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McGrane Minton H, Murray L, Allan MJ, Perry R, Bettencourt AF, Gross D, Strano L, Breitenstein SM. Implementation of a Parent Training Program During Community-Based Dissemination (From In-Person to Hybrid): Mixed Methods Evaluation. JMIR Pediatr Parent 2024; 7:e55280. [PMID: 38959504 DOI: 10.2196/55280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Parent training interventions support and strengthen parenting practices and parent-child relationships and improve child behavior. Between March 2018 and February 2020, a community-based parenting program conducted 38 in-person Chicago Parent Program (CPP) groups. In response to the COVID-19 pandemic, we modified the delivery of the in-person CPP to hybrid delivery using the self-administered, web-based version of the CPP (ezParent) paired with web-based, videoconferenced group sessions. OBJECTIVE This study aims to describe the delivery transition and implementation outcomes of the hybrid delivery of the CPP (ezParent+group) during community-based dissemination. METHODS This single-group, mixed methods retrospective evaluation examined the implementation outcomes using the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework. We report on data from hybrid ezParent delivery between September 2020 and August 2022. Parents completed pre- and postprogram surveys that included motivation to participate and perceived changes in parent-child behavior. Digital analytics captured ezParent completion. Facilitators completed fidelity assessments and participated in postintervention interviews. RESULTS In total, 24 hybrid ezParent groups (n=240 parents) were delivered by 13 CPP-trained facilitators. Parents reported high levels of satisfaction with the program and improvements in their feelings of parenting self-efficacy and their child's behavior following their participation in hybrid ezParent. On average, parents completed 4.58 (SD 2.43) 6 ezParent modules. The average group attendance across the 4 sessions was 71.2%. Facilitators found the hybrid delivery easy to implement and reported high parent engagement and understanding of CPP strategies. CONCLUSIONS Using the hybrid ezParent intervention is a feasible and effective way to engage parents. Lessons learned included the importance of academic and community-based organization partnerships for delivering and evaluating robust programs. Implementation facilitators and barriers and future research recommendations are discussed.
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Affiliation(s)
| | - Linda Murray
- Children's Institute, University of Rochester, Rochester, NY, United States
| | - Marjorie J Allan
- Children's Institute, University of Rochester, Rochester, NY, United States
| | - Roslyn Perry
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Amie F Bettencourt
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Deborah Gross
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Lauri Strano
- Children's Institute, University of Rochester, Rochester, NY, United States
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Danford CA, Mooney-Doyle K, Deatrick JA, Feetham S, Gross D, Knafl KA, Kobayashi K, Moriarty H, Østergaard B, Swallow V. Building Family Interventions for Scalability and Impact. JOURNAL OF FAMILY NURSING 2024; 30:94-113. [PMID: 38629802 DOI: 10.1177/10748407241231342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani's five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.
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Affiliation(s)
| | | | | | - Suzanne Feetham
- University of Illinois Chicago, Chicago, IL USA
- Children's National Hospital, Washington, DC, USA
| | | | - Kathleen A Knafl
- The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | | | - Helene Moriarty
- Villanova University, PA, Villanova, USA
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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Breitenstein SM, Berteletti J, Smoske S, Barger C, Tipps K, Helsabeck NP. Administrative Dashboard for Monitoring Use of a Web-Based Parent Training Intervention: Usability Study. JMIR Form Res 2024; 8:e53439. [PMID: 38289675 PMCID: PMC10865193 DOI: 10.2196/53439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Web-based parent training (PT) programs can strengthen parent-child relationships by equipping caregivers with knowledge and evidence-based strategies to manage behavior. Hybrid facilitation of PT includes facilitator interaction paired with self-administered and web-based PT. Web-based administrative dashboards provide users (eg, administrators, facilitators, and researchers) with an integrated platform to monitor parent progress and activities within a PT program or website. Despite the utility and prevalence of administrative dashboards for web-based behavioral interventions, to our knowledge, no research studies have explored the perspectives and insights of dashboard users to enhance user experience and program delivery. OBJECTIVE The purpose of this study is to evaluate the usability of the administrative dashboard (ezDashboard) for the ezParent program, a 6-module web-based PT program for parents of children aged 2-5 years. METHODS This study used a descriptive, single-group design with administrators who were overseeing the implementation of the ezParent program and trained facilitators for hybrid ezParent delivery. Participants spent at least 30 minutes reviewing and evaluating the ezDashboard and then completed a survey of their experience with the dashboard. The survey included the validated 10-item System Usability Scale and open-ended questions focusing on user performance, navigation ease, and overall usefulness of the ezDashboard. RESULTS Participants (N=15) indicated high usability of the ezDashboard with System Usability Scale scoring a total mean score of 83.5 (SD 16.3). Most participants (n=13, 87%) rated the overall user-friendliness of the ezDashboard as good (n=3, 20%), excellent (n=9, 60%), or best imaginable (n=1, 7%). Open-ended questions revealed the ezDashboard is or would be useful to monitor parent progress and trends in engagement (n=8, 53%) and for reviewing topics for discussion and communicating with parents (n=5, 33%). ezParent administrators (n=4) identified that real-time data for ezParent use helps overall management of program uptake. Suggestions for features to add to the ezDashboard included the ability to track partial progress of program modules (4/14, 29%), total time spent per module (2/14, 14%), and exportable reports (4/14, 29%). Other ideas for improvement included direct messaging capabilities, videoconferencing platform integration, and being able to modify participant account and contact information. CONCLUSIONS Results indicate that the ezDashboard is easy to use and provides functional information to facilitators and administrators in delivering ezParent. Qualitative results indicate that integrating suggested features into the ezDashboard may help provide a smoother experience for facilitators, administrators, and ultimately the parents using the program. Providing resources for facilitators and administrators in real time to monitor intervention participants' progress in a program can be helpful in tracking progress and providing facilitated support in tailoring program content and program completion.
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Affiliation(s)
| | | | - Shea Smoske
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | | | - Kyrie Tipps
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Nathan P Helsabeck
- College of Nursing, The Ohio State University, Columbus, OH, United States
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Tu Y, Sarkar K, Svirydzenka N, Palfreyman Z, Parry YK, Ankers M, Parikh P, Raghavan R, Lakhanpaul M. Interventions to promote the health and well-being of children under 5s experiencing homelessness in high-income countries: a scoping review. BMJ Open 2024; 14:e076492. [PMID: 38216205 PMCID: PMC10806763 DOI: 10.1136/bmjopen-2023-076492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/13/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES Homelessness among families with children under 5 residing in temporary accommodation is a growing global concern, especially in high-income countries (HICs). Despite significant impacts on health and development, these 'invisible' children often fall through the gaps in policy and services. The study's primary objective is to map the content and delivery methods of culturally sensitive interventions for children under 5 experiencing homelessness in HICs. DESIGN A scoping review guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SOURCES Databases include PubMed, Medline, SCOPUS, The Cochrane Library and Google Scholar were searched up to 24 March 2022. ELIGIBILITY CRITERIA This scoping review includes studies that describe, measure or evaluate intervention strategies aimed at improving child health programmes, specifically those yielding positive outcomes in key areas like feeding, nutrition, care practices and parenting. DATA EXTRACTION AND SYNTHESIS Articles were selected and evaluated by two independent reviewers, with a dispute resolution system involving a third reviewer for contested selections. The methodological quality of the studies was assessed using various tools including the Risk of Bias (RoB) tool, Cochrane RoB V.2.0, the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), each selected according to the type of article. RESULTS The database search yielded 951 results. After deduplication, abstract screening and full review, 13 articles met the inclusion criteria. Two predominant categories of intervention delivery methods were identified in this research: group-based interventions (educational sessions) and individual-based interventions (home visits). CONCLUSION This review highlights effective interventions for promoting the health and well-being of children under 5 experiencing homelessness, including educational sessions and home visits. Research has supported the importance of home visiting to be instrumental in breaking down language, cultural and health literacy barriers.
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Affiliation(s)
- Yanxin Tu
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK
| | | | - Nadia Svirydzenka
- School of Applied Social Sciences, De Montfort University Faculty of Health and Life Sciences, Leicester, UK
| | - Zoe Palfreyman
- School of Applied Social Sciences, De Montfort University Faculty of Health and Life Sciences, Leicester, UK
| | - Yvonne Karen Parry
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Matthew Ankers
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Priti Parikh
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | - Raghu Raghavan
- School of Nursing and Midwifery, De Montfort University Faculty of Health and Life Sciences, Leicester, UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK
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Bierman KL, Stormshak EA, Mannweiler MD, Hails KA. Preschool Programs that Help Families Promote Child Social-Emotional School Readiness: Promising New Strategies. Clin Child Fam Psychol Rev 2023; 26:865-879. [PMID: 37453988 PMCID: PMC11154596 DOI: 10.1007/s10567-023-00444-5] [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: 07/01/2023] [Indexed: 07/18/2023]
Abstract
Parents play a central role in supporting the early learning that positions young children for success when they enter formal schooling. For this reason, efforts to engage families in meaningful collaboration is a long-standing goal of high-quality early childhood education (ECE). Family-school engagement can take multiple forms; in this review, we focus on universal preschool-based outreach strategies that help parents support growth in child social-emotional and self-regulation competencies and prepare them for the transition into formal schooling. Recent research has expanded understanding of the neurodevelopmental processes that underlie child school readiness, and the impact of parenting (and the social ecology affecting parenting) on those processes. These new insights have fueled innovation in preschool-based efforts to partner with and support parents, expanding and shifting the focus of that programming. In addition, new approaches to intervention design and delivery are emerging to address the pervasive challenges of reaching and engaging families, especially those representing diverse racial, ethnic, cultural, and socioeconomic backgrounds. This paper reviews developmental research that underscores the importance of prioritizing child social-emotional learning (with attention to self-regulation and approaches to learning) in universal preschool-based parenting programs targeting young children. We highlight the intervention strategies used in programs with strong evidence of impact on child readiness and school adjustment based on randomized controlled trials (RCTs). New directions in intervention design and delivery strategies are highlighted, with the hope of extending intervention reach and improving family engagement and benefit.
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Affiliation(s)
- Karen L Bierman
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
| | | | - Morgan D Mannweiler
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Berry V, Melendez-Torres GJ, Axford N, Axberg U, de Castro BO, Gardner F, Gaspar MF, Handegård BH, Hutchings J, Menting A, McGilloway S, Scott S, Leijten P. Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1447-1458. [PMID: 35870094 PMCID: PMC10678811 DOI: 10.1007/s11121-022-01404-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Abstract
There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1-144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs-an 8-19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.
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Affiliation(s)
| | | | | | - Ulf Axberg
- VID Specialized University, Oslo, Norway
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Slade EP, Bettencourt AF, Gross DA. Cost-Effectiveness a Parenting Skills Program Implemented in Public PreK Schools in Disadvantaged Urban Communities. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:888-900. [PMID: 37493933 DOI: 10.1007/s10488-023-01287-6] [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: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Little is known about the cost-effectiveness of parent training programs when offered universally in U.S. elementary schools in disadvantaged urban communities. OBJECTIVE To estimate the cost-effectiveness of a universal school-based implementation study of the Chicago Parent Program (CPP). METHODS CPP was offered universally from 2014 to 2017 to parents of PreK students in 12 Baltimore City Title 1 schools (n = 380; 61.1% Black/African American, 24.1% Hispanic). CPP program implementation and operating costs were estimated using microcosting methods and data drawn from study records. A Complier Average Causal Effects (CACE) framework was used to estimate an Incremental Cost Effectiveness Ratio (ICER) for CPP's average cost per child per 1% decrease in conduct problem prevalence at follow-up. This ICER was then compared with comparable ICERs for four parenting interventions that have been implemented and evaluated in Europe: Connect, Incredible Years, COPE, and Comet. RESULTS CPP cost $937.51 per child (95% CI: $902.09 to $971.92). Adjusted CACE estimates indicated that CPP resulted in a 31.4% reduction (95% CI: -39.7% to -23.9%) in conduct problem prevalence at follow-up among children whose parents attended CPP. The mean ICER for CPP was $29.86 per each 1% reduction in prevalence (95% CI: $21.05 to $50.71). CPP's ICER was similar to ICERs for Connect ($25.50) and COPE ($29.72), and less than ICERs for Incredible Years ($50.36) and Comet ($59.69). CONCLUSION School-based CPP offered universally to parents of children transitioning to Kindergarten in extremely disadvantaged U.S. urban communities was found to offer relatively good value compared with similar parenting programs that are widely used in Europe.
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Affiliation(s)
- Eric P Slade
- Johns Hopkins School of Nursing, Baltimore, MD, USA.
- Johns Hopkins School of Public Health, Baltimore, MD, USA.
- School of Nursing and School of Public Health, Johns Hopkins University, 525 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - Amie F Bettencourt
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Deborah A Gross
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
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8
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Plesko CM, Yu Z, Tobin K, Richman R, Gross D. A mixed-methods study of parents' social connectedness in a group-based parenting program in low-income communities. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2023; 94:1-14. [PMID: 37796597 PMCID: PMC10922201 DOI: 10.1037/ort0000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Group-based parent training (PT) is an evidence-based approach for strengthening parenting skills and reducing child behavior problems. However, there has been little research on the social connectedness (SC) formed among PT participants, particularly in low-income communities where parents may be more socially isolated. This study describes SC formed among parents in a group-based PT program implemented in their children's school and its association with changes in child behavior. Using a convergent mixed-methods design, data collection occurred between 2020 and 2022. Parents (n = 97) completed measures of their SC to other parents in their PT group and their child's behavior. Qualitative interviews with a representative subsample of parents (n = 17) were also conducted to understand parents' perceptions and experiences of SC within their PT group. Parents reported high levels of SC (M = 4.45 [range = 3.04-5 on scale of 1-5]; SD = 0.4). From baseline to postintervention, the number of children with child behavior problems significantly decreased (32.12%, 37.5% behavior intensity and problems, respectively). The magnitude of decline in child behavior problems was significantly related to parents' SC (b = -11.52, p = .02, SE = 4.99). Qualitative data confirmed high levels of SC, which parents linked to improvements in their parenting and children's behavior. Themes focused on the building of connections, committing to a safe space with parents who share similar goals, supporting one another, and gaining connections within the school environment and during the COVID-19 pandemic. Results highlight the potential synergistic effects of SC formed in the context of group-based PT with implications for strengthening parenting skills and children's well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Zhiyuan Yu
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Karin Tobin
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rebecca Richman
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Deborah Gross
- Johns Hopkins University School of Nursing, Baltimore, Maryland
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Silver J, Thorpe D, Olino TM, Klein DN. Intergenerational Effects of Parenting on Children's Internalizing and Externalizing Trajectories: A Latent Growth Model Analysis. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01554-5. [PMID: 37378791 DOI: 10.1007/s10578-023-01554-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Externalizing and internalizing problems in childhood are associated with risk for later psychopathology. It is important to identify antecedents as they may be targets for intervention. In a sample of 501 children (M = 6.07; 54.7% male; 12.4% Hispanic; 12.2% non-White), we leveraged data from a longitudinal study to examine the transmission of parenting behaviors across two generations and its effects on children's internalizing and externalizing outcomes in the subsequent generation. The results suggested transmission of parenting behaviors, confirmed the role of parenting on children's psychopathology, and provided novel evidence of a direct and indirect role of grandparent's caregiving on children's psychopathology via parenting continuity. These findings may inform interventions addressing continuity of parenting behaviors and their subsequent effects.
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Affiliation(s)
- Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, New York, NY, 11794-2500, USA.
| | - Daneele Thorpe
- Department of Psychology, Stony Brook University, Stony Brook, New York, NY, 11794-2500, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York, NY, 11794-2500, USA
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Backhaus S, Leijten P, Jochim J, Melendez-Torres G, Gardner F. Effects over time of parenting interventions to reduce physical and emotional violence against children: a systematic review and meta-analysis. EClinicalMedicine 2023; 60:102003. [PMID: 37251634 PMCID: PMC10209692 DOI: 10.1016/j.eclinm.2023.102003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Background Violence against children affects over one billion children globally. International organisations promote parenting interventions as a main strategy to reduce violence against children. Parenting interventions have therefore been implemented rapidly across the globe. Yet, evidence for their longer-term effects remains unclear. We integrated global evidence to estimate effects over time of parenting interventions to reduce physical and emotional violence against children. Methods In this systematic review and meta-analysis, we searched 26 databases and trial registries (14 non-English: Spanish, Chinese, Farsi, Russian, Thai) and conducted an extensive grey literature search up to August 01, 2022. We included randomised controlled trials (RCTs) of parenting interventions based on social learning theory for parents of children aged 2-10 years, without time or context restrictions. We critically appraised studies using Cochrane's Risk of Bias Tool. Data were synthesised using robust variance estimation meta-analyses. This study is registered with PROSPERO, CRD42019141844. Findings We screened 44,411 records and included 346 RCTs. Sixty RCTs reported outcomes on physical or emotional violence. Trials were distributed across 22 countries (22% LMICs). Risk of bias was high for various domains. Outcome data ranged from 0 weeks to 2 years after the intervention, and was largely based on parent self-report. Parenting interventions reduced physical and emotional violent parenting behaviours immediately after the intervention (n = 42, k = 59; d = -0.46; 95% CI: -0.59, -0.33), at 1-6 months follow-up (n = 18, k = 31; d = -0.24; 95% CI: -0.37, -0.11) and at 7-24 months follow-up (n = 12, k = 19; d = -0.18; 95% CI: -0.34, -0.02), but effects were smaller over time. Interpretation Our findings suggest that parenting interventions can reduce physical and emotional violence against children. Effects are maintained up to 24 months follow-up, but with diminished effect sizes. With global policy interest and imminent importance, research beyond 2 years and how effects can be better sustained over time is urgently needed. Funding Student scholarship from the Economic Social Research Council, Clarendon, and Wolfson Isaiah Berlin Fund.
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Affiliation(s)
- Sophia Backhaus
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
| | - Patty Leijten
- Research Institute Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Postbus 15776, 1001 NG, Amsterdam, the Netherlands
| | - Janina Jochim
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
| | | | - Frances Gardner
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
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Rae S, Maguire J, Aglipay M, Barwick M, Danavan K, Haines J, Jenkins J, Klaassen M, Moretti ME, Ong F, Persaud N, Porepa M, Straus S, Tavares E, Willan A, Birken C. Randomized controlled trial evaluating a virtual parenting intervention for young children at risk of obesity: study protocol for Parenting Addressing Early Years Intervention with Coaching Visits in Toronto (PARENT) trial. Trials 2023; 24:8. [PMID: 36600302 PMCID: PMC9811050 DOI: 10.1186/s13063-022-06947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of overweight (15%) and obesity (6%) in children under 5 years of age in Canada are high, and young children with overweight and obesity are at increased risk of the development of chronic disease(s) in adulthood. Prior research has demonstrated very few published trials on effective obesity prevention interventions in young children at risk of obesity, within primary healthcare settings. The aim of this study is to determine if 18-48-month-old children at risk for obesity, who are randomized to receive the Parents Together program (i.e., intervention group), have reduced body mass index z-score (zBMI), compared to those not receiving the intervention, at a 12-month follow-up. Secondary clinical outcomes between the intervention and control groups will be compared at 12 months. METHODS A pragmatic, parallel group, 1:1, superiority, randomized control trial (RCT) through the TARGetKids! Practice Based Research Network will be conducted. Young children (ages 18-48 months) who are at increased risk for childhood obesity will be invited to participate. Parents who are enrolled in the intervention group will participate in eight weekly group sessions and 4-5 coaching visits, facilitated by a trained public health nurse. Children and parents who are enrolled in the control group will receive the usual health care. The primary outcome will be compared between intervention arms using an analysis of covariance (ANCOVA). Feasibility and acceptability will be assessed by parent focus groups and interviews, and fidelity to the intervention will be measured using nurse-completed checklists. A cost-effectiveness analysis (CEA) will be conducted. DISCUSSION This study will aim to reflect the social, cultural, and geographic diversity of children in primary care in Toronto, Ontario, represented by an innovative collaboration among applied child health researchers, community health researchers, and primary care providers (i.e., pediatricians and family physicians in three different models of primary care). Clinical and implementation outcomes will be used to inform future research to test this intervention in a larger number, and diverse practices across diverse geographic settings in Ontario. TRIAL REGISTRATION ClinicalTrials.gov NCT03219697. Registered on June 27, 2017.
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Affiliation(s)
- Sarah Rae
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Jonathon Maguire
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Mary Aglipay
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada
| | - Melanie Barwick
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Karoon Danavan
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Jess Haines
- grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Jennifer Jenkins
- grid.17063.330000 0001 2157 2938Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Marie Klaassen
- grid.417191.b0000 0001 0420 3866Toronto Public Health, Toronto, ON Canada
| | - Myla E. Moretti
- grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Frank Ong
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Nav Persaud
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.415502.7Department of Family and Community Medicine, Centre for Urban Health Solutions and Department of Family and Community Medicine, University of Toronto, St. Michael’s Hospital, Toronto, ON Canada
| | - Michelle Porepa
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Sharon Straus
- grid.415502.7Department of Pediatrics, St Michael’s Hospital, Pediatric Research, Toronto, ON Canada
| | - Erika Tavares
- grid.42327.300000 0004 0473 9646Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Andrew Willan
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Catherine Birken
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada
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12
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Wesemann DG, Wilson AC, Riley AR. Parental Cannabis Use, Negative Parenting, and Behavior Problems of Young Children. Subst Use Misuse 2022; 57:2015-2019. [PMID: 36194195 PMCID: PMC9659323 DOI: 10.1080/10826084.2022.2130001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
Introduction: Cannabis use in the United States is increasingly accepted and legal. Rise in use among childbearing aged adults is potentially concerning, as the impacts of parental cannabis use on children are largely unknown, especially for young children. This study examined whether cannabis use is associated with increased risk for negative parenting and child emotional and behavioral problems among the parents of young children. Methods: We conducted a cross-sectional survey of parents and child behavior, recruited through five primary care practices in three states. Parents of children aged 1.5-5 years reported on family demographics, last 6-months cannabis use, negative parenting, parent mental health, parents' adverse childhood experiences (ACEs), and child emotional/behavioral problems. We conducted hierarchical regressions to determine if parental cannabis use predicts negative parenting and/or child emotional/behavioral problems when controlling for other risk factors. Results: Of 266 responding parents, 34 (13%) reported cannabis use in the last 6 months. Parents who endorsed cannabis use reported significantly more negative parenting, ACEs, anxiety, depression, and child emotional/behavioral problems. Adjusting for the effects of other risk factors, cannabis use significantly predicted more negative parenting, but was not uniquely and significantly associated with child emotional/behavioral problems. Conclusion: Parental cannabis predicted negative parenting, which in turn predicted early childhood emotional/behavioral problems; however, parental cannabis use did not predict child emotional/behavioral problems when other risk factors were considered. Further research is needed to elucidate the nature and direction of relationships between parent cannabis use, negative parenting, child psychological outcomes, and other risk factors.
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Affiliation(s)
- Dalton G. Wesemann
- Build EXITO Scholars Program, Portland State University, Portland, Oregon, United States
| | - Anna C. Wilson
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States
| | - Andrew R. Riley
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States
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13
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Hails KA, Petts RA, Hostutler CA, Simoni M, Greene R, Snider TC, Riley AR. COVID-19 distress, negative parenting, and child behavioral problems: The moderating role of parent adverse childhood experiences. CHILD ABUSE & NEGLECT 2022; 130:105450. [PMID: 34969517 PMCID: PMC8710429 DOI: 10.1016/j.chiabu.2021.105450] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Heightened familial stress and distress during the COVID-19 pandemic may lead to increased negative parenting practices, particularly for parents with substantial adverse childhood experiences (ACES). OBJECTIVE To determine whether families' COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' ACEs. PARTICIPANTS AND SETTING Participants were 267 parents of children ages 1.5-5 years recruited from five primary care sites across the United States. METHODS Participants completed internet questionnaires including measures of demographics, parent ACES, negative parenting, parent mental health, and COVID-19 distress. We used regression analyses to test a moderated mediation model in which the relationship between COVID-19 distress and child emotional/behavioral problems is mediated by negative parenting, and both the direct and indirect effects of COVID-19 distress on child emotional/behavioral problems is moderated by parents' ACEs. RESULTS Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems (indirect effect β = 0.07). Parents' ACEs moderated the associations between COVID-19 distress and both negative parenting and child emotional/behavioral problems, such that each relationship was stronger in the context of higher parental ACEs. The model accounted for 42% of the variance in child emotional/behavioral problems. CONCLUSIONS Findings have implications for managing risk and promoting well-being in young children during periods of significant stress and routine disruption. This study advances understanding of factors influencing negative outcomes in children during the pandemic's acute phase and may have implications for the development of targeted interventions to improve families' adjustment in the future.
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Affiliation(s)
- Katherine A Hails
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America; University of Oregon Prevention Science Institute, 1600 Millrace Dr., Eugene, OR 97403, United States of America.
| | - Rachel A Petts
- Fairleigh Dickinson University, 1000 River Rd., Teaneck, NJ 07666, United States of America.
| | - Cody A Hostutler
- Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH 43205, United States of America.
| | - Marisa Simoni
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
| | - Rachel Greene
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
| | - Tyanna C Snider
- Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH 43205, United States of America.
| | - Andrew R Riley
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
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14
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Greene MM, Schoeny ME, Berteletti J, Keim SA, Neel ML, Patra K, Smoske S, Breitenstein S. ezPreemie study protocol: a randomised controlled factorial trial testing web-based parent training and coaching with parents of children born very preterm. BMJ Open 2022; 12:e063706. [PMID: 35732380 PMCID: PMC9226920 DOI: 10.1136/bmjopen-2022-063706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Children born very preterm (VPT; gestational age <32 weeks) are twice as likely to demonstrate behaviour problems such as aggression, non-compliance, temper tantrums and irritability compared with their term-born peers. While behavioural parent training (BPT), also referred to as behaviour therapy is a gold standard for prevention and treatment of childhood problem behaviours, there are limited accessible and effective BPT interventions for families with children born VPT. The purpose of this paper is to describe a multicentre, randomised controlled protocol for a factorial design trial evaluating the independent and combined effects of the ezParent BPT intervention plus brief, weekly coaching calls on parent and child outcomes for families with toddlers born VPT. METHODS AND ANALYSIS The study employs a 2×2 factorial randomised design. Parents (n=220) of children aged 20-30 months corrected age who were born VPT (<32 weeks) will be recruited from two large metropolitan Neonatal Intensive Care Units follow-up clinics and randomised to one of four conditions: (1) ezParent (2) ezParent +coach, (3) Active control or (4) Active Control +coach. Data on parenting and child behaviour outcomes will be obtained from all participants at baseline and 3, 6 and 12 months postbaseline. All analyses will use an intention-to-treat approach, independent of their actual dose of each intervention. ETHICS AND DISSEMINATION The study protocol has been approved by The Ohio State University Institutional Review Board (IRB) using a single IRB. Study results will be disseminated through presentations at regional and national conferences, publications in peer-reviewed journals, and sharing research reports with participating families and recruiting sites. TRIAL REGISTRATION NUMBER NCT05217615.
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Affiliation(s)
- Michelle M Greene
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - M E Schoeny
- College of Nursing, Rush University, Chicago, Illinois, USA
| | | | - Sarah A Keim
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics and Division of Epidemiology, The Ohio State University, Columbus, Ohio, USA
| | - Mary Lauren Neel
- Division of Neonatology & Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kousiki Patra
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - Shea Smoske
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
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15
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Or PL, Ching TY. The effectiveness of raising Hong Kong parents' awareness of antimicrobial resistance through an education program with peer support on social media: a randomized, controlled pilot study. BMC Public Health 2022; 22:315. [PMID: 35168586 PMCID: PMC8845248 DOI: 10.1186/s12889-022-12697-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background The aim of this study was to address the misuse of antibiotics and test the feasibility of an education program with peer support on social media in improving parents’ knowledge on antimicrobial resistance at a regional level in Hong Kong. This pilot, if successful, will be developed into a main study. Methods A cluster randomized controlled trial with two-arms were implemented. The intervention program consisted of two weekly sessions and each session lasted for 90 min. Parents in the intervention group would join a Facebook Page of Antibiotic Use, this online platform would allow participants to build a social network. A total of 48 parents had participated in the program. Parental knowledge and attitude were measured before and after the program using the Parental Perception on Antibiotics (PAPA) scale and the General Self-Efficacy Scale (GSE) to assess differences between and within the intervention and control groups. Results All parents in the intervention group had an understanding that antibiotics could be effective at treating some infections only, as compared to 40% in the control group. All parents in the intervention group and 85% of the control group disagreed that they should reduce the dose of antibiotics when their children were recovering. The test was statistically significant (p = 0.039) at p < 0.05. There were a significant difference and a strong negative correlation between peer support on Facebook and the parents’ belief that antibiotics could be stopped when their children felt better, with Pearson coefficient of − 0.78 at p < 0.001. In general, there was no significant difference between the two groups with respect to the scale. Conclusions Based on the findings in this pilot study, a further study focused on the education program with enhancement and peer support should be implemented on a larger scale with considerations of how it might support reducing incidence of antimicrobial resistance and potentially influencing prescription expectations of patients when seeking healthcare. Trial registration Retrospectively registered Chinese Clinical Trial Registry ChiCTR2100044870. Registered on 31 March 2021.
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Affiliation(s)
- Pui-Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China.
| | - Tai-Yin Ching
- WHO Collaboration Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, China
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Montero-Zamora P, Brown EC, Ringwalt CL, Schwartz SJ, Prado G, Ortiz-García J. Predictors of Engagement and Attendance of a Family-Based Prevention Program for Underage Drinking in Mexico. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:237-247. [PMID: 34626326 DOI: 10.1007/s11121-021-01301-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
Underage drinking represents a major global health problem. Given the crisis that underage drinking represents, Tomando Buenas Decisiones, a family-based prevention program, was adapted and piloted in Mexico based on the existing Guiding Good Choices program. Although family-based interventions in the USA are promising for preventing underage drinking, little is known about how adapted versions of these interventions may work in low-middle income countries, such as in Latin America. The present study examined whether baseline individual, familial, and cultural factors predict participants' engagement and attendance in an adapted program for preventing underage drinking in Zacatecas, Mexico. The study was conducted with a sample of 178 parents who participated in the adapted program and were employed at local private companies. Latent growth curve modeling was used to analyze (a) change in engagement, (b) predictors of engagement, and (c) predictors of attendance. Results indicated that perceived engagement evidenced a significant linear increase throughout the intervention. Participants' familism values, such as perceived family as referents and family support, at baseline predicted both initial levels of and change in engagement. Perceived familial obligation also predicted change in engagement. Attendance was negatively predicted by male gender, by perceived stress, and by perceived familial obligations among women only. Poor family management, and perceived familial obligations among men, positively predicted attendance. Our findings have important implications for the conceptualization of engagement and attendance in family-based preventive interventions for underage drinking among Hispanics. Researchers interested in implementing interventions in Latin America can use these findings to better comprehend how and for whom adapted family-based preventive interventions work.
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Affiliation(s)
- Pablo Montero-Zamora
- Departments of Kinesiology and Health Education, College of Education, University of Texas at Austin, 2109 San Jacinto Blvd, Bellmont HallAustin, TX, 78712, USA. .,Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
| | - Eric C Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Christopher L Ringwalt
- Pacific Institute for Research and Evaluation, 1229 E Franklin St, Chapel Hill, Chatham, NC, 27514, USA
| | - Seth J Schwartz
- Departments of Kinesiology and Health Education, College of Education, University of Texas at Austin, 2109 San Jacinto Blvd, Bellmont HallAustin, TX, 78712, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Jorge Ortiz-García
- Academic Unit of Psychology, Autonomous University of Zacatecas, Zacatecas, Mexico
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17
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Hill Z, Spiegel M, Gennetian L, Hamer KA, Brotman L, Dawson-McClure S. Behavioral Economics and Parent Participation in an Evidence-Based Parenting Program at Scale. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:891-902. [PMID: 34014490 PMCID: PMC8458200 DOI: 10.1007/s11121-021-01249-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 10/26/2022]
Abstract
Evidence-based and culturally relevant parenting programs strengthen adults' capacity to support children's health and development. Optimizing parent participation in programs implemented at scale is a prevailing challenge. Our collaborative team of program developers, implementers, and researchers applied insights from the field of behavioral economics (BE) to support parent participation in ParentCorps-a family-centered program delivered as an enhancement to pre-kindergarten-as it scaled in a large urban school district. We designed a bundle of BE-infused parent outreach materials and successfully showed their feasibility in site-level randomized pilot implementation. The site-level study did not show a statistically significant impact on family attendance. A sub-study with a family-level randomization design showed that varying the delivery time of BE-infused digital outreach significantly increased the likelihood of families attending the parenting program. Lessons on the potential value of a BE-infused approach to support outreach and engagement in parenting programs are discussed in the context of scaling up efforts.
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Affiliation(s)
- Zoelene Hill
- New York Academy of Medicine , NY, 10029, New York, United States
| | | | | | - Kai-Ama Hamer
- NYU Grossman School of Medicine , NY, 10016, New York, United States
| | - Laurie Brotman
- NYU Grossman School of Medicine , NY, 10016, New York, United States
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18
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Highlander AR, Jones DJ. Integrating Objective and Subjective Social Class to Advance Our Understanding of Externalizing Problem Behavior in Children and Adolescents: A Conceptual Review and Model. Clin Child Fam Psychol Rev 2021; 25:300-315. [PMID: 34533656 DOI: 10.1007/s10567-021-00369-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/25/2022]
Abstract
Extant research has identified both objective measures of socioeconomic status (SES) and subjective social class (SSC) as important predictors of psychosocial outcomes in childhood and adolescence, particularly with regard to externalizing symptoms. Given the importance of the associations with SES and SSC, a more nuanced and integrated conceptual understanding of early pathways of vulnerability implicated in the development and maintenance of youth externalizing problems is warranted. Thus, this review will: (1) operationalize both SES and SSC and their current standards of measurement; (2) examine current literature describing their respective associations with a range of externalizing symptoms in both children and adolescents; (3) review current theoretical models connecting SES and SSC and youth development and the strengths and limitations of those approaches; (4) propose a new conceptual socioecological model situating the impact of SES and SSC on youth externalizing problems in the context of parents and peers as a framework to further integrate existing research and guide future work; and (5) discuss potential clinical implications at the intersection of this work.
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Affiliation(s)
- April R Highlander
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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19
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Breitenstein SM, Fehrenbacher C, Holod AF, Schoeny ME. A Randomized Trial of Digitally Delivered, Self-Administered Parent Training in Primary Care: Effects on Parenting and Child Behavior. J Pediatr 2021; 231:207-214.e4. [PMID: 33338496 PMCID: PMC9272894 DOI: 10.1016/j.jpeds.2020.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the effects of a self-administered, digital behavioral parent training program on parent and child behavior for parents of young children. STUDY DESIGN A randomized controlled trial compared ezParent (digital delivery of the evidence-based Chicago Parent Program) with an enhanced usual-care control. Introduction to the study occurred during well-child visits at 4 primary care clinics. In total, 287 parents of children age 2-5 years were randomized to ezParent or the control. Parents responded to surveys evaluating parent behavior, self-efficacy, and stress, and child behavior at baseline, and 3-, 6-, and 12-months postbaseline. Multilevel growth models examined parent and child outcomes for intervention efficacy in intent-to-treat analyses. Secondary moderation analysis explored intervention effects by program use and baseline parenting stress and child behavior problems. RESULTS The intervention main effect was not significant for parent and child behaviors. In exploratory moderation analysis, parents in the ezParent condition with greater baseline parenting stress reported less corporal punishment (P = .044); and greater improvement in parental warmth (P = .008), setting limits (P = .026), and proactive parenting (P = .019). Parents reporting greater baseline child behavior problems reported greater improvements in parental warmth (P = .007), setting limits (P = .003), and proactive parenting (P = .010). There were no differences in outcomes based on program usage. CONCLUSIONS Results suggest that ezParent as a self-administered behavioral parent training program may not be intense enough for child and parent behavioral change as a universal prevention model. Parents may require different levels of support for completion based on their level of service seeking, family characteristics, risk profile, and motivation for change. TRIAL REGISTRATION Clinicaltrials.gov: NCT02723916.
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Affiliation(s)
| | | | - Alicia F Holod
- The Ohio State University, College of Nursing, Columbus, OH
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20
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Engaging Parents in Mental Health Services: A Qualitative Study of Community Health Workers' Strategies in High Poverty Urban Communities. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:1019-1033. [PMID: 33682061 DOI: 10.1007/s10488-021-01124-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 10/22/2022]
Abstract
Empirical engagement-promoting strategies in child and family mental health services have been identified largely within the context of clinic-based services delivered by mental health professionals. However, the magnitude of unmet youth mental health need necessitates expanding the scope of mental health services, and the associated engagement strategies, beyond traditional models and service providers. The present study aimed to extend our understanding of engagement strategies to a school-based mental health service model, using a community health worker (CHW) workforce implementing an early intervention program with parents and school-aged children (K-4) in high poverty urban communities. Qualitative semi-structured individual interviews were conducted with 16 CHWs to capture their descriptions of the engagement strategies they utilized with parents throughout program implementation. Transcripts were coded and themes were identified following procedures for thematic analysis. Thematic analyses revealed ten themes describing a range of engagement strategies falling into two overarching categories: (1) rapport building, and (2) responsive delivery. Themes within the rapport building category included non-judgmental supportive listening, increasing social proximity, praise, privacy and confidentiality, and leveraging relationships. Themes within the responsive delivery category included flexibility, consistency, advocacy, incentives, and meeting needs. Findings provide preliminary evidence regarding the ability of CHWs to identify and implement a range of engagement strategies with parents and families that parallel empirically-based engagement strategies in traditional services. These findings speak to the potential of this workforce to engage underserved families in mental health services, underscoring the important role for CHWs in reducing mental health disparities.
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21
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Brager J, Breitenstein SM, Miller H, Gross D. Low-Income Parents' Perceptions of and Engagement With a Digital Behavioral Parent Training Program: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2021; 27:33-43. [PMID: 31509052 DOI: 10.1177/1078390319872534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Parent training is a method for strengthening parenting skills, reducing child behavior problems, and promoting positive parent-child relationships. However, few parents have access to these evidence-based programs. The ezParent program, a tablet-based delivery adaptation of the group-based Chicago Parent Program, is a parent training program designed to address the needs of families raising young children in urban poverty. AIMS: This study aimed to explore (a) parents' perceptions of the benefits and barriers associated with their use of the ezParent program and (b) the ways in which the ezParent components and perceived usability varied by program use (module completion). METHOD: An explanatory mixed-methods design was used with the overall intent to use the qualitative data to help explain in greater detail the quantitative results. RESULTS: Fifty-nine parents of 2- to 5-year-old children from two pediatric primary care clinics serving predominantly low-income and racial/ethnic minority families in Chicago (Cohort 1) and Baltimore (Cohort 2) participated in follow-up interviews. Among those interviewed, 23 (38.9.5%) parents completed all six modules and 12 parents (20.3%) completed none of the modules. However, of those 12, 8 (67%) logged in to the program and completed portions of Module 1. Parents who completed more modules reported more program benefits, and those who completed fewer modules reported more barriers. CONCLUSIONS: Exploring users' experience with current digital applications, researchers and application developers can better design future tablet-based interventions to be both effective and acceptable by consumers.
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Affiliation(s)
- Jenna Brager
- Jenna Brager, PhD, RN, LifeBridge Health-Sinai Hospital, Baltimore, MD, USA
| | - Susan M Breitenstein
- Susan M. Breitenstein, PhD, RN, FAAN, The Ohio State University, Columbus, OH, USA
| | - Hailey Miller
- Hailey Miller, BSN-RN, Johns Hopkins University, Baltimore, MD, USA
| | - Deborah Gross
- Deborah Gross, DNSc, RN, FAAN, Johns Hopkins University, Baltimore, MD, USA
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22
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Rusch D, Walden AL, DeCarlo Santiago C. A Community-Based Organization Model to Promote Latinx Immigrant Mental Health Through Advocacy Skills and Universal Parenting Supports. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:337-346. [PMID: 32880968 DOI: 10.1002/ajcp.12458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The unique mental health context of children in Latinx immigrant families calls for innovative community-based intervention strategies. We use an ecological public health approach to highlight the importance of community-based organization (CBO) settings, the critical role of community-based paraprofessionals (i.e., non-clinicians, near-peers) and capacity-building, and the expansion of mental health promotion strategies to include realistic, day-to-day supports for Latinx immigrant parents and families. This realigns mental health with the goals and mission of trusted spaces, like CBOs, that can offer more equitable and non-stigmatized access for Latinx immigrant families. We draw upon two strength-based and empowerment-focused interventions that utilize community-based workforces to promote positive parenting skills (Partners Achieving Student Success-PASS; Mehta et al., 2019) and self-advocacy skills (Community Advocacy Project-CAP; Sullivan & Bybee, 1999) to provide the conceptual framework for Family Mental Health Advocacy (FMHA). FMHA aligns mental health promotion with the advocacy mission of CBOs, engages CBO staff with feasible mental health "messages," and empowers immigrant parents as critical change agents in the lives of their children. We acknowledge the challenges associated with implementing mental health promotion strategies and providing workforce support, as well as the importance of local and national policy influences.
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Affiliation(s)
- Dana Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Angela L Walden
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
- Office of the Vice Provost for Diversity, University of Illinois at Chicago, Chicago, IL, USA
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23
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Prguda E, Burke K, Antrobus E, Bennett S. Accessibility of evidence‐based parenting programs in the community: Parents who are involved in the Criminal Justice System encounter barriers to program access. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Emina Prguda
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia,
| | - Kylie Burke
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia,
| | - Emma Antrobus
- School of Social Science, The University of Queensland, Brisbane, Queensland, Australia,
| | - Sarah Bennett
- School of Social Science, The University of Queensland, Brisbane, Queensland, Australia,
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Online parent programs for children's behavioral problems: a meta-analytic review. Eur Child Adolesc Psychiatry 2020; 29:1555-1568. [PMID: 31925545 DOI: 10.1007/s00787-020-01472-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
A recent increase in the development of online parent programs calls for the need to understand how effective these strategies are for improving children's mental health. We meta-analyzed the effects of online parent programs on children's behavioral problems. Moreover, we explored the combinations of program components to yield stronger program effects. Medline, PsycINFO, Web of Science, and the Cochrane Library were searched. We included peer-reviewed randomized studies evaluating the effect of an online parent program. Effect sizes (Hedges' g) were calculated from post intervention means and standard deviations. We used Qualitative Comparative Analysis (QCA) to identify pathways to effectiveness and individual content and delivery components that seem sufficient or necessary for yielding high effectiveness. Of 2941 articles, 12 articles with a total of 2025 participants met the inclusion criteria. Online parent programs have significant effects on children's behavioral problems (g = - 0.32; 95% CI, - 0.47 to - 0.17), emotional problems (g = - 0.22; 95% CI, - 0.31 to - 0.13), and parental mental health problems (g = - 0.30; 95% CI, - 0.42 to - 0.17). In the QCA, sending parents reminders to work on the program was the only one sufficient component. In conclusion, online support programs reduce children's behavioral and emotional problems and improve parental mental health. Sending parents reminders to work on the program seems to contribute to high effectiveness. Review Registration This study was registered with PROSPERO, number CRD42017080051.
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Boruszak-Kiziukiewicz J, Kmita G. Parenting Self-Efficacy in Immigrant Families-A Systematic Review. Front Psychol 2020; 11:985. [PMID: 32528373 PMCID: PMC7264399 DOI: 10.3389/fpsyg.2020.00985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/20/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Parenting self-efficacy (PSE) refers to parents' belief in their ability to perform the parenting role successfully, and derives from Bandura's concept of personal self-efficacy formulated within the social cognitive theory. PSE has been demonstrated to be a strong predictor of parenting functioning. At the same time, relatively less is known about its possible role in the situation of migration, when a family experiences acculturation stress in the process of adaptation to the new culture. Therefore, the aim of this systematic review was to summarize available data on the conceptualization, measurement, and the role of parenting self-efficacy in the context of acculturation processes, and in various groups of immigrant parents. Methods: An extensive search of eight electronic databases was conducted in August 2018 and updated in February 2020 to identify peer-reviewed articles on parenting self -efficacy among immigrants. Eleven studies met pre-specified criteria for inclusion. Nine of the studies employed a quantitative design, whereas the remaining two studies used qualitative methods. In three of the quantitative studies, interventions/programs for immigrants were assessed. Results: Three different approaches to conceptualizing and measuring PSE were identified in the analyzed papers: domain-general, domain-specific, and narrow domain. Incongruent results were found with regards to the links between the strength of PSE and immigrants' cultural orientation. Additionally, PSE was identified as a mediator between a stronger orientation toward the mainstream culture and more supportive parenting. The qualitative studies indicated that a reduction in PSE was typical for the initial period of immigration and might be a consequence of a forced orientation toward the standards of the receiving country, which was a consequence of the parents wanting to maintain close relations with their teenage children. Discussion: Overall, the theoretical and methodological quality of the reported studies varied and hence their findings have to be interpreted with caution. Our analysis clearly points to the usefulness of a multifaceted approach to PSE. Further research is needed to understand the mechanisms by which parental self-efficacy may exert a positive effect on the functioning of immigrant families.
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Affiliation(s)
- Joanna Boruszak-Kiziukiewicz
- Department of Clinical Psychology of Child and Family, Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Grażyna Kmita
- Department of Clinical Psychology of Child and Family, Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Greene MM, Patra K, Czyzewski P, Gonring K, Breitenstein S. Adaptation and Acceptability of a Digitally Delivered Intervention for Parents of Very Low Birth Weight Infants. Nurs Res 2020; 69:S47-S56. [PMID: 32496399 DOI: 10.1097/nnr.0000000000000445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Very low birth weight (VLBW) infants are at elevated risk for behavioral problems as early as the second year of life. The purpose of this feasibility study was to evaluate the adaptation and acceptability of an existing digitally delivered behavioral parent training program-the ezParent program, with the addition of weekly coaching calls-for parents of former VLBW infants in their second year of life. OBJECTIVES To assess the adaptation of ezParent for this population, we assessed parent access and use of ezParent and coaching calls, parent learning of strategies from ezParent, and changes in parenting practices or child behavior after using ezParent plus coaching calls. For acceptability, we assessed if parents viewed ezParent content as applicable to their experiences of parenting a former VLBW infant and how parents viewed coaching calls. METHODS Ten parents of VLBW infants (20 months of age adjusted for prematurity) were recruited from a neonatal intensive care follow-up clinic. Parents completed the six modules of ezParent plus weekly coaching calls over 10-week intervention period. ezParent usage data were electronically uploaded to secure servers. Completion and timing of coaching calls were monitored using a tracking log. Parents completed child behavior and parenting belief and practice questionnaires pre- and postintervention. Calls were recorded and transcribed to assess for learning of parenting strategies, acceptability with the VLBW population, and acceptability of coaching calls. RESULTS On average, parents completed 85% of the ezParent modules and 89% of the scheduled coaching calls, respectively. Parents spontaneously introduced 44% of the ezParent strategies during their coaching calls. Modest within-group effect sizes were detected for improvement in parenting self-efficacy and child externalizing behavior. Parents felt the ezParent content applied to their experiences parenting a preterm infant and had high satisfaction with coaching calls as a method of reinforcing program content and assessing knowledge and supporting accountability for program participation. DISCUSSION ezParent with coaching calls is a feasible method of delivering behavioral parent training to parents of former VLBW infants in their second year of life. Coaching calls have high potential to be a low-cost, time-efficient component of digitally delivered programs that would allow for rapid integration into clinical practice.
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Affiliation(s)
- Michelle M Greene
- Michelle M Greene, PhD, is Associate Professor, Rush University Medical Center, Chicago, Illinois. Kousiki Patra, MD, is Associate Professor, Rush University Medical Center, Chicago, Illinois. Patryk Czyzewski, BHS, is Research Assistant, Rush University Medical Center, Chicago, Illinois. Kelsey Gonring, PhD, is Post-Doctoral Fellow and Instructor, Rush University Medical Center, Chicago, Illinois. She is now Assistant Professor, Helen DeVos Children's Hospital, Grand Rapids, Michigan. Susan Breitenstein, PhD, RN, FAAN, is Associate Professor, Rush University Medical Center, Chicago, Illinois. She is now Associate Professor, The Ohio State University, Columbus
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Abstract
Preschoolers are presenting in increasing numbers to primary care providers and mental health clinics with emotional and behavioural impairment. Preschoolers in the US have the highest rates of school expulsion of all age groups. Because young children are limited in their capacity to convey distress and internal states, impairment is most often expressed behaviourally. Disruptive behaviour, frequently in the form of aggression or dysregulation, is a final common pathway for many disorders in this age group. Tools and training to diagnose pre-school disorders are limited, and while some effective non-medication interventions exist, the evidence base for medication use in this age group is extremely limited. This article reviews approaches to assessing common pre-school disorders including attention deficit hyperactivity disorder (ADHD), disruptive behaviour disorders, anxiety and mood disorders, perceptual disturbances and psychosis, and trauma related disorders. The evidence base for both therapeutic and psychopharmacologic interventions for these disorders is discussed.
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Affiliation(s)
- Nadia Zaim
- Division of Child and Adolescent Psychiatry, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Joyce Harrison
- Division of Child and Adolescent Psychiatry, The Johns Hopkins Hospital, Baltimore, MD, USA.,Department of Psychiatry, Kennedy Krieger Institute, Baltimore, MD, USA
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Lakind D, Cua G, Mehta TG, Rusch D, Atkins MS. Trajectories of Parent Participation in Early Intervention/Prevention Services: The Case for Flexible Paraprofessional-led Services. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 50:243-257. [DOI: 10.1080/15374416.2019.1689823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Grace Cua
- Educational Psychology, University of Illinois at Chicago
| | - Tara G. Mehta
- Department of Psychiatry, University of Illinois at Chicago
| | - Dana Rusch
- Department of Psychiatry, University of Illinois at Chicago
| | - Marc S. Atkins
- Department of Psychiatry, University of Illinois at Chicago
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Rerkswattavorn C, Chanprasertpinyo W. Prevention of child physical and verbal abuse from traditional child discipline methods in rural Thailand. Heliyon 2019; 5:e02920. [PMID: 31867455 PMCID: PMC6906657 DOI: 10.1016/j.heliyon.2019.e02920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/05/2019] [Accepted: 11/22/2019] [Indexed: 11/24/2022] Open
Abstract
Background In rural areas of Thailand, physical and verbal abuse are accepted as child discipline strategies due to the strong influence of religious beliefs and social norms. Objective To investigate the effects of a nonviolent parenting program on subject's knowledge and attitudes regarding physical and verbal abuse in child discipline. Participant This randomized controlled trial enrolled the villagers who had children under care in a rural area of Thailand. Methods This study was scheduled in the following three stages with 3-month intervals: before the program (P0); 3 months after the program (P1); and 6 months after the program (P2). We compared knowledge and attitude scores of subjects at each stage. Results A total of 85 subjects were enrolled in this study: 50.6% (n = 43) in the control group and 49.4% (n = 42) in the intervention group. In the intervention group, the knowledge score increased after the intervention (P1), decreased 3 months later (P2), but was still higher than the score at P0 (p = < 0.001). The attitude score increased after the intervention at P1 and was maintained at P2 (p = < 0.001). In the control group, data did not demonstrate any difference regarding knowledge and attitude toward child discipline. Conclusions The nonviolent parenting program was effective in increasing knowledge and changing attitudes in this study. The intervention can be applied effectively in rural communities because of its simplicity, ease of use, and no required technology.
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Shenderovich Y, Eisner M, Cluver L, Doubt J, Berezin M, Majokweni S, Murray AL. What Affects Attendance and Engagement in a Parenting Program in South Africa? PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:977-986. [PMID: 30121876 PMCID: PMC6182387 DOI: 10.1007/s11121-018-0941-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. Studies in high-income countries show varying results regarding whether more disadvantaged families are equally engaged in parenting interventions. In low- and middle-income countries (LMICs), almost nothing is known about the patterns of participation in parent training. This paper examines group session attendance and engagement data from 270 high-risk families enrolled in the intervention arm of a cluster-randomized controlled trial in South Africa. The trial evaluated a 14-week parenting intervention aiming to improve parenting and reduce maltreatment by caregivers. The intervention was delivered in 20 groups, one per study cluster, with 8 to 16 families each. Overall, caregivers attended 50% of group sessions and children, 64%. Using linear multilevel models with Kenward-Roger correction, we examined child and caregiver baseline characteristics as predictors of their attendance and engagement in the group sessions. Variables examined as predictors included measures of economic, educational, and social and health barriers and resources, as well as family problems and sociodemographic characteristics. Overall, the study yielded no evidence that the level of stressors, such as poverty, was related to attendance and engagement. Notably, children from overcrowded households attended on average 1.2 more sessions than their peers. Our findings suggest it is possible to engage highly disadvantaged families that face multiple challenges in parenting interventions in LMICs. However, some barriers such as scheduling, and alcohol and substance use, remain relevant.
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Affiliation(s)
- Yulia Shenderovich
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England.
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, England.,HIV Mental Health Research Unit, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jenny Doubt
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, England
| | - McKenzie Berezin
- Department of Applied Psychology, New York University, 246 Greene Street, New York, NY, 10003, USA
| | - Sybil Majokweni
- HIV Mental Health Research Unit, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Aja Louise Murray
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England
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Gross D, Belcher HME, Budhathoki C, Ofonedu ME, Dutrow D, Uveges MK, Slade E. Reducing Preschool Behavior Problems in an Urban Mental Health Clinic: A Pragmatic, Non-Inferiority Trial. J Am Acad Child Adolesc Psychiatry 2019; 58:572-581.e1. [PMID: 30768419 PMCID: PMC8745406 DOI: 10.1016/j.jaac.2018.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 08/23/2018] [Accepted: 09/13/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This pragmatic, randomized, non-inferiority trial compared the effectiveness and cost of group-based parent management training with mastery-based individual coaching parent management training in a low-income, predominantly African American sample. METHOD Parents seeking treatment for their 2- to 5-year-old children's behavior problems in an urban fee-for-service child mental health clinic were randomized to the Chicago Parent Program (CPP; n = 81) or Parent-Child Interaction Therapy (PCIT; n = 80). Consent followed clinic intake and diagnostic assessment and parent management training was delivered by clinicians employed at the clinic. Primary outcome measures were externalizing child behavior problems, assessed at baseline and postintervention follow-up, using the Child Behavior Checklist (CBCL) and average per-participant treatment cost. RESULTS Data from 158 parents were analyzed. Most were mothers (75.9%), African American (70.3%), and economically disadvantaged (98.7% Medicaid insured). Of children, 58.2% were boys, and mean age was 3.6 years (SD 1.03). Based on CBCL scores, behavior problems improved in the 2 conditions (Cohen d = 0.57 for CPP and 0.50 for PCIT). CPP was not inferior to PCIT (90% CI -1.58 to 4.22) at follow-up, even after controlling for differences in treatment length (90% CI -1.63 to 4.87). Average per-participant treatment cost was higher for PCIT (mean $2,151) than for CPP (mean $1,413, 95% CI -1,304 to -170). CONCLUSION For parents of young children living in urban poverty, CPP is not inferior to PCIT for decreasing child behavior problems. CPP requires less time to complete and costs a third less than PCIT. CLINICAL TRIAL REGISTRATION INFORMATION Early Parenting Intervention Comparison (EPIC); https://clinicaltrials.gov/; NCT01517867.
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Affiliation(s)
| | | | | | - Mirian E Ofonedu
- Kennedy-Krieger Institute; Maryland Center for Developmental Disabilities, Windsor Mill
| | | | | | - Eric Slade
- Johns Hopkins School of Nursing, Baltimore, MD; University of Maryland School of Medicine, Baltimore; US Department of Veteran Affairs VISN5 MIRECC, Baltimore
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Mehta TG, Lakind D, Rusch D, Walden AL, Cua G, Atkins MS. Collaboration with Urban Community Stakeholders: Refining Paraprofessional-led Services to Promote Positive Parenting. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 63:444-458. [PMID: 30825221 DOI: 10.1002/ajcp.12316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper describes the process of a community-academic partnership to navigate implementation challenges for a school-based service model led by paraprofessionals to promote positive parenting in high poverty urban communities. We describe the process by which we (a) identified implementation challenges, (b) sustained a university-community collaboration to redesign the paraprofessional service model, and (c) assessed the feasibility of the new model involving four social service agencies in 16 schools with over 600 families. The structure and process of the collaboration and refinement are described with attention to who was best positioned to engage in the collaboration and how the partnership worked to balance scientific rigor with responsiveness to paraprofessional workforce strengths. Feasibility data indicated that the revised model was successfully implemented by paraprofessional staff; 92.2% of possible staff monthly reports were completed and discussion of key goals was incorporated into 94.2% of interactions. Continual monitoring provided critical feedback from stakeholders as we drew on and interpreted these various sources of information to build and refine the service model. We suggest that these processes are critical steps to bridge the research-to-practice gap, by promoting practices that are aligned with the needs of children and families, and the staff who serve them.
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Affiliation(s)
- Tara G Mehta
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Davielle Lakind
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dana Rusch
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Angela L Walden
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Grace Cua
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Marc S Atkins
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA
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Gross D, Bettencourt AF. Financial Incentives for Promoting Participation in a School-Based Parenting Program in Low-Income Communities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:585-597. [PMID: 30645733 PMCID: PMC6517342 DOI: 10.1007/s11121-019-0977-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although financial incentives are a well-accepted strategy for raising parent participation rates in prevention studies, they are rarely employed in practice due to concerns about their ethics, sustainability, and public acceptability. We sought to address these common concerns in the context of a larger prevention study using financial incentives to boost parent participation in a group-based parenting program implemented in an urban school district. We examined the extent to which the financial incentives delivered via bank debit cards ($15 for attending weekly group sessions, $5 for completing weekly practice assignments) motivated parents to enroll in the program and were associated with higher attendance and practice completion but poorer participation quality in group sessions, and how parents used the extra cash. Over 3 years, 67.4% (n = 372) of eligible families enrolled in a parenting program called the Chicago Parent Program. Most parents were African American (68%) or Latinx (24%); 67% reported annual household incomes < $20,000. Although 71.2% of parents reported that the financial incentives motivated their enrollment, the most important motivators pertained to wanting to be a better parent. Parents citing incentives as motivating their enrollment had higher attendance than those who did not (p = .01). Quality of parent participation was high and unrelated to whether financial incentives motivated enrollment. Parents reported using the extra cash to purchase items for their children (92%) and groceries (56%). Results suggest that financial incentives targeting low-income families of young children may improve parent participation rates without diminishing their intrinsic motivation to improve their parenting.
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Supporting parent engagement in a school readiness program: Experimental evidence applying insights from behavioral economics. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2019. [DOI: 10.1016/j.appdev.2018.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hanson CL, Crandall A, Barnes MD, Magnusson B, Novilla MLB, King J. Family-Focused Public Health: Supporting Homes and Families in Policy and Practice. Front Public Health 2019; 7:59. [PMID: 30949468 PMCID: PMC6435478 DOI: 10.3389/fpubh.2019.00059] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
Life expectancy in the US is on the decline. Mental health issues associated with opioid abuse and suicide have been implicated for this decline necessitating new approaches and procedures. While Public Health 3.0 provides a call to action for stakeholders to work closely together to address such complex problems as these, less attention has been given to engaging and supporting the most important stakeholders and primary producers of health within the US: families and households. The idea that health begins at home is discussed from the perspective of primary, secondary, and tertiary prevention levels. Primary prevention where research provides evidence for the role of the family in healthy child development. Secondary and tertiary prevention where research offers evidence for the role of the family in caregiving. Despite this evidence, greater focus and attention must be placed on the family at all prevention levels as an often overlooked setting of public health practice and level of influence. Prevention across all levels is enhanced as public health practitioners think family when designing and implementing public health policy. Four family impact principles are presented to help guide planning and implementation decisions to nourish family engagement.
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Affiliation(s)
- Carl L Hanson
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Ali Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Michael D Barnes
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Brianna Magnusson
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | | | - Jaron King
- Department of Public Health, Brigham Young University, Provo, UT, United States
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Hajihashemi M, Mazaheri MA, Hasanzadeh A. Assessment of educational intervention in enhancing parenting self-efficacy in parents of primary school students. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:43. [PMID: 30993136 PMCID: PMC6432816 DOI: 10.4103/jehp.jehp_260_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND AIMS Parenting self-efficacy, which is one of the main determinants of effective and positive parental behavior, has been commonly defined as the parents' opinions and beliefs to develop their ability to affect their children in a way that raises their confidence development and adjustment. This study was performed to examine the effect of educational intervention on parenting self-efficacy in parents of primary school students. MATERIALS AND METHODS This quasi-experimental study was conducted on 104 parents of primary school students in Khomeini Shahr city, Isfahan province of Iran, in 2017. In this study, 104 parents (52 couples) of primary school students were selected and randomly assigned to experimental and control groups. Then, an educational intervention was implemented in the experimental group during 6 sessions of 2 h while the control group received only the usual family school education program. The parenting self-efficacy was measured before the intervention and 2 months afterward. The data were analyzed by independent t-test, paired t-test. RESULTS There was no statistically significant difference between the demographic variables of parents in both groups. Both the experimental and control groups were similar in terms of age, number of children, education, and employment as well as parenting self-efficacy. Two months after the intervention, the mean of total parenting self-efficacy, as well as play and entertainment with the child, discipline and boundaries, self-acceptance, learning and knowledge in the experimental group, were significantly higher than the control group, but the mean scores of other areas were not significantly different between the two groups (P > 0.05). CONCLUSION Educational interventions that engage parents in group task and facilitate expression of experiences, are feasible in the primary school meetings and have a helpful effect on parenting self-efficacy.
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Affiliation(s)
- Mina Hajihashemi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Amidi Mazaheri
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Boyd RC, Price J, Mogul M, Yates T, Guevara JP. Pilot RCT of a social media parenting intervention for postpartum mothers with depression symptoms. J Reprod Infant Psychol 2018; 37:290-301. [DOI: 10.1080/02646838.2018.1556788] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Rhonda C. Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jordan Price
- Policylab: Center to Bridge Research Practice, & Policy, The Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
| | - Marjie Mogul
- Research Department, Maternity Care Coalition, Philadelphia, PA, USA
| | - Tweety Yates
- Children’s Research Center, University of Illinois, Champaign, IL, USA
| | - James P. Guevara
- Policylab: Center to Bridge Research Practice, & Policy, The Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
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Akcan A, Ergun A. The effect of an aggressive behavior prevention program on kindergarten students. Public Health Nurs 2018; 36:330-340. [PMID: 30548326 DOI: 10.1111/phn.12575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/23/2018] [Accepted: 11/18/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This quasi-experimental study with a pretest-posttest control group was conducted to determine the effects of the "Aggressive Behavior Prevention Program (ABPP)" on kindergarten students. The program was based on Social Cognitive Theory. DESIGN AND SAMPLE The study was carried out with 90 children (intervention group = 45, control group = 45) who were registered in the kindergarten of a primary school. The ABPP was implemented with children and their families for 12 weeks. Data were collected with a subscale of Aggressiveness of the Eyberg Child Behavior Inventory, the subscales of overt and relational aggression of the Preschool Social Behavior Scale-Teacher Form, and the Victimisation Scale. RESULTS The ABPP significantly decreased levels of aggression among kindergarten students (p = 0.019). No significant difference was found between the two groups for peer victimization. CONCLUSIONS This is the first study in Turkey implemented by a nurse based in school and it is important because it offers an example for nurses' practice and research. Findings suggest that the ABPP is effective in reducing the aggression of children.
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Affiliation(s)
- Arzu Akcan
- Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Ayse Ergun
- Department of Public Health Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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Chu JTW, Whittaker R, Jiang Y, Wadham A, Stasiak K, Shepherd M, Bullen C. Evaluation of MyTeen - a SMS-based mobile intervention for parents of adolescents: a randomised controlled trial protocol. BMC Public Health 2018; 18:1203. [PMID: 30367613 PMCID: PMC6204020 DOI: 10.1186/s12889-018-6132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parents play an important role in the lives of adolescents and efforts aimed at strengthening parenting skills and increasing knowledge on adolescent development hold much promise to prevent and mitigate adolescent mental health problems. Innovative interventions that make use of technology-based platforms might be an effective and efficient way to deliver such support to parents. This protocol presents the design of a randomised controlled trial to investigate the effectiveness of a SMS-based mobile intervention (MyTeen) for parents of adolescents on promoting parental competence and mental health literacy. METHODS A parallel two-arm randomised controlled trial will be conducted in New Zealand, aiming to recruit 214 parents or primary caregivers of adolescents aged 10-15 years via community outreach and social media. Eligible participants will be allocated 1:1 into the control or the intervention group, stratified by ethnicity. The intervention group will receive a tailored programme of text messages aimed at improving their parental competence and mental health literacy, over 4 weeks. The control group (care-as-usual) will receive no intervention from the research team, but can access alternative services if they wish, and will be offered the intervention programme upon completion of a 3-month post-randomisation follow-up assessment. Data will be obtained at baseline, post intervention (1-month), and 3-month follow up. The primary outcome is parental competence assessed by the Parental Sense of Competence Scale at 1-month follow up. Secondary outcomes include: mental health literacy; knowledge of help-seeking; parental distress; parent-adolescent communication; and programme satisfaction. DISCUSSION To our knowledge this is the first randomised controlled trial on the effectiveness of delivering a parenting support intervention for parents of adolescents solely via a SMS-based mobile intervention. If effective, it could have great potential to reach and support parents of adolescents. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ( ACTRN12618000117213 ) Registered on 29/01/2018.
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Affiliation(s)
- Joanna Ting Wai Chu
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Angela Wadham
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Matthew Shepherd
- School of Counselling, Human Services & Social Work School of Counselling, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Francis L, DePriest K, Wilson M, Gross D. Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination. ONLINE JOURNAL OF ISSUES IN NURSING 2018; 23. [PMID: 31427855 DOI: 10.3912/ojin.vol23no03man02] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Social determinants of health (SDOH) refer to the social, economic, and physical conditions in which people live that may affect their health. Poverty, which affects nearly 15 million children in the United States, has far-reaching effects on children's physical and mental health. Although it is difficult to change a family's economic circumstances, nurses can play a critical role to address SDOH through screening and effective coordination of care. As nurses, our role is to minimize the effects of SDOH, including poverty, on child health and well-being through our practice, research, and professional education. We present three exemplars of child poverty to demonstrate the impact on child health and well-being and propose a model of care for nurses to assess and address SDOH in the pediatric clinical setting.
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41
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Confident Parents for Easier Children: A Parental Self-Efficacy Program to Improve Young Children’s Behavior. EDUCATION SCIENCES 2018. [DOI: 10.3390/educsci8030134] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study presents the effects on children’s behavior of Confident Parents, a focused parenting program targeting parental self-efficacy. This parenting program aims to improve child behavior through the enhancement of parental self-efficacy. Confident Parents was experimentally tested on a total sample of 80 parents of three-to-six-year-old preschool aged children with moderate to clinical levels of externalizing behavior. Thirty-seven parents participated in the program, and were compared with a waitlist control group (n = 43). The intervention consisted of eight weekly group sessions. Effect sizes were evaluated through both observational and parent-report measures on the child’s behavior, as well as self-reported parental self-efficacy at pretest, post-test, and a four-month follow-up. Through a multi-level analysis, predictors of the change in the child’s behavior were identified. The moderating effect of socio-economic risk and externalizing behavior at baseline were also included in the analysis. Results show that Confident Parents improved the child’s behavior, both reported by parents and, to a lesser extent, when observed in interaction with the parent. Children with higher levels of behavior difficulty benefited more while those with socio-economic risk benefited less from this program. These results illustrate that focusing a parenting program on improving self-efficacy is effective to reduce externalizing behavior in children. This underdeveloped treatment target is worthy of investigation in parenting intervention research.
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42
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Nix RL, Bierman KL, Motamedi M, Heinrichs BS, Gill S. Parent Engagement in a Head Start Home Visiting Program Predicts Sustained Growth in Children's School Readiness. EARLY CHILDHOOD RESEARCH QUARTERLY 2018; 45:106-114. [PMID: 30911204 PMCID: PMC6430128 DOI: 10.1016/j.ecresq.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examined three components of parent engagement in an enriched Head Start home visiting program: intervention attendance, the working alliance between parents and home visitors, and parents' use of program materials between sessions. The study identified those family and child characteristics that predicted the different components of parent engagement, and the study tested whether those components predicted sustained growth in children's school readiness skills across four years, from preschool through second grade. Ninety-five low-income parents with four year-old children attending Head Start (56% white; 26% black; 20% Latino; 44% girls) were randomly assigned to receive the home visiting program. Assessments included home visitor, parent, and teacher ratings, as well as interviewer observations and direct testing of children; data analyses relied on correlations and hierarchical multiple regression equations. Results showed that baseline family characteristics, like warm parent-child interactions, and child functioning predicted both working alliance and use of program materials, but only race/ethnicity predicted intervention attendance. The use of program materials was the strongest predictor of growth in children's literacy skills and social adjustment at home during the intervention period itself. In contrast, working alliance emerged as the strongest predictor of growth in children's language arts skills, attention skills, and social adjustment at school through second grade, two years after the end of the home visiting intervention. To maximize intervention effectiveness across school readiness domains over time, home visiting programs need to support multiple components of parent engagement, particularly working alliance and the use of program materials between sessions.
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43
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Bettencourt AF, Gross D, Breitenstein S. Evaluating Implementation Fidelity of a School-Based Parenting Program for Low-Income Families. J Sch Nurs 2018; 35:325-336. [PMID: 29996719 DOI: 10.1177/1059840518786995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Young children first develop the social-behavioral skills needed to succeed in school from parents. However, most school-based interventions designed to bolster children's social-behavioral skills have focused on strengthening teachers' skills. This study examined the extent to which a 12-session group-based program for strengthening parenting skills, the Chicago Parent Program (CPP), could be implemented with fidelity in 12 urban schools serving a large population of young children (>95% African American or Latino) living in poverty. Parents of 380 prekindergarten students enrolled in the CPP. Data were collected on child behavior problems; parent satisfaction, attendance, and weekly practice completion; and implementation adherence and competence. Results indicated that CPP group leaders were highly adherent and competent; parents rated groups highly and attended an average of 8 sessions indicating CPP was implemented with high fidelity. Barriers and supports to implementation are reviewed, and implications for long-term sustainability of school-based interventions like CPP are discussed.
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Affiliation(s)
- Amie F Bettencourt
- 1 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Deborah Gross
- 2 Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Susan Breitenstein
- 3 Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, USA
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44
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Pilot Randomized Trial of a Family Management Efficacy Intervention for Caregivers of African American Adolescents with Disruptive Behaviors. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9462-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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45
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Marti M, Merz EC, Repka KR, Landers C, Noble KG, Duch H. Parent Involvement in the Getting Ready for School Intervention Is Associated With Changes in School Readiness Skills. Front Psychol 2018; 9:759. [PMID: 29904362 PMCID: PMC5991166 DOI: 10.3389/fpsyg.2018.00759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/30/2018] [Indexed: 11/13/2022] Open
Abstract
The role of parent involvement in school readiness interventions is not well-understood. The Getting Ready for School (GRS) intervention is a novel program that has both home and school components and aims to improve early literacy, math, and self-regulatory skills in preschool children from socioeconomically disadvantaged families. In this study, we first examined associations between family characteristics and different indices of parent involvement in the GRS intervention. We then examined associations between parent involvement and change in children's school readiness skills over time. Participants were 133 preschool children attending Head Start and their parents who participated in the GRS intervention during the academic year 2014–2015. Parent involvement was operationalized as attendance to GRS events at the school, time spent at home doing GRS activities, and usage of digital program materials, which included a set of videos to support the implementation of parent-child activities at home. Although few family characteristics were significantly associated with parent involvement indices, there was a tendency for some markers of higher socioeconomic status to be linked with greater parent involvement. In addition, greater parent involvement in the GRS intervention was significantly associated with greater gains in children's early literacy, math, and self-regulatory skills. These findings suggest that parent involvement in comprehensive early interventions could be beneficial in terms of improving school readiness for preschoolers from disadvantaged families.
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Affiliation(s)
- Maria Marti
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Emily C Merz
- Neurocognition, Early Experience and Development Lab, Neuroscience & Education, Teachers College, Columbia University, New York City, NY, United States
| | - Kelsey R Repka
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Cassie Landers
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Kimberly G Noble
- Neurocognition, Early Experience and Development Lab, Neuroscience & Education, Teachers College, Columbia University, New York City, NY, United States
| | - Helena Duch
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York City, NY, United States
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Derscheid DJ, Fogg LF, Julion W, Johnson ME, Tucker S, Delaney KR. Emotional Availability Scale Among Three U.S. Race/Ethnic Groups. West J Nurs Res 2018; 41:193945918776617. [PMID: 29781393 DOI: 10.1177/0193945918776617] [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: 11/17/2022]
Abstract
This study used a cross-sectional design to conduct a subgroup psychometric analysis of the Emotional Availability Scale among matched Hispanic ( n = 20), African American ( n = 20), and European American ( n = 10) English-speaking mother-child dyads in the United States. Differences by race/ethnicity were tested ( p < .05) among (a) Emotional Availability Scale dimensions with ANOVA, and (b) relationships of Emotional Availability Scale dimensions with select Dyadic Parent-Child Interaction Coding System variables with Pearson correlation and matched moderated regression. Internal consistency was .950 (Cronbach's α; N = 50). No significant differences in the six Emotional Availability Scale dimension scores by race/ethnicity emerged. Two Dyadic Parent-Child Interaction Coding System behaviors predicted two Emotional Availability Scale dimensions each for Hispanic and African American mother-child dyads. Results suggest emotional availability similarity among race/ethnic subgroups with few predictive differences of emotional availability dimensions by specific behaviors for Hispanic and African American subgroups.
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Gross D, Belcher HME, Budhathoki C, Ofonedu ME, Uveges MK. Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk? JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1579-1593. [PMID: 29713137 PMCID: PMC5918300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We examined whether parent engagement in parent training (PT) differed based on PT format (parent group-based with video versus mastery-based individual coaching with child) in an economically disadvantaged sample of families seeking behavioral treatment for their preschool children in an urban mental health clinic. Parents (N=159; 76.1% mothers, 69.8% African American, 73% low-income) were randomized to one of two interventions, Chicago Parent Program (parent group + video; CPP) or Parent Child Interaction Therapy (individualized mastery-based coaching; PCIT). Parent engagement indicators compared were PT attendance and completion rates, participation quality, and parent satisfaction. Risk factors predictive of PT attrition (parent depression, psychosocial adversity, child behavior problem severity, length of wait time to start PT) were also compared to determine whether they were more likely to affect engagement in one PT format versus the other. No significant differences were found in PT attendance or completion rates by format. Clinicians rated parents' engagement higher in PCIT than in CPP while satisfaction with PT was rated higher by parents in CPP compared to PCIT. Never attending PT was associated with more psychosocial adversity and externalizing behavior problems for CPP and with higher baseline depression for PCIT. Parents with more psychosocial adversities and higher baseline depression were less likely to complete PCIT. None of the risk factors differentiated CPP completers from non-completers. Delay to treatment start was longer for PCIT than CPP. Strengths and limitations of each PT format are discussed as they relate to the needs and realities of families living in urban poverty.
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Affiliation(s)
- Deborah Gross
- School of Nursing, Johns Hopkins University, 525 N. Wolfe St., Baltimore, MD 21205, 410-614-5311
| | - Harolyn M E Belcher
- Center for Diversity in Public Health Leadership Training, Kennedy Krieger Institute, 716 Broadway, Baltimore, MD 21205, 443-923-5933
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, 525 N. Wolfe St., Baltimore, MD 21205, 410-614-5320
| | - Mirian E Ofonedu
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1750 E. Fairmont Avenue, 443-923-9200
| | - Melissa K Uveges
- School of Nursing, Johns Hopkins University, 525 N. Wolfe St., Baltimore, MD 21205, 410-614-5311
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48
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Leijten P, Gardner F, Landau S, Harris V, Mann J, Hutchings J, Beecham J, Bonin EM, Scott S. Research Review: Harnessing the power of individual participant data in a meta-analysis of the benefits and harms of the Incredible Years parenting program. J Child Psychol Psychiatry 2018; 59:99-109. [PMID: 28696032 DOI: 10.1111/jcpp.12781] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. METHODS We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent-reported outcomes, including parenting practices, children's mental health, and parental mental health. RESULTS Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self-efficacy, and stress) did not improve. There was no evidence of harmful effects. CONCLUSIONS The Incredible Years parenting program improves the aspects of family well-being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent-reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes.
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Affiliation(s)
- Patty Leijten
- University of Oxford, Oxford, UK.,University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | | | - Jennifer Beecham
- London School of Economics, London, UK.,Kent University, Canterbury, UK
| | - Eva-Maria Bonin
- London School of Economics, London, UK.,Kent University, Canterbury, UK
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Lefever JEB, Bigelow KM, Carta JJ, Borkowski JG, Grandfield E, McCune L, Irvin DW, Warren SF. Long-Term Impact of a Cell Phone-Enhanced Parenting Intervention. CHILD MALTREATMENT 2017; 22:305-314. [PMID: 28845676 DOI: 10.1177/1077559517723125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Home visiting programs support positive parenting in populations at-risk of child maltreatment, but their impact is often limited by poor retention and engagement. The current study assessed whether a cellular phone-supported version (PCI-C) of the Parent-Child Interactions (PCI) intervention improved long-term parenting practices, maternal depression, and children's aggression. Low-income mothers ( n = 371) of preschool-aged children were assigned to one of the three groups: PCI-C, PCI, and a wait-list control (WLC) group. Parenting improved in both intervention groups between baseline and 12-month follow-up compared to the WLC. Children in the PCI-C group were rated to be more cooperative and less aggressive than children in the WLC. The results offer evidence of the long-term effectiveness of PCI and the additional benefits of cellular phone supports for promoting intervention retention and improving children's behavior.
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Affiliation(s)
- Jennifer E Burke Lefever
- 1 William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA
| | - Kathryn M Bigelow
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
| | - Judith J Carta
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
| | - John G Borkowski
- 1 William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA
| | - Elizabeth Grandfield
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
| | - Luke McCune
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
| | - Dwight W Irvin
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
| | - Steven F Warren
- 2 Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, USA
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50
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Breitenstein SM, Brager J, Ocampo EV, Fogg L. Engagement and Adherence With ezPARENT, an mHealth Parent-Training Program Promoting Child Well-Being. CHILD MALTREATMENT 2017; 22:295-304. [PMID: 28870112 DOI: 10.1177/1077559517725402] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mobile health (mHealth) interventions use mobile technology (tablets and smartphones) delivery platforms for interventions to improve health outcomes. Despite growing acceptance, there is little understanding of how consumers engage with and adhere to mHealth interventions. This study analyzes usage data from the intervention arm ( n = 42) of a randomized clinical trial testing the efficacy of the ezPARENT program and provides recommendations for using engagement and adherence metrics. Engagement was measured by parent usage (duration, frequency, and activity) of ezPARENT and adherence using an adherence index (the sum of individual modules completed, number of visits to ezPARENT, and maximum time between visits). Parents spent M = 37.15 min per module and had M = 13.55 program visits in the 3-month intervention period. Parents visited the program over a period of M = 69.5 days and completed 82% of the modules. These data provide support that parents will use intervention programs delivered digitally; engagement and adherence metrics are useful in evaluating program uptake.
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Affiliation(s)
| | - Jenna Brager
- 2 Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | - Louis Fogg
- 1 Rush University College of Nursing, Chicago, IL, USA
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