both groups demonstrated significant reductions over time in child behavioural problems, developmental problems and parenting stress. Significant improvements were observed in children's executive functioning, parents' sense of competence and mindfulness in parenting. Group differences were observed in parent's sense of competence, with individuals receiving KEEP-P displaying greater increases over time. Higher intervention dosage predicted a greater reduction in stressful child behaviours and greater improvements in children's inhibitory control.
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Affiliation(s)
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Sarah R Horn
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Shannon J Peake
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Philip A Fisher
- Department of Psychology, University of Oregon, Eugene, OR, USA
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Witte AL, Schumacher RE, Sheridan SM. The Effectiveness of Technology-Delivered Conjoint Behavioral Consultation: Addressing Rural Student and Family Needs. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2022. [DOI: 10.1080/10474412.2022.2083624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wu Q, Krysik J, Thornton A. Black Kin Caregivers: Acceptability and Cultural Adaptation of the Family Check-Up/Everyday Parenting Program. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 39:607-618. [PMID: 35400806 PMCID: PMC8976461 DOI: 10.1007/s10560-022-00841-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
Black children join kinship care disproportionately and black kin caregivers often face financial, housing, mental health, and parenting challenges when caring for relative children. Few interventions have been developed specifically for kin caregivers, let alone Black kin caregivers. This study evaluated the initial acceptability of an evidence based parenting intervention and worked to culturally adapt it for Black kin caregivers. The intervention was delivered in a family camp format. Feedback from participant interviews were analyzed for this study. Participants felt that overall the intervention was culturally appropriate. However, they also proposed changes to the curriculum, as well as to the process and format of the intervention. This study experienced challenges in terms of participant recruitment and sample size, which was exacerbated by COVID-19-related safety concerns. Future steps regarding recruitment, content, and format are discussed. Implications for child welfare practice, policy, and research are also provided.
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Affiliation(s)
- Qi Wu
- School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004-0689 USA
| | - Judy Krysik
- School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004-0689 USA
| | - Anthony Thornton
- School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004-0689 USA
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Bourion-Bédès S, Bisch M, Baumann C. Factors associated with family involvement in a family-centered care program among incarcerated French adolescents with conduct disorder. Int J Prison Health 2022; 19:220-229. [PMID: 35150213 DOI: 10.1108/ijph-09-2021-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to identify the patient characteristics that may influence family involvement in a family-centered care program during detention. DESIGN/METHODOLOGY/APPROACH Little is known about the needs of incarcerated adolescents and their families. This exploratory study used a cross-sectional design to collect data from incarcerated adolescents with conduct disorder followed in a French outpatient psychiatric department. Logistic regression models were used to identify the sociodemographic, clinical and family characteristics of these incarcerated adolescents that could predict family involvement in their care. FINDINGS Among 44 adolescents with conduct disorder, the probability of family involvement during the adolescent's detention was 9.6 times greater (95% CI 1.2-14.4, p = 0.03) for adolescents with no than for those with cannabis substance use disorder, and family involvement decreased with the age of the adolescent (OR = 0.22, 95% CI 0.1-0.9, p = 0.04). RESEARCH LIMITATIONS/IMPLICATIONS Increased knowledge of the characteristics of these adolescents and their families is needed to develop programs that will increase family interventions by specialty treatment services during detention. ORIGINALITY/VALUE No study has yet been published on French incarcerated adolescents with conduct disorder. As conduct disorder is one of the most important mental health disorders among delinquent adolescents, this study provides knowledge about these adolescents and the need to involve their parents in their care to prevent the further escalation of problem behaviors.
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Affiliation(s)
- Stéphanie Bourion-Bédès
- Centre Hospitalier de Versailles, Le Chesnay, France and EA4360 APEMAC, University of Lorraine, Nancy, France
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Somaraki M, Ek A, Eli K, Ljung S, Mildton V, Sandvik P, Nowicka P. Parenting and childhood obesity: Validation of a new questionnaire and evaluation of treatment effects during the preschool years. PLoS One 2021; 16:e0257187. [PMID: 34555050 PMCID: PMC8459975 DOI: 10.1371/journal.pone.0257187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives Parenting is an integral component of obesity treatment in early childhood. However, the link between specific parenting practices and treatment effectiveness remains unclear. This paper introduces and validates a new parenting questionnaire and evaluates mothers’ and fathers’ parenting practices in relation to child weight status during a 12-month childhood obesity treatment trial. Methods First, a merged school/clinical sample (n = 558, 82% mothers) was used for the factorial and construct validation of the new parenting questionnaire. Second, changes in parenting were evaluated using clinical data from the More and Less Study, a randomized controlled trial (RCT) with 174 children (mean age = 5 years, mean Body Mass Index Standard Deviation Score (BMI SDS) = 3.0) comparing a parent support program (with and without booster sessions) and standard treatment. Data were collected at four time points over 12 months. We used linear mixed models and mediation models to investigate associations between changes in parenting practices and treatment effects. Findings The validation of the questionnaire (9 items; responses on a 5-point Likert scale) revealed two dimensions of parenting (Cronbach’s alpha ≥0.7): setting limits to the child and regulating one’s own emotions when interacting with the child, both of which correlated with feeding practices and parental self-efficacy. We administered the questionnaire to the RCT participants. Fathers in standard treatment increased their emotional regulation compared to fathers in the parenting program (p = 0.03). Mothers increased their limit-setting regardless of treatment allocation (p = 0.01). No treatment effect was found on child weight status through changes in parenting practices. Conclusion Taken together, the findings demonstrate that the new questionnaire assessing parenting practices proved valid in a 12-month childhood obesity trial. During treatment, paternal and maternal parenting practices followed different trajectories, though they did not mediate treatment effects on child weight status. Future research should address the pathways whereby maternal and paternal parenting practices affect treatment outcomes, such as child eating behaviors and weight status.
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Affiliation(s)
- Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Veronica Mildton
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Saldana L, Chapman JE, Campbell M, Alley Z, Schaper H, Padgett C. Meeting the Needs of Families Involved in the Child Welfare System for Parental Substance Abuse: Outcomes From an Effectiveness Trial of the Families Actively Improving Relationships Program. Front Psychol 2021; 12:689483. [PMID: 34276517 PMCID: PMC8283009 DOI: 10.3389/fpsyg.2021.689483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Limited evidence-based practices exist to address the unique treatment needs of families involved in the child welfare system with parental substance abuse. Specifically, parental opioid and methamphetamine abuse have increased over the last decade, with associated increases of families reported to the child welfare system. The Families Actively Improving Relationships (FAIR) program was developed to address the complexities of these families. Evidence-based strategies to address the interrelated needs of parents—including substance abuse and mental health treatment, parent skills training, and supportive case management to improve access to ancillary needs—are integrated in an intensive community outpatient program. This study examined the clinical effectiveness of FAIR when delivered in a Medicaid billable outpatient clinic. Parents (n = 99) were randomized either to the immediate FAIR condition or to the Waitlist (WL) condition, using a dynamic wait-listed design, with all parents provided the opportunity to eventually receive FAIR. Outcomes show statistically and clinically significant reductions in parental opioid and methamphetamine use, mental health symptoms, and parenting risk, and improvements in stability in parents receiving FAIR. Providing services to families who require travel in excess of 20 miles for sessions has challenging implications for program costs under a Medicaid structure. Study outcomes highlight the need for policies to support funding of intensive family-based programs.
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Affiliation(s)
- Lisa Saldana
- Oregon Social Learning Center, Eugene, OR, United States
| | | | - Mark Campbell
- Oregon Social Learning Center, Eugene, OR, United States
| | - Zoe Alley
- Oregon Social Learning Center, Eugene, OR, United States
| | - Holle Schaper
- Oregon Social Learning Center, Eugene, OR, United States
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Dose C, Hautmann C, Bürger M, Schürmann S, Döpfner M. Negative parenting behaviour as a mediator of the effects of telephone-assisted self-help for parents of pharmacologically treated children with attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2021; 30:861-875. [PMID: 32488456 PMCID: PMC8140965 DOI: 10.1007/s00787-020-01565-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
A previous randomised controlled trial demonstrated the effects of a telephone-assisted self-help (TASH) intervention for parents of pharmacologically treated children with attention-deficit/hyperactivity disorder (ADHD) on ADHD symptoms, oppositional symptoms, functional impairment, and negative parenting behaviour (per-protocol analyses). In the current study, we examined whether changes in positive and negative parenting behaviour mediated the effects on symptoms and impairment. Parents in an enhancement group (n = 51) participated in a 12-month TASH intervention (eight booklets plus up to 14 telephone consultations) as an adjunct to routine clinical care, whereas parents in a waitlist control group (n = 52) received routine clinical care only. Parents completed measures of child symptoms, child functional impairment, and parenting behaviour at baseline, at 6 months, and at 12 months. The mediating effects of parenting behaviour were examined using regression analyses. Per-protocol analyses (n = 74) revealed a significant indirect intervention effect on functional impairment through negative parenting behaviour at 6 months as well as indirect intervention effects on oppositional symptoms and functional impairment through negative parenting behaviour at 12 months. The indirect effect on ADHD symptoms through negative parenting behaviour at 12 months just failed to reach significance. The analyses yielded no indirect intervention effects through positive parenting behaviour. The study provides some, albeit limited, support for the importance of changes in negative parenting behaviour to achieve changes in symptoms and functional impairment during parent training. In consideration of the inconsistent results of previous studies concerning the mediating role of positive and negative parenting behaviour, further research is required to better understand the mechanisms of change during parent training, also including other possible mediators like parenting stress and parental self-efficacy.
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Affiliation(s)
- Christina Dose
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
| | - Christopher Hautmann
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Mareike Bürger
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Stephanie Schürmann
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany ,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Manfred Döpfner
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany ,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
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A Narrative Review of the Needs of Children in Foster and Kinship Care: Informing a Research Agenda. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAs a result of maltreatment, children in care can present with a range of complex needs and challenges. In addition to direct clinical care commonly provided by paediatricians, psychiatrists, and clinical psychologists, the provision of knowledge and skills to foster and kinship carers have become modes of support common in responding to these needs and challenges. A narrative review of key systematic reviews and empirical research was conducted to assess the effectiveness of existing foster carer interventions. Results indicated a range of methodological characteristics that limit our ability to develop a sound, research-driven, evidence base. As a result, we remain limited in our knowledge about which treatments are effective, for which symptoms they are effective, and for which population subgroups they are most likely to be effective. This review provides a summary of identified needs and challenges in the delivery of foster carer interventions. It provides an account of current treatment components and offers a platform for the development and progression of a programme of research in an effort to advance knowledge in the area.
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Wu Q, Zhu Y, Ogbonnaya I, Zhang S, Wu S. Parenting intervention outcomes for kinship caregivers and child: A systematic review. CHILD ABUSE & NEGLECT 2020; 106:104524. [PMID: 32450459 PMCID: PMC7371572 DOI: 10.1016/j.chiabu.2020.104524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/09/2020] [Accepted: 05/03/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Kinship foster caregivers often face serious challenges but lack adequate parenting capacities and resources. The importance of parenting interventions for kinship foster caregivers has been recognized, and researchers have assessed the effect of various parenting interventions on the caregivers and children. However, no systematic review has been conducted to summarize findings related to parenting interventions targeting kinship care. OBJECTIVES This study systematically summarizes the effect of parenting interventions on kinship foster caregivers and their cared for children, and examines the intervention strategies and research methods used in order to provide a context in which to better understand effects of interventions. METHODS From six academic databases, 28 studies were identified for review. A data template was used to extract the following information from each study: intervention targets, research design, settings, intervention description, outcome measures, and main results for each study. RESULTS Various parenting interventions targeting kinship foster care families have been developed to improve parenting capacities and reduce parental stress. Most of the interventions had a positive impact on the outcomes of both caregivers and children, although the assessed outcomes often differed across studies. Parenting interventions improve caregivers' parenting competency, reduce parental stress, and advance child wellbeing. However, some interventions appear less promising in achieving targeted goals. DISCUSSION The findings suggest that promoting evidence-based parenting interventions with a special focus on kinship care is important for child welfare. Future directions for research are also discussed in this study.
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Affiliation(s)
- Qi Wu
- Arizona State University, School of Social Work, United States.
| | - Yiqi Zhu
- Brown School at Washington University in St. Louis, United States
| | | | - Saijun Zhang
- University of Mississippi Department of Social Work, United States
| | - Shiyou Wu
- Arizona State University, School of Social Work, United States
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Foster Parent Stress as Key Factor Relating to Foster Children’s Mental Health: A 1-Year Prospective Longitudinal Study. CHILD & YOUTH CARE FORUM 2020. [DOI: 10.1007/s10566-020-09547-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abstract
Background
Foster children are reported to often have mental health difficulties. To optimize foster children’s development chances, we need to know more about the characteristics that are predictive of foster children’s mental health.
Objective
In the current study, we aimed to establish what accounts for the differences in foster children’s mental health, by examining the change and predictors of change in foster children’s mental health. Insight into foster children’s mental health outcomes and their predictors could inform the design of targeted interventions and support for foster children and foster families.
Method
In a sample of 432 foster children between 4 and 17 years old (M = 10.90) we examined a multivariate model in which characteristics of the foster child, the child’s care experiences, foster family, and foster placement were included as predictors of foster children’s mental health (internalizing, externalizing, and prosocial behaviors) using a three-wave longitudinal design
Results
Results showed that levels of mental health were generally stable over time. Differences between foster children’s developmental outcomes were mainly predicted by foster parent stress.
Conclusions
Foster parent stress levels were high and consistently found to be the strongest predictor of foster children’s mental health outcomes. Given this finding it is important for researchers and practitioners to consider foster parent stress in screening as a point of attention in creating conditions conducive to foster children’s mental health.
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15
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Taussig HN, Weiler LM, Garrido EF, Rhodes T, Boat A, Fadell M. A Positive Youth Development Approach to Improving Mental Health Outcomes for Maltreated Children in Foster Care: Replication and Extension of an RCT of the Fostering Healthy Futures Program. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:405-417. [PMID: 31468553 PMCID: PMC6917986 DOI: 10.1002/ajcp.12385] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Preventing the negative impact of maltreatment on children's mental health requires interventions to be contextually sensitive, grounded in theory and research, and effective in reaching and retaining children and families. This study replicates and extends previous findings of the Fostering Healthy Futures (FHF) program, a 30-week mentoring and skills group intervention for preadolescent maltreated children in foster care. Participants included 426 children recently placed in out-of-home care who were randomized to intervention or control conditions. Outcomes measured 6-10 months postintervention included a multi-informant (child, caregiver, teacher) index of mental health problems as well as measures of posttraumatic stress symptoms, dissociative symptoms, quality of life, and use of mental health services and psychotropic medications. There were high rates of program initiation, retention, and engagement; 95% of those randomized to FHF started the program, 92% completed it, and over 85% of the mentoring visits and skills groups were attended. The FHF program demonstrated significant impact in reducing mental health symptomatology, especially trauma symptoms, and mental health service utilization. These program effects were consistent across almost all subgroups, suggesting that FHF confers benefit for diverse children. Results indicate that positive youth development programming is highly acceptable to children and families and that it can positively impact trauma and its sequelae.
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Affiliation(s)
- Heather N Taussig
- University of Denver, Denver, CO, USA
- Kempe Center, University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - Tara Rhodes
- Colorado Department of Education, Denver, CO, USA
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16
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Eiffener E, Eli K, Ek A, Sandvik P, Somaraki M, Kremers S, Sleddens E, Nowicka P. The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial. Pediatr Obes 2019; 14:e12556. [PMID: 31290278 DOI: 10.1111/ijpo.12556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/13/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Few studies have explored the influence of preschoolers' behavioural problems on obesity treatment. OBJECTIVES To assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status. METHOD The study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions. RESULTS Child emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores. CONCLUSIONS Child behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.
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Affiliation(s)
- Elodie Eiffener
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Anna Ek
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Stef Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ester Sleddens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Paulina Nowicka
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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17
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Sellers R, Smith AF, Leve LD, Nixon E, Cane T, Cassell JA, Harold GT. Utilising Genetically-Informed Research Designs to Better Understand Family Processes and Child Development: Implications for Adoption and Foster Care Focused Interventions. ADOPTION & FOSTERING 2019; 43:351-371. [PMID: 31576061 PMCID: PMC6771282 DOI: 10.1177/0308575919866526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding the interplay between genetic factors and family environmental processes (e.g., inter-parental relationship quality, positive versus negative parenting practices) and children's mental health (e.g., anxiety, depression, conduct problems, ADHD) in the contexts of adoption and foster-care research and practice is critical for effective prevention and intervention programme development. Whilst evidence highlights the importance of family environmental processes for the mental health and well-being of children in adoption and foster care, there is relatively limited evidence of effective interventions specifically for these families. Additionally, family-based interventions not specific to the context of adoption and foster-care typically show small to medium effects, and even where interventions are efficacious, not all children benefit. One explanation for why interventions may not work well for some is that responses to intervention may be influenced by an individual's genetic make-up. This paper summarises how genetically-informed research designs can help disentangle genetic from environmental processes underlying psychopathology outcomes for children, and how this evidence can provide improved insights into the development of more effective preventative intervention targets for adoption and foster-care families. We discuss current difficulties in translating behavioural genetics research to prevention science, and provide recommendations to bridge the gap between behavioural genetics research and prevention science, with lessons for adoption and foster-care research and practice.
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Affiliation(s)
- R Sellers
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - A F Smith
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
| | - L D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - E Nixon
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
| | - T Cane
- School of Social Work and Social Care, University of Sussex, UK
| | - J A Cassell
- Brighton and Sussex Medical School, Falmer, Brighton BN1 9PH
| | - G T Harold
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
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18
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Abstract
Foster and adoptive parents often face challenges while taking care of children who, due to their adverse early life experiences, are at risk of developing insecure attachment relationships, behavior problems, and stress dysregulation. Several intervention programs have been developed to help foster and adoptive parents to overcome these challenges. In the current study, a series of eight meta-analyses were performed to examine the effectiveness of these intervention programs on four parent outcomes (sensitive parenting, k = 11, N = 684; dysfunctional discipline, k = 4, N = 239; parenting knowledge and attitudes, k = 7, N = 535; parenting stress, k = 18, N = 1,306), three child outcomes (attachment security, k = 6, N = 395; behavior problems, k = 33, N = 2,661; diurnal cortisol levels, k = 3, N = 261), and placement disruption (k = 7, N = 1,100). Results show positive effects for the four parent outcomes and child behavior problems, but not for attachment security, child diurnal cortisol levels, or placement disruption. Indirect effects on child outcomes may be delayed, and therefore long-term follow-up studies are needed to examine the effects of parenting interventions on children.
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19
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Ek A, Chamberlain KL, Sorjonen K, Hammar U, Malek ME, Sandvik P, Somaraki M, Nyman J, Lindberg L, Nordin K, Ejderhamn J, Fisher PA, Chamberlain P, Marcus C, Nowicka P. A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial. Pediatrics 2019; 144:peds.2018-3457. [PMID: 31300528 PMCID: PMC8853645 DOI: 10.1542/peds.2018-3457] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Early obesity treatment seems to be the most effective, but few treatments exist. In this study, we examine the effectiveness of a parent-only treatment program with and without booster sessions (Booster or No Booster) focusing on parenting practices and standard treatment (ST). METHODS Families of children 4 to 6 years of age with obesity were recruited from 68 child care centers in Stockholm County and randomly assigned to a parent-only program (10 weeks) with or without boosters (9 months) or to ST. Treatment effects on primary outcomes (BMI z score) and secondary outcomes (BMI and waist circumference) during a 12-month period were examined with linear mixed models. The influence of sociodemographic factors was examined by 3-way interactions. The clinically significant change in BMI z score (-0.5) was assessed with risk ratios. RESULTS A total of 174 children (mean age: 5.3 years [SD = 0.8]; BMI z score: 3.0 [SD = 0.6], 56% girls) and their parents (60% foreign background; 39% university degree) were included in the analysis (Booster, n = 44; No Booster, n = 43; ST, n = 87). After 12 months, children in the parent-only treatment had a greater reduction in their BMI z score (0.30; 95% confidence interval [CI]: -0.45 to -0.15) compared with ST (0.07; 95% CI: -0.19 to 0.05). Comparing all 3 groups, improvements in weight status were only seen for the Booster group (-0.54; 95% CI: -0.77 to -0.30). The Booster group was 4.8 times (95% CI: 2.4 to 9.6) more likely to reach a clinically significant reduction of ≥0.5 of the BMI z score compared with ST. CONCLUSION A parent-only treatment with boosters outperformed standard care for obesity in preschoolers.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology,
| | | | - Kimmo Sorjonen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Ulf Hammar
- Department of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden,Section of Molecular Epidemiology, Departments of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mahnoush Etminan Malek
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden,Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Sandvik
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden,Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Maria Somaraki
- Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Jonna Nyman
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Louise Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Ejderhamn
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Philip A. Fisher
- Oregon Social Learning Center, Eugene, Oregon,Department of Psychology, University of Oregon, Eugene, Oregon
| | | | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden,Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
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20
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Ek A, Delisle Nyström C, Chirita-Emandi A, Tur JA, Nordin K, Bouzas C, Argelich E, Martínez JA, Frost G, Garcia-Perez I, Saez M, Paul C, Löf M, Nowicka P. A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study - an intervention within the STOP project. BMC Public Health 2019; 19:945. [PMID: 31307412 PMCID: PMC6631737 DOI: 10.1186/s12889-019-7161-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/15/2022] Open
Abstract
Background Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families. Methods/design A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline. Discussion This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided. Trial registration ClinicalTrials.gov NCT03800823; 11 Jan 2019.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | | | - Adela Chirita-Emandi
- Genetics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, Romania
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Cristina Bouzas
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Emma Argelich
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.,Department of Nutrition, Food Science, and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IMDEA Food Precision Nutrition, Madrid, Spain
| | - Gary Frost
- Section for Nutrition Research, Department of Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - Isabel Garcia-Perez
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Campus de Montilivi, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto Carlos III, Madrid, Spain
| | - Corina Paul
- Pediatrics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,2nd Pediatrics Clinic, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
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21
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Font S, Haddock Potter M. Socioeconomic Resource Environments in Biological and Alternative Family Care and Children's Cognitive Performance. SOCIOLOGICAL INQUIRY 2019; 89:263-287. [PMID: 32523232 PMCID: PMC7286547 DOI: 10.1111/soin.12262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE We examined social and economic resources in the environments of children involved with child protective services and their associations with children's cognitive performance. METHODS We used a national dataset of child protection investigations (children ages 6 to 16 at wave 1). Using latent class analysis, we constructed profiles of the financial resources, parental education and employment, and family structure and size. We then examined within- and across-time associations between resource environment profiles and children's math and reading scores, and tested whether associations differed by family care type. RESULTS Our latent class analysis identified four distinct family resource environments: educated middle class, single earner, large working class, and severely disadvantaged. Family resource environment profiles predicted current cognitive performance and changes in performance over time, but associations were more consistent for children in biological family care. CONCLUSION Children who remain in home following maltreatment allegations may benefit from services that target social as well as economic resources.
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Affiliation(s)
- Sarah Font
- Department of Sociology and Criminology, Pennsylvania State University, 505 Oswald Tower, University Park, PA 16801, , 814/863-2259
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22
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Lim S, Lambie I, van Toledo A. Characteristics of Female Youth Offenders in New Zealand. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:198-217. [PMID: 30198362 DOI: 10.1177/0306624x18799002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Female youth offending is poorly understood, despite increased rates of such offending. Research indicates there are a range of factors that have a causal impact on the development of offending in young people. This study investigated risk factors using a retrospective file audit of 184 female youth offenders in New Zealand. The findings were classified using Bronfenbrenner's ecological model, which highlights the different contextual levels that influence behavior, including individual, family, peer, school, community, and cultural factors. The results indicate that there are significant risk factors for female youth offenders. There were high rates of mental health difficulties, drug use, histories of maltreatment, family stressors, peer issues, and school behavior problems in the cohort. There was very little difference between violent and nonviolent offenders. All the young women had risk factors affecting them at many levels. Targeted, multisystemic intervention and prevention programs are therefore needed to address female youth offending.
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Affiliation(s)
- Stacey Lim
- 1 The University of Auckland, Auckland, New Zealand
| | - Ian Lambie
- 1 The University of Auckland, Auckland, New Zealand
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23
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Shelleby EC, Shaw DS, Dishion TJ, Wilson MN, Gardner F. Effects of the Family Check-Up on reducing growth in conduct problems from toddlerhood through school age: An analysis of moderated mediation. J Consult Clin Psychol 2018; 86:856-867. [PMID: 30265044 DOI: 10.1037/ccp0000337] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The Family Check-Up (FCU) is a preventive intervention found to significantly reduce child conduct problems (CP). This study examined the extent to which parents reported that their child's CP were a problem for them at baseline (baseline CP) as a moderator of FCU effects into middle childhood and moderated mediation models to explore positive parent-child dyadic interaction and maternal depressive symptoms as mediators. METHOD Participants included 731 mother-child dyads followed from child ages 2 to 9.5 (49% female; 28% African American, 50% European American, 13% biracial, and 9% other; 13% self-reported as Hispanic), with half assigned to the FCU. Maternal depressive symptoms, observed parent and child behavior (positive dyadic interaction), and CP were assessed annually. RESULTS Support was found for baseline CP as a moderator of the FCU, with significant decreases in CP for children in the FCU demonstrating high baseline CP. The following associations did not differ between those with high versus low baseline CP. The FCU significantly increased positive dyadic interaction. Lower maternal depressive symptoms were associated with significantly lower CP. CONCLUSIONS Findings add to existing evidence that preventive interventions are effective for high-risk families, and the FCU is especially beneficial for children whose parents report high levels of CP in early childhood. Further, the FCU significantly improved positive dyadic interaction for families of children with both high and low baseline CP. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | - Thomas J Dishion
- Department of Psychology, REACH Institute, Arizona State University
| | | | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford
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24
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Akin BA, McDonald TP. Parenting intervention effects on reunification: A randomized trial of PMTO in foster care. CHILD ABUSE & NEGLECT 2018; 83:94-105. [PMID: 30025308 DOI: 10.1016/j.chiabu.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/20/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
Evidence-supported parenting interventions (ESPIs) have expanded into child welfare because a growing research base has demonstrated positive results among children with serious emotional and behavioral problems. Despite a clear federal policy emphasis on reunification, few randomized trials have tested ESPIs with biological families of children in foster care; even fewer studies have investigated the distal outcomes of ESPIs. The aim of the current study was to examine the effects of Parent Management Training, Oregon (PMTO) model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (n = 461) or services as usual (SAU) (n = 457). Cox regression models tested whether children in the PMTO group achieved higher rates of reunification. We applied life tables data for integrals calculations to estimate days saved in foster care. Analyses were conducted as intent-to-treat (ITT), and per protocol analysis (PPA). ITT results showed reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. PPA indicated that intervention completion strengthened effects as PMTO completers' reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than non-completers (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and non-completers (358 days). Overall, findings suggest that an in-home parenting intervention positively affected reunification as delivered to biological parents of children and youth in foster care with serious emotional and behavioral problems. Implications and future considerations for research are discussed.
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Affiliation(s)
- Becci A Akin
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA.
| | - Thomas P McDonald
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA
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25
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Schmitt SA, Mihalec-Adkins BP, Pratt ME, Lipscomb ST. Teacher-child closeness as a protective factor for at-risk children experiencing residential mobility. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2018. [DOI: 10.1016/j.appdev.2018.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Kim HK, Buchanan R, Price JM. Pathways to Preventing Substance Use Among Youth in Foster Care. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 18:567-576. [PMID: 28523585 DOI: 10.1007/s11121-017-0800-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Substance use problems are highly prevalent among youth in foster care. Such problems in adolescence have long-lasting implications for subsequent adjustment throughout adulthood and even across generations. Although several programs have demonstrated positive results in reducing substance use in at-risk youth, few studies have systemically examined how such programs work for foster youth and whether they are effective for both genders. This study examined the efficacy of KEEP SAFE, a family-based and skill-focused program designed to prevent substance use and other related health risking behaviors among youth in foster care. We hypothesized that improving the caregiver-youth relationship would lead to later reductions in youths' involvement with deviant peers, which subsequently would lead to less substance use, and that this mechanism would work comparably for both genders. A sample of 259 youth (154 girls, ages 11-17 years) in foster care and their caregivers participated in a randomized controlled trial and was followed for 18 months post-baseline. Results indicated that the intervention significantly reduced substance use in foster youth at 18 months post-baseline and that the intervention influenced substance use through two processes: youths' improved quality of relationships with caregivers at 6 months post-baseline and fewer associations with deviant peers at 12 months post-baseline. This suggests that these two processes may be fruitful immediate targets in substance use prevention programs for foster youth. We also found little gender differences in direct and mediating effects of the intervention, suggesting KEEP SAFE may be effective for both genders in foster care.
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Affiliation(s)
- Hyoun K Kim
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA. .,Department of Child and Family Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Rohanna Buchanan
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Joseph M Price
- Child and Adolescent Services Research Center, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
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Toward Creating Synergy Among Policy, Procedures, and Implementation of Evidence-Based Models in Child Welfare Systems: Two Case Examples. Clin Child Fam Psychol Rev 2018; 20:78-86. [PMID: 28236157 DOI: 10.1007/s10567-017-0226-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Over the past four to five decades, multiple randomized controlled trials have verified that preventive interventions targeting key parenting skills can have far-reaching effects on improving a diverse array of child outcomes. Further, these studies have shown that parenting skills can be taught, and they are malleable. Given these advances, prevention scientists are in a position to make solid empirically based recommendations to public child service systems on using parent-mediated interventions to optimize positive outcomes for the children and families that they serve. Child welfare systems serve some of this country's most vulnerable children and families, yet they have been slow (compared to juvenile justice and mental health systems) to adopt empirically based interventions. This paper describes two child-welfare-initiated, policy-based case studies that have sought to scale-up research-based parenting skills into the routine services that caseworkers deliver to the families that they serve. In both case studies, the child welfare system leaders worked with evaluators and model developers to tailor policy, administrative, and fiscal system practices to institutionalize and sustain evidence-based practices into usual foster care services. Descriptions of the implementations, intervention models, and preliminary results are described.
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Perry KJ, Price JM. Concurrent child history and contextual predictors of children's internalizing and externalizing behavior problems in foster care. CHILDREN AND YOUTH SERVICES REVIEW 2018; 84:125-136. [PMID: 29551846 PMCID: PMC5854395 DOI: 10.1016/j.childyouth.2017.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This study contributes to current research on the behavior problems of children in foster care by analyzing a more comprehensive set of concurrent child history and contextual predictors. Kinship home status and sibling status (i.e., whether the sibling was a biological sibling to the foster child) were evaluated as moderators of significant associations. Data were collected at the baseline of a foster parent training intervention program prior to any intervention services using parent phone interviews (N= 310, 51.6% male, M age = 7.57 years). Two linear hierarchical regressions were used to evaluate each set of predictors' association with behavior problems as well as each individual predictor's contribution. Results indicated that as a set, the contextual variables predicted a significant and unique amount of variability in the child's internalizing and externalizing behavior scores, but the child history variables did not. Specifically, the child's placement in a non-kinship home, being in a non-ethnically matched child-parent pair, higher parent stress scores, a greater number of prior group home placements, and higher internalizing behavior scores for the child predicted higher child externalizing scores. Higher parent stress scores, higher focal sibling externalizing behavior scores, and higher externalizing behavior scores for the child predicted higher internalizing scores for the child. The association between focal sibling externalizing behavior scores and child internalizing scores was moderated by kinship home status, such that there was a stronger association between the focal sibling's externalizing score and the child's internalizing score if the child was in a kinship compared to a non-kinship home. Implications for intervention services are discussed, particularly the importance of assessing the child's foster home environment when addressing the child's behavior problems.
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Chen K, Cheng Y, Berkout O, Lindhiem O. Analyzing Proportion Scores as Outcomes for Prevention Trials: a Statistical Primer. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:312-321. [PMID: 26960687 DOI: 10.1007/s11121-016-0643-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In prevention trials, outcomes of interest frequently include data that are best quantified as proportion scores. In some cases, however, proportion scores may violate the statistical assumptions underlying common analytic methods. In this paper, we provide guidelines for analyzing frequency and proportion data as primary outcomes. We describe standard methods including generalized linear regression models to compare mean proportion scores and examine tools for testing normality and other assumptions for each model. Recommendations are made for instances when the assumptions are not met, including transformations for proportion scores that are non-normal. We also discuss more sophisticated analytical tools to model change in proportion scores over time. The guidelines provide ready-to-use analytical strategies for frequency and proportion data that are commonly encountered in prevention science.
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Affiliation(s)
- Kehui Chen
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Olga Berkout
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oliver Lindhiem
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Shaffer A, Lindhiem O, Kolko D. Treatment Effects of a Primary Care Intervention on Parenting Behaviors: Sometimes It's Relative. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:305-311. [PMID: 27469458 DOI: 10.1007/s11121-016-0689-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The goal of this brief report is to demonstrate the utility of quantifying parental discipline practices as relative frequencies in measuring changes in parenting behavior and relations to child behavior following intervention. We explored comparisons across methodological approaches of assessing parenting behavior via absolute and relative frequencies in measuring improvements in parent-reported disciplinary practices (increases in positive parenting practices in response to child behavior; decreases in inconsistent discipline and use of corporal punishment) and child behavior problems. The current study was conducted as part of a larger clinical trial to evaluate the efficacy of a collaborative care intervention for behavior problems, ADHD, and anxiety in pediatric primary care practices (Doctor Office Collaborative Care; DOCC). Participants were 321 parent-child dyads (M child age = 8.00, 65 % male children) from eight pediatric practices that were cluster randomized to DOCC or enhanced usual care (EUC). Parents reported on their own discipline behaviors and child behavior problems. While treatment-related decreases in negative parenting were found using both the absolute and relative frequencies of parenting behaviors, results were different for positive parenting behaviors, which showed decreases when measured as absolute frequencies but increases when measured as relative frequencies. In addition, positive parenting was negatively correlated with child behavior problems when using relative frequencies, but not absolute frequencies, and relative frequencies of positive parenting mediated relations between treatment condition and outcomes. Our findings indicate that the methods used to measure treatment-related change warrant careful consideration.
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Affiliation(s)
- Anne Shaffer
- Department of Psychology, University of Georgia, Athens, GA, USA.
| | - Oliver Lindhiem
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Kolko
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Gardner F, Leijten P, Mann J, Landau S, Harris V, Beecham J, Bonin EM, Hutchings J, Scott S. Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05100] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BackgroundChild disruptive behavioural problems are a large and costly public health problem. The Incredible Years®(IY) parenting programme has been disseminated across the UK to prevent this problem and shown to be effective in several trials. It is vital for policy to know for which families IY is most effective, to be sure that it helps reduce, rather than widen, socioeconomic inequalities. Individual trials lack power and generalisability to examine differential effects; conventional meta-analysis lacks information about within-trial variability in effects.ObjectivesTo overcome these limitations by pooling individual-level data from the IY parenting trials in Europe to examine to what extent it benefits socially disadvantaged families. Secondary objectives examine (1) additional moderators of effects on child behaviour, (2) wider health benefits and potential harms and (3) costs, cost-effectiveness and potential long-term savings.DesignIndividual participant data meta-analysis of 14 randomised trials of the IY parenting intervention.SettingsUK (eight trials), the Netherlands, Ireland, Norway, Sweden and Portugal.ParticipantsData were from 1799 families, with children aged 2–10 years (mean 5.1 years; 63% boys).InterventionsIY Basic parenting programme.Main outcome measuresPrimary outcome was disruptive child behaviour, determined by the Eyberg Child Behavior Inventory Intensity scale (ECBI-I). Secondary outcomes included self-reported parenting practices, parenting stress, mental health, children’s attention deficit hyperactivity disorder (ADHD) and emotional symptoms.ResultsThere were no differential effects of IY on disruptive behaviour in families with different levels of social/socioeconomic disadvantage or differential effects for ethnic minority families, families with different parenting styles, or for children with comorbid ADHD or emotional problems or of different ages. Some moderators were found: intervention effects were strongest in children with more severe baseline disruptive behaviour, in boys, and in children with parents who were more depressed. Wider health benefits included reduced child ADHD symptoms, greater parental use of praise, and reduced harsh and inconsistent discipline. The intervention did not improve parental depression, stress, self-efficacy or children’s emotional problems. Economic data were available for five UK and Ireland trials (maximumn = 608). The average cost per person of the IY intervention was £2414. The probability that the IY intervention is considered cost-effective is 99% at a willingness to pay of £145 per 1-point improvement on the ECBI-I. Estimated longer-term savings over 20 years range from £1000 to £8400 per child, probably offsetting the cost of the intervention.LimitationsLimitations include a focus on one parenting programme; the need to make assumptions in harmonising data; and the fact that data addressed equalities in the effectiveness of, not access to, the intervention.ConclusionsThere is no evidence that the benefits of the IY parenting intervention are reduced in disadvantaged or minority families; benefits are greater in the most distressed families, including parents who are depressed. Thus, the intervention is unlikely to widen socioeconomic inequalities in disruptive behaviour and may have effects in narrowing inequalities due to parent depression. It was as likely to be effective for older as for younger children. It has wider benefits for ADHD and parenting and is likely to be considered to be cost-effective. Researchers/funders should encourage data sharing to test equity and other moderator questions for other interventions; further research is needed on enhancing equality of access to interventions.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Frances Gardner
- Department of Social Policy and Intervention, Centre for Evidence-based Intervention, University of Oxford, Oxford, UK
| | - Patty Leijten
- Department of Social Policy and Intervention, Centre for Evidence-based Intervention, University of Oxford, Oxford, UK
| | - Joanna Mann
- Department of Social Policy and Intervention, Centre for Evidence-based Intervention, University of Oxford, Oxford, UK
| | - Sabine Landau
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Victoria Harris
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jennifer Beecham
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Eva-Maria Bonin
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | | | - Stephen Scott
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Dickes A, Kemmis-Riggs J, McAloon J. Methodological Challenges to the Evaluation of Interventions for Foster/Kinship Carers and Children: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:109-145. [DOI: 10.1007/s10567-017-0248-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kemmis-Riggs J, Dickes A, McAloon J. Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:13-40. [DOI: 10.1007/s10567-017-0247-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The potential for negative peer influence has been well established in research, and there is a growing interest in how positive peer influence also impacts youth. No research, however, has concurrently examined positive and negative peer influence in the context of residential care. Clinical records for 886 residential care youth were used in a Hierarchical Linear Model analysis to examine the impact of negative and positive peer influence on naturally occurring patterns of serious problem behavior over time. Negative peer influence, where the majority of youth in a home manifested above the average number of serious behavior problems, occurred 13.7% of the time. Positive peer influence, where the majority of youth manifested no serious problem behaviors for the month, occurred 47.7% of the time. Overall, youth problem behavior improved over time. There were significantly lower rates of serious problem behavior in target youth during positive peer influence months. Conversely, there were significantly higher rates of serious problem behaviors in target youth during negative peer influence months. Negative peer influence had a relatively greater impact on target peers' serious behavior problems than did positive peer influence. Caregiver experience significantly reduced the impact of negative peer influence, but did not significantly augment positive peer influence. Months where negative peer influence was combined with inexperienced caregivers produced the highest rates of serious problem behavior. Our results support the view that residential programs for troubled youth need to create circumstances that promote positive and control for negative peer influence.
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Baker S, Sanders MR. Predictors of Program Use and Child and Parent Outcomes of A Brief Online Parenting Intervention. Child Psychiatry Hum Dev 2017; 48:807-817. [PMID: 28035556 DOI: 10.1007/s10578-016-0706-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Web-based parenting interventions have the potential to increase the currently low reach of parenting programs, but few evidence-based online programs are available, and little is known about who benefits from this delivery format. This study investigated if improvements in child behavior and parenting, following participation in a brief online parenting program (Triple P Online Brief), can be predicted by family and program-related factors. Participants were 100 parents of 2-9-year-old children displaying disruptive behavior problems. Regression analyses showed that higher baseline levels of child behavior problems, older parental age and more intense conflict over parenting pre-intervention predicted greater improvement in child behavior at 9-month follow-up. Improvement in parenting was predicted by higher pre-intervention levels of ineffective parenting. Family demographics, parental adjustment and program related factors did not predict treatment outcomes. Younger child age and lower disagreement over parenting pre-intervention predicted completion of the recommended minimum dose of the program.
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Affiliation(s)
- Sabine Baker
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, 4072, Australia.
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, 4072, Australia
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Lohaus A, Chodura S, Möller C, Symanzik T, Ehrenberg D, Job AK, Reindl V, Konrad K, Heinrichs N. Children's mental health problems and their relation to parental stress in foster mothers and fathers. Child Adolesc Psychiatry Ment Health 2017; 11:43. [PMID: 28878817 PMCID: PMC5585922 DOI: 10.1186/s13034-017-0180-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 07/31/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study focuses on children living in foster families with a history of maltreatment or neglect. These children often show adverse mental health outcomes reflected in increased externalizing and internalizing problems. It is expected that these adverse outcomes are associated with increased parental stress levels experienced by foster mothers as well as foster fathers. METHODS The study sample included 79 children living in foster families and 140 children living in biological families as comparison group. The age of the children ranged from 2 to 7 years. Mental health problems were assessed with the Child Behavior Checklist, while parenting stress was measured with a parenting stress questionnaire including subscales on the amount of experienced stress and the amount of perceived support. The Child Behavior Checklist assessments were based mainly on maternal reports, while the parental stress assessments were based on maternal as well as paternal reports. RESULTS As expected the results showed increased externalizing and internalizing scores for the foster children accompanied by increased parental stress experiences in the foster family sample (however only in the maternal, but not in the paternal stress reports). The stress differences between the foster and biological family groups disappeared, when the children's mental health problem scores were included as covariates. Moreover, especially the externalizing scores were strong predictors of parental stress in both, the groups of foster and biological parents. The amount of perceived social support was associated with reduced parental stress, but only in the group of biological fathers. CONCLUSION The emergence of parental stress in biological as well as foster parents is closely related to child characteristics (mainly externalizing child problems). Possible implications for the reduction of parental stress are discussed as a consequence of the present results.
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Affiliation(s)
- Arnold Lohaus
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501 Bielefeld, Germany
| | - Sabrina Chodura
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501 Bielefeld, Germany
| | - Christine Möller
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501 Bielefeld, Germany
| | - Tabea Symanzik
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501 Bielefeld, Germany
| | - Daniela Ehrenberg
- 0000 0001 1090 0254grid.6738.aUniversity of Braunschweig, Institute of Psychology, Humboldtstr. 33, 38106 Brunswick, Germany
| | - Ann-Katrin Job
- 0000 0001 1090 0254grid.6738.aUniversity of Braunschweig, Institute of Psychology, Humboldtstr. 33, 38106 Brunswick, Germany
| | - Vanessa Reindl
- 0000 0000 8653 1507grid.412301.5Department for Child and Adolescent Psychiatry, University Hospital Aachen, Neuenhoferweg 21, 52074 Aachen, Germany
| | - Kerstin Konrad
- 0000 0000 8653 1507grid.412301.5Department for Child and Adolescent Psychiatry, University Hospital Aachen, Neuenhoferweg 21, 52074 Aachen, Germany
| | - Nina Heinrichs
- 0000 0001 1090 0254grid.6738.aUniversity of Braunschweig, Institute of Psychology, Humboldtstr. 33, 38106 Brunswick, Germany
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McDonald T, Bhattarai J, Akin B. Predictors of Consent in a Randomized Field Study in Child Welfare. ACTA ACUST UNITED AC 2017; 14:243-265. [PMID: 28486033 DOI: 10.1080/23761407.2017.1319774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Randomized controlled trials (RCTs) are often viewed as the "gold standard" for proving the efficacy and effectiveness of new interventions. However, some are skeptical of the generalizability of the findings that RCTs produce. The characteristics of those willing to participate in research studies have the potential to affect the generalizability of its findings. This study examined factors that could influence consent among families recruited to participate in a randomized field trial in a real-world child welfare setting. METHODS This study tested the Parent Management Training Oregon Model for children in foster care with serious emotional disturbance. It employed a post-randomization consent design, whereby the entire sample of eligible participants, not just those who are willing to consent to randomization, are included in the sample. Initial eligibility assessment data and data from the federally mandated reporting system for public child welfare agencies provided the pool of potential predictors of consent. Bivariate and multivariate analyses were conducted to identify statistically significant predictors of consent. RESULTS Being a dual reunification family was the most significant factor in predicting consent. Unmarried individuals, younger, female parents, cases where parental incarceration was the reason for removal and cases where the removal reason was not due to their children's behavioral problem(s) were also more likely to participate. DISCUSSION As one of the first research studies to examine predictors of consent to a randomized field study in child welfare settings, results presented here can act as a preliminary guide for conducting RCTs in child welfare settings.
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Affiliation(s)
- Tom McDonald
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Jackie Bhattarai
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Becci Akin
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
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Brown CH, Curran G, Palinkas LA, Aarons GA, Wells KB, Jones L, Collins LM, Duan N, Mittman BS, Wallace A, Tabak RG, Ducharme L, Chambers DA, Neta G, Wiley T, Landsverk J, Cheung K, Cruden G. An Overview of Research and Evaluation Designs for Dissemination and Implementation. Annu Rev Public Health 2017; 38:1-22. [PMID: 28384085 PMCID: PMC5384265 DOI: 10.1146/annurev-publhealth-031816-044215] [Citation(s) in RCA: 290] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The wide variety of dissemination and implementation designs now being used to evaluate and improve health systems and outcomes warrants review of the scope, features, and limitations of these designs. This article is one product of a design workgroup that was formed in 2013 by the National Institutes of Health to address dissemination and implementation research, and whose members represented diverse methodologic backgrounds, content focus areas, and health sectors. These experts integrated their collective knowledge on dissemination and implementation designs with searches of published evaluations strategies. This article emphasizes randomized and nonrandomized designs for the traditional translational research continuum or pipeline, which builds on existing efficacy and effectiveness trials to examine how one or more evidence-based clinical/prevention interventions are adopted, scaled up, and sustained in community or service delivery systems. We also mention other designs, including hybrid designs that combine effectiveness and implementation research, quality improvement designs for local knowledge, and designs that use simulation modeling.
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Affiliation(s)
- C Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611;
| | - Geoffrey Curran
- Division of Health Services Research, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205;
| | - Lawrence A Palinkas
- Department of Children, Youth and Families, School of Social Work, University of Southern California, Los Angeles, California 90089;
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, California 92093;
| | - Kenneth B Wells
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California 90024;
| | - Loretta Jones
- Healthy African American Families, Los Angeles, California 90008;
| | - Linda M Collins
- The Methodology Center and Department of Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania 16802;
| | - Naihua Duan
- Department of Psychiatry, Columbia University Medical Center, Columbia University, New York, NY 10027;
| | - Brian S Mittman
- VA Center for Implementation Practice and Research Support, Virginia Greater Los Angeles Healthcare System, North Hills, California 91343;
| | - Andrea Wallace
- College of Nursing, The University of Iowa, Iowa City, Iowa 52242;
| | - Rachel G Tabak
- Prevention Research Center, George Warren Brown School, Washington University, St. Louis, Missouri 63105;
| | - Lori Ducharme
- National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20814;
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland 20850; ,
| | - Gila Neta
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland 20850; ,
| | - Tisha Wiley
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland 20814;
| | | | - Ken Cheung
- Mailman School of Public Health, Columbia University, New York, NY 10032;
| | - Gracelyn Cruden
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611;
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, North Carolina 27514;
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Observed Parenting in Families Exposed to Homelessness: Child and Parent Characteristics as Predictors of Response to the Early Risers Intervention. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-50886-3_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Solomon DT, Niec LN, Schoonover CE. The Impact of Foster Parent Training on Parenting Skills and Child Disruptive Behavior. CHILD MALTREATMENT 2017; 22:3-13. [PMID: 27909237 DOI: 10.1177/1077559516679514] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Children in foster care are at risk for behavioral and emotional problems that require higher levels of care than other children. To meet these needs and reduce placement disruptions, foster parents require effective parenting skills. Although a number of training models have been evaluated, the findings on the efficacy of foster parent training (FPT) are mixed. We conducted a meta-analysis of the FPT outcome research from 1984 to 2014 to develop a clearer understanding of the impact of such trainings. Fifteen samples (16 studies) were identified that investigated the impact of FPT on self-reported parenting skills and knowledge and child problem behaviors. The mean effect size for child disruptive behavior using a random effects model was small but significant at -.20 (95% confidence interval [CI] = [-.39, -.01], Z = 2.05, p < .05), suggesting that, on average, foster parents who were involved in the trainings reported fewer child behavior problems than parents who did not receive the training. The mean effect size for parenting was moderate and significant at .52 (95% CI = [.22, .82], Z = 3.38, p < .05), indicating that, on average, parents in the treatment groups reported higher levels of skills and knowledge following training than did those in the control group. While these results are promising, more research is necessary to investigate the inconsistency in effect sizes across studies.
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Affiliation(s)
- David T Solomon
- 1 Center for Children Families and Communities, Central Michigan University, Mt. Pleasant, MI, USA
| | - Larissa N Niec
- 1 Center for Children Families and Communities, Central Michigan University, Mt. Pleasant, MI, USA
| | - Ciera E Schoonover
- 1 Center for Children Families and Communities, Central Michigan University, Mt. Pleasant, MI, USA
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Potential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses. Clin Child Fam Psychol Rev 2016; 20:127-145. [PMID: 28028654 DOI: 10.1007/s10567-016-0221-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Parenting and family interventions have repeatedly shown effectiveness in preventing and treating a range of youth outcomes. Accordingly, investigators in this area have conducted a number of studies using statistical mediation to examine some of the potential mechanisms of action by which these interventions work. This review examined from a methodological perspective in what ways and how well the family-based intervention studies tested statistical mediation. A systematic search identified 73 published outcome studies that tested mediation for family-based interventions across a wide range of child and adolescent outcomes (i.e., externalizing, internalizing, and substance-abuse problems; high-risk sexual activity; and academic achievement), for putative mediators pertaining to positive and negative parenting, family functioning, youth beliefs and coping skills, and peer relationships. Taken as a whole, the studies used designs that adequately addressed temporal precedence. The majority of studies used the product of coefficients approach to mediation, which is preferred, and less limiting than the causal steps approach. Statistical significance testing did not always make use of the most recently developed approaches, which would better accommodate small sample sizes and more complex functions. Specific recommendations are offered for future mediation studies in this area with respect to full longitudinal design, mediation approach, significance testing method, documentation and reporting of statistics, testing of multiple mediators, and control for Type I error.
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Dishion T, Forgatch M, Chamberlain P, Pelham WE. The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change. Behav Ther 2016; 47:812-837. [PMID: 27993335 PMCID: PMC5389456 DOI: 10.1016/j.beth.2016.02.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/15/2015] [Accepted: 02/03/2016] [Indexed: 11/18/2022]
Abstract
This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children's adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training-Oregon model), and family attenuation and dissolution (Treatment Foster Care-Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements.
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Affiliation(s)
| | - Marion Forgatch
- Implementation Sciences International Inc., and Oregon Social Learning Center
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Hambrick EP, Oppenheim-Weller S, N'zi AM, Taussig HN. Mental Health Interventions for Children in Foster Care: A Systematic Review. CHILDREN AND YOUTH SERVICES REVIEW 2016; 70:65-77. [PMID: 28496286 PMCID: PMC5421550 DOI: 10.1016/j.childyouth.2016.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least "possibly efficacious" (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is not consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.
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Affiliation(s)
- Erin P Hambrick
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
- University of Denver - Graduate School of Social Work
| | - Shani Oppenheim-Weller
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
| | - Amanda M N'zi
- Children's Hospital Colorado, University of Colorado - School of Medicine
| | - Heather N Taussig
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
- University of Denver - Graduate School of Social Work
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Haggerty KP, Barkan SE, Skinner M, Ben Packard W, Cole JJ. Feasibility of Connecting, a Substance-Abuse Prevention Program for Foster Teens and their Caregivers. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2016; 7:639-659. [PMID: 27891209 PMCID: PMC5120679 DOI: 10.1086/686986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To test the feasibility, usability, and proximal outcomes of Connecting, an adaptation of a low-cost, self-directed, family-based substance use prevention program, Staying Connected with Your Teen, with foster families in a randomized, waitlist control pilot study. METHOD Families (n = 60) fostering teens between 11 and 15 years of age were recruited into the study and randomly assigned into the self-administered program with telephone support from a family consultant (n = 32) or a waitlist control condition (n = 28). RESULTS Overall satisfaction with the program was high, with 100% of parents reporting they would recommend the program to other caregivers and reporting being "very satisfied" or "satisfied with the program. Program completion was good, with 62% of families completing all 91 specified tasks. Analyses of proximal outcomes revealed increased communication about sex and substance use (posttest1 OR = 1.97, and 2.03, respectively). Teens in the intervention vs. the waitlist condition reported lower family conflict (OR=.48), and more family rules related to monitoring (OR = 4.02) and media use (OR = 3.24). Caregivers in the waitlist group reported significant increases in the teen's positive involvements (partial eta sq = 17% increase) after receiving the intervention. CONCLUSIONS Overall, program participation appeared to lead to stronger family management, better communication between teens and caregivers around monitoring and media use, teen participation in setting family rules, and decreased teen attitudes favorable to antisocial behavior. This small pilot study shows promising results for this adapted program.
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Affiliation(s)
- Kevin P. Haggerty
- Social Development Research Group, School of Social Work, University of Washington
| | - Susan E. Barkan
- Partners for Our Children, School of Social Work, University of Washington
| | - Martie Skinner
- Social Development Research Group, School of Social Work, University of Washington
| | - W. Ben Packard
- Social Development Research Group, School of Social Work, University of Washington
| | - Janice J. Cole
- Social Development Research Group, School of Social Work, University of Washington
- Partners for Our Children, School of Social Work, University of Washington
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Maaskant AM, van Rooij FB, Overbeek GJ, Oort FJ, Arntz M, Hermanns JMA. Effects of PMTO in Foster Families with Children with Behavior Problems: A Randomized Controlled Trial. JOURNAL OF CHILD AND FAMILY STUDIES 2016; 26:523-539. [PMID: 28190946 PMCID: PMC5272898 DOI: 10.1007/s10826-016-0579-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4-12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children's behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6-9 months, with weekly sessions) parent management training, is to reduce children's problem behavior through improvement of parenting practices. We specifically investigated whether Parent Management Training Oregon is effective to reduce foster parenting stress. A significant effect of Parent Management Training Oregon, compared to Care as Usual was expected on reduced parenting stress improved parenting practices, and on reduced child behavior problems. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 foster families (46 Parent Management Training Oregon, 40 Care as Usual) using a pre-posttest design. Multilevel analyses based on the intention to treat principle (retention rate 73 %) showed that Parent Management Training Oregon, compared to Care as Usual, reduced general levels of parenting stress as well as child related stress and parent-related stress (small to medium effect sizes). The clinical significance of this effect was, however, limited. Compared to a decrease in the Care as Usual group, Parent Management Training Oregon helped foster mothers to maintain parental warmth (small effect size). There were no other effects of Parent Management Training Oregon on self-reported parenting behaviors. Child behavior problems were reduced in both conditions, indicating no additive effects of Parent Management Training Oregon to Care as Usual on child functioning. The potential implication of reduced foster parenting stress for placement stability is discussed.
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Affiliation(s)
- Anne M. Maaskant
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Floor B. van Rooij
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Geertjan J. Overbeek
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Frans J. Oort
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Maureen Arntz
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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Job AK, Lohaus A, Konrad K, Scharke W, Reindl V, Heinrichs N. Die Rolle von adaptiver und maladaptiver Emotionsregulation bei Pflegekindern mit Misshandlungserfahrung. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2016. [DOI: 10.1026/1616-3443/a000385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Es wird angenommen, dass der familiäre Kontext einen erheblichen Einfluss auf die Entwicklung der kindlichen Emotionsregulation hat. Bei Pflegekindern wird durch die Fremdplatzierung entscheidend Einfluss auf den familiären Kontext genommen. Pflegekinder mit Misshandlungs- oder Vernachlässigungserfahrungen haben außerdem ein erhöhtes Risiko emotionale und Verhaltensauffälligkeiten zu entwickeln. In dieser Studie wird der Einfluss ausgewählter Variablen des familiären Kontextes auf die Emotionsregulation junger Kinder in zwei Stichproben untersucht. Fragestellung: Wie hängt das elterliche Erziehungsverhalten mit der kindlichen Emotionsregulation und beides wiederum mit kindlichen emotionalen und Verhaltensauffälligkeiten zusammen? Methode: Die primären Bezugspersonen von 99 Kindern, die in ihrer Herkunftsfamilie aufwachsen, und 51 Pflegekindern, die in den letzten 24 Monaten in einer Pflegefamilie untergebracht wurden, berichteten über das eigene Erziehungsverhalten, die kindliche Emotionsregulation sowie psychische Auffälligkeiten ihres (Pflege–)Kindes im Alter von 2;0 bis 7;11 Jahren. Ergebnisse: Während das Erziehungsverhalten bei den Herkunftsfamilien signifikant die Nutzung adaptiver (nicht aber maladaptiver) Emotionsregulationsstrategien vorhersagte, ergaben sich bei den Pflegefamilien diesbezüglich keine signifikanten Zusammenhänge. Der signifikante Einfluss maladaptiver Emotionsregulationsstrategien auf psychische Auffälligkeiten fand sich in beiden Stichproben. Schlussfolgerungen: Dass der Einfluss des familiären Kontexts auf die Emotionsregulation in den Herkunftsfamilien größer ist als in den Pflegefamilien, könnte auf mögliche konfundierende genetische Effekte oder darauf zurückzuführen sein, dass die Einflussmöglichkeiten der Herkunftsfamilien-Eltern bereits über längere Zeiträume bestanden. Insbesondere bezogen auf die Pflegefamilien bieten die Ergebnisse verschiedene Ansatzpunkte für Interventionen.
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Affiliation(s)
- Ann-Katrin Job
- Abt. für Klinische Psychologie, Psychotherapie & Diagnostik, Technische Universität Braunschweig
| | - Arnold Lohaus
- Abt. für Entwicklungspsychologie und Entwicklungspsychopathologie, Universität Bielefeld
| | - Kerstin Konrad
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Aachen
| | - Wolfgang Scharke
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Aachen
| | - Vanessa Reindl
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Aachen
| | - Nina Heinrichs
- Abt. für Klinische Psychologie, Psychotherapie & Diagnostik, Technische Universität Braunschweig
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Leathers SJ, Spielfogel JE, Blakey J, Christian E, Atkins MS. The Effect of a Change Agent on Use of Evidence-Based Mental Health Practices. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 43:768-782. [PMID: 26487393 PMCID: PMC4838563 DOI: 10.1007/s10488-015-0694-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Children's service systems are faced with a critical need to disseminate evidence-based mental health interventions. Despite the proliferation of comprehensive implementation models, little is known about the key active processes in effective implementation strategies. This proof of concept study focused on the effect of change agent interactions as conceptualized by Rogers' diffusion of innovation theory on providers' (N = 57) use of a behavioral intervention in a child welfare agency. An experimental design compared use for providers randomized to training as usual or training as usual supplemented by change agent interactions after the training. Results indicate that the enhanced condition increased use of the intervention, supporting the positive effect of change agent interactions on use of new practices. Change agent types of interaction may be a key active process in implementation strategies following training.
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Affiliation(s)
- Sonya J Leathers
- Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL, 60607-7134, USA.
| | - Jill E Spielfogel
- Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL, 60607-7134, USA
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
| | - Joan Blakey
- Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL, 60607-7134, USA
- Helen Bader School of Social Welfare, University of Wisconsin at Milwaukee, Milwaukee, WI, USA
| | - Errick Christian
- Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL, 60607-7134, USA
- Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Marc S Atkins
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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48
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Goemans A, van Geel M, Vedder P. Psychosocial functioning in Dutch foster children: The relationship with child, family, and placement characteristics. CHILD ABUSE & NEGLECT 2016; 56:30-43. [PMID: 27131271 DOI: 10.1016/j.chiabu.2016.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/20/2016] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
Foster care is the preferred alternative for out-of-home care, but not necessarily beneficial for foster children's psychosocial functioning. This dilemma leaves researchers with a challenge to find out more about the factors related to foster children's social and emotional functioning. In a sample of 446 Dutch foster children we examined the extent to which three clusters of characteristics, those akin to the foster child, the foster family, or foster placement, were related to foster children's functioning at the time of research. Multivariate three-step hierarchical regression analyses were performed for three outcome variables: externalizing problems, internalizing problems, and prosocial behavior. We found that all three clusters of foster care characteristics were significantly related to foster children's functioning. Foster placement characteristics, in particular interventions aimed at foster children, explained the largest amount of variance in behavior problems. Children receiving interventions had more externalizing and internalizing problems. A possible explanation is that interventions are indicated for those foster children who are in the highest need of additional support. Prosocial behavior was particularly related to foster family characteristics. The results were mostly in line with international research. Careful screening and monitoring of the social and emotional functioning of foster children may help to identify problems at an early stage. In addition (preventive) support should be offered to those foster children and families who are in need of it.
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Affiliation(s)
- Anouk Goemans
- Institute of Education and Child Studies, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - Mitch van Geel
- Institute of Education and Child Studies, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Paul Vedder
- Institute of Education and Child Studies, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Czaja SJ, Valente TW, Nair SN, Villamar JA, Brown CH. Characterizing implementation strategies using a systems engineering survey and interview tool: a comparison across 10 prevention programs for drug abuse and HIV sexual risk behavior. Implement Sci 2016; 11:70. [PMID: 27184963 PMCID: PMC4869203 DOI: 10.1186/s13012-016-0433-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 05/04/2016] [Indexed: 01/29/2023] Open
Abstract
Background Although many behavioral interventions have proven to be efficacious, new methodologies are required beyond efficacy trials to understand how to adopt, implement with fidelity, and sustain behavioral interventions in community settings. In this paper, we present a new approach, based on systems engineering concepts and methods, for characterizing implementation strategies that are used to deliver evidence-based behavioral interventions in health and social service settings. We demonstrate the use of this approach with implementation strategies, used or being used for broader dissemination of 10 evidence-based prevention program projects focused on the prevention of drug or HIV sex risk behaviors. Results The results indicate that there are wide variations in intervention approaches and that there are challenges in program implementation including maintaining program fidelity, serving community needs, and adequate resources. The results also indicate that implementation requires a committed partnership between the program developers, implementation researchers, and community partners. In addition, there is a need for adaptability within programs to meet community needs, resources, and priorities while maintaining program fidelity. Conclusions Our methodological approach enabled us to highlight challenges associated with the community implementation of health risk prevention interventions. We also demonstrate how comprehensive descriptions of interventions facilitate understanding of the requirements of program implementation and decisions about the feasibility of implementing a program in community settings.
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Affiliation(s)
- Sara J Czaja
- Department of Psychiatry and Behavioral Science, Miller School of Medicine, University of Miami, 1694 NW 9th Ave., Miami, FL, 33136, USA.
| | - Thomas W Valente
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Sankaran N Nair
- Center for Aging, Miller School of Medicine, University of Miami, Miami, USA
| | - Juan A Villamar
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Evanston, USA
| | - C Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Evanston, USA
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50
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N'zi AM, Stevens ML, Eyberg SM. Child Directed Interaction Training for young children in kinship care: A pilot study. CHILD ABUSE & NEGLECT 2016; 55:81-91. [PMID: 27012997 PMCID: PMC5012006 DOI: 10.1016/j.chiabu.2016.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 02/14/2016] [Accepted: 03/01/2016] [Indexed: 05/27/2023]
Abstract
This pilot study used a randomized controlled trial design to examine the feasibility and explore initial outcomes of a twice weekly, 8-session Child Directed Interaction Training (CDIT) program for children living in kinship care. Participants included 14 grandmothers and great-grandmothers with their 2- to 7-year-old children randomized either to CDIT or a waitlist control condition. Training was delivered at a local, community library with high fidelity to the training protocol. There was no attrition in either condition. After training, kinship caregivers in the CDIT condition demonstrated more positive relationships with their children during behavioral observation. The caregivers in the CDIT condition also reported clinically and statistically significant decreases in parenting stress and caregiver depression, as well as fewer externalizing child behavior problems than waitlist controls. Parent daily report measures indicated significant changes in disciplining that included greater use of limit-setting and less use of critical verbal force. Results appeared stable at 3-month follow-up. Changes in child internalizing behaviors and caregiver use of non-critical verbal force were not seen until 3-month follow-up. Results of this pilot study suggest both the feasibility of conducting full scale randomized clinical trials of CDIT in the community and the promise of this approach for providing effective parent training for kinship caregivers.
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Affiliation(s)
- Amanda M N'zi
- Department of Clinical and Health Psychology, University of Florida, United States.
| | - Monica L Stevens
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Sheila M Eyberg
- Department of Clinical and Health Psychology, University of Florida, United States
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