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Shapiro CJ, Hill-Chapman C, Williams S. Mandated Parent Education: Applications, Impacts, and Future Directions. Clin Child Fam Psychol Rev 2024; 27:300-316. [PMID: 38761324 PMCID: PMC11222221 DOI: 10.1007/s10567-024-00488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/20/2024]
Abstract
Mandated participation in parent education programs is a common practice across the United States for families who are undergoing divorce or who are involved in the child welfare or juvenile justice systems. Mandates to participate in parenting programs create substantial challenges for families, service providers, and service systems. Furthermore, the type and quality of the parenting services accessed vary widely, and their impacts need to be better understood. To address this need, an overview of the current state of the empirical literature on the impacts and outcomes of mandated parenting interventions for divorce and in child welfare and juvenile justice settings is provided, and suggestions to the field are offered to refine research related to mandated parenting programs. Given the challenges that mandated parenting programs pose, an alternative approach that views parenting through a public health lens is highlighted to build on the growing body of research on the impacts of population-wide applications of parenting support programs, and as a possible way to decrease the number of parents who are required to attend parenting programs. Opportunities to advance universal parenting support within a range of community settings, including primary care, early childhood education, and community mental health systems are offered. Gaps in knowledge regarding mechanisms of action of universal supports and impacts on the number of parents mandated to treatment are highlighted, and future directions for research in this area are suggested.
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Affiliation(s)
- Cheri J Shapiro
- Institute for Families in Society, College of Social Work, University of South Carolina, 1600 Hampton St., Suite 507, Columbia, SC, 29208, USA.
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Baumel A, Brandes O, Brendryen H, Muench F, Kane JM, Saar C. The impact of therapeutic persuasiveness on engagement and outcomes in unguided interventions: A randomized pilot trial of a digital parent training program for child behavior problems. Internet Interv 2023; 34:100680. [PMID: 37840647 PMCID: PMC10568087 DOI: 10.1016/j.invent.2023.100680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
Understanding how to design engaging unguided digital health interventions is key in our ability to utilize digital tools to improve access to care. Therapeutic persuasiveness (TP) is a design concept that relates to how the digital intervention features as a whole should be designed to encourage users to make positive changes in their lives, while reducing the experienced effort required from them to engage in these activities. In our previous work, we examined the user traffic of publicly available programs, finding programs' TP quality to be a reliable, robust, and stable predictor of real-world usage; however, these findings have not been subject to experimental manipulation in a controlled trial. The current study examined the impact of TP quality in digital parent training programs (DPTs) aimed at treating child's behavior problems. We conducted a pilot randomized controlled trial comparing two interventions that utilize the same evidence-based content of established DPTs, but that differ in terms of the quality of TP (standard: DPT-STD; enhanced: DPT-TP). Altogether, parents from 88 families who have a child with behavior problems were enrolled in the study. Compared to DPT-STD (n = 43), participants allocated to DPT-TP (n = 45) used the program significantly more (ps < 0.001; Cohen's ds = 0.91-2.22). In terms of program completion, 68.9 % of DPT-TP participants completed it compared to 27.9 % of DPT-STD participants. Significant differences between the interventions were also found in reported improvements in child behavior problems favoring DPT-TP (ps < 0.05; Cohen's ds = 0.43-0.54). The results point to the importance of adequate product design and the utilization of conceptual frameworks in order to improve user engagement challenges.
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Affiliation(s)
- Amit Baumel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Or Brandes
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Fred Muench
- The Unregret Foundation, New York, NY, United States of America
| | - John M. Kane
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
- The Feinstein Institutes for Medical Research, Institute of Behavioral Science, Northwell Health, Manhasset, NY, United States of America
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, United States of America
| | - Chen Saar
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Yam-Ubon U, Thongseiratch T. Using a Design Thinking Approach to Develop a Social Media-Based Parenting Program for Parents of Children With Attention-Deficit/Hyperactivity Disorder: Mixed Methods Study. JMIR Pediatr Parent 2023; 6:e48201. [PMID: 37534490 PMCID: PMC10461405 DOI: 10.2196/48201] [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: 04/15/2023] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background: Parenting programs have proven effective in improving the behavior of children with attention-deficit/hyperactivity disorder (ADHD). However, barriers such as job and transportation constraints hinder parents from attending face-to-face therapy appointments. The COVID-19 pandemic has further exacerbated these challenges. Objective: This study aimed to develop and test the feasibility of a social media-based parenting program for parents of children with ADHD, considering both the pre-existing challenges faced by parents and the additional barriers imposed by the COVID-19 pandemic. Methods: This study used a 5-stage design thinking process, encompassing empathizing with parents, defining their needs, ideating innovative solutions, prototyping the program, and testing the program with parents. Qualitative interviews were conducted with 18 parents of children with ADHD to understand their unique needs and values. Brainstorming techniques were used to generate creative ideas, leading to the creation of a prototype that was tested with 32 parents. Participants' engagement with the program was measured, and posttraining feedback was collected to assess the program's effectiveness. Results: Parents of children with ADHD encounter specific challenges, including managing impulsive behavior and difficulties in emotion regulation. The social media-based parenting program was delivered through the LINE app (Line Corporation) and consisted of 7 modules addressing topics related to ADHD management and effective parenting strategies. The program exhibited a high completion rate, with 84% (27/32) of participants successfully finishing it. Program provider-participant interaction peaked during the first week and gradually decreased over time. Qualitative feedback indicated that the program was feasible, accessible, and well received by participants. The LINE app was found to be convenient and helpful, and participants preferred content delivery once or twice per week, expressing acceptance for various content formats. Conclusions: This study emphasizes the significance of adopting a human-centered design thinking approach to develop parenting programs that cater to the unique needs and values of parents. By leveraging social media platforms, such as LINE, a parenting program can overcome the challenges posed by the COVID-19 pandemic and other constraints faced by parents. LINE offers a viable and feasible option for supporting parents of children with ADHD, with the potential for customization and widespread dissemination beyond the pandemic context.
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Affiliation(s)
- Umaporn Yam-Ubon
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. https://orcid.org/0009-0000-4753-1122
| | - Therdpong Thongseiratch
- Songklanagarind ADHD Multidisciplinary Assessment and Care Team for Quality Improvement, Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. https://orcid.org/0000-0002-9907-6106
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Hickey G, Dunne C, Maguire L, McCarthy N. A mixed-methods exploration of practitioners' experiences of delivering digital social care interventions with vulnerable children and families during the Covid19 pandemic. JMIR Form Res 2023; 7:e43498. [PMID: 36888555 PMCID: PMC10182457 DOI: 10.2196/43498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Digital technology is an increasing feature of social care practice, and its use has accelerated greatly in response to the Covid-19 pandemic. OBJECTIVE This research assessed social care practitioners' experiences of delivering digital interventions with vulnerable children and families during the pandemic. METHODS A mixed-methods study combining survey and qualitative research was conducted. In total, 102 social care practitioners working in the Republic of Ireland who delivered a range of digital social care supports, took part in an online survey. This survey captured practitioners' engagement and experiences of delivering digital social care interventions to children and families, as well as training and capacity building needs. Subsequently, 19 focus groups with 106 social care practitioners working with children and families were also conducted. These focus groups were directed by a topic guide and explored in more depth practitioners' perceptions of digital social care practice, the perceived impact of digital technology on their work with children and families and future application of digital social care interventions. RESULTS Survey findings revealed that 54% and 45% of practitioners respectively felt 'confident' and 'comfortable' engaging in digital service delivery. The vast majority (93%) identified maintaining connection during the pandemic as a benefit of digital social care practice; approximately three-quarters (74%) felt that digital social care practice offered service users 'increased access/flexibility'; however, a similar proportion (70%) identified inadequate home environments (e.g. lack of privacy) during service provision as a barrier to digital social care practice. Over half identified poor Wi-Fi / device access as a challenge to child and family engagement with digital social care. In total, 79% felt that they needed further training in the use of digital platforms for service delivery. Thematic analysis of qualitative (focus group) data revealed three overarching themes including: (i) perceived advantages and disadvantages for service users; (ii) practitioner challenges in working with children and families through digital technologies; and (iii) practitioners' personal challenges and training needs. CONCLUSIONS These findings shed light on practitioners' experiences of delivering digital child and family social care services during the Covid-19 pandemic. Both benefits and challenges within the delivery of digital social care supports, as well as conflicting findings across the experiences of practitioners were identified. The implications of the findings for the development of therapeutic practitioner-service user relationships through digital practice, as well as confidentiality and safeguarding are discussed. Training and support needs for the future implementation of digital social care interventions are also outlined. CLINICALTRIAL
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Affiliation(s)
- Grainne Hickey
- Barnardos Ireland, Christchurch Sq., Dublin 8, Dublin, IE
| | - Claire Dunne
- Barnardos Ireland, Christchurch Sq., Dublin 8, Dublin, IE.,Technological University Dublin, Dublin, IE
| | - Lauren Maguire
- Barnardos Ireland, Christchurch Sq., Dublin 8, Dublin, IE
| | - Niamh McCarthy
- Barnardos Ireland, Christchurch Sq., Dublin 8, Dublin, IE
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Entenberg GA, Dosovitsky G, Aghakhani S, Mostovoy K, Carre N, Marshall Z, Benfica D, Mizrahi S, Testerman A, Rousseau A, Lin G, Bunge EL. User experience with a parenting chatbot micro intervention. Front Digit Health 2023; 4:989022. [PMID: 36714612 PMCID: PMC9874295 DOI: 10.3389/fdgth.2022.989022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Background The use of chatbots to address mental health conditions have become increasingly popular in recent years. However, few studies aimed to teach parenting skills through chatbots, and there are no reports on parental user experience. Aim: This study aimed to assess the user experience of a parenting chatbot micro intervention to teach how to praise children in a Spanish-speaking country. Methods A sample of 89 parents were assigned to the chatbot micro intervention as part of a randomized controlled trial study. Completion rates, engagement, satisfaction, net promoter score, and acceptability were analyzed. Results 66.3% of the participants completed the intervention. Participants exchanged an average of 49.8 messages (SD = 1.53), provided an average satisfaction score of 4.19 (SD = .79), and reported that they would recommend the chatbot to other parents (net promoter score = 4.63/5; SD = .66). Acceptability level was high (ease of use = 4.66 [SD = .73]; comfortability = 4.76 [SD = .46]; lack of technical problems = 4.69 [SD = .59]; interactivity = 4.51 [SD = .77]; usefulness for everyday life = 4.75 [SD = .54]). Conclusions Overall, users completed the intervention at a high rate, engaged with the chatbot, were satisfied, would recommend it to others, and reported a high level of acceptability. Chatbots have the potential to teach parenting skills however research on the efficacy of parenting chatbot interventions is needed.
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Affiliation(s)
- G. A. Entenberg
- Research Department, Fundación ETCI, Buenos Aires, Argentina,Correspondence: G. A. Entenberg E. L. Bunge
| | - G. Dosovitsky
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - S. Aghakhani
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - K. Mostovoy
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - N. Carre
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - Z. Marshall
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - D. Benfica
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - S. Mizrahi
- Research Department, Fundación ETCI, Buenos Aires, Argentina
| | - A. Testerman
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - A. Rousseau
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - G. Lin
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States
| | - E. L. Bunge
- Children and Adolescents Psychotherapy and Technology Lab (CAPT), Palo Alto University, Palo Alto, CA, United States,Department of Psychology, International Institute for Internet Interventions i4Health, Palo Alto, CA, United States,Correspondence: G. A. Entenberg E. L. Bunge
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Agazzi H, Hayford H, Thomas N, Dickinson S, Ortiz C, Salinas-Miranda A. Pandemic parenting: A pilot study of in-person versus internet-DOCS K-5 for caregivers of school-age children with disruptive behaviors. Clin Child Psychol Psychiatry 2022; 27:569-585. [PMID: 35485248 DOI: 10.1177/13591045221096313] [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] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are needed to address disruptive behavior disorders among school-aged children. Given the prolonged COVID-19 pandemic and associated mental health consequences, adapting BPTs to telehealth modalities is necessary to ensure continued services to children and families. This pilot study evaluated the use of a telehealth vs in-person modality to deliver the Developing Our Children's Skills K-5 (DOCS K-5) BPT. Participants were caregivers of children enrolled in elementary school exhibiting disruptive behaviors who participated in either in-person DOCS K-5 (n = 21) or internet-DOCS K-5 (i-DOCS K-5; n = 34). Pre- and post-intervention outcome measures were collected for child disruptive behavior, parenting stress, and caregiver symptoms of depression while consumer satisfaction was assessed at post-test only. Multiple linear and Poisson regression models were performed to assess the effect of session modality on the outcomes. Child disruptive behavior, parenting stress and depression, and consumer satisfaction scores were not significantly different across groups, even after adjusting for baseline characteristics. The results of this study provide preliminary evidence that the i-DOCS K-5 modality is as effective as the in-person program. Study findings may be beneficial to practitioners treating school-age children and utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics & Psychiatry, 33697University of South Florida, USA
| | - Holland Hayford
- Department of Pediatrics, 33697University of South Florida, USA
| | - Nicholas Thomas
- Harrell Center for the Study of Family Violence, College of Public Health, 27117University of South Florida, USA
| | - Sarah Dickinson
- Department of Pediatrics, 33697University of South Florida, USA
| | - Cristina Ortiz
- Department of Pediatrics, 33697University of South Florida, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence & USF Center of Excellence in Maternal and Child Health Education, Science and Practice, 27117University of South Florida, USA
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A Preliminary Evaluation of a Brief Behavioral Parent Training for Challenging Behavior in Autism Spectrum Disorder. J Autism Dev Disord 2022:10.1007/s10803-022-05493-3. [PMID: 35488976 PMCID: PMC9055015 DOI: 10.1007/s10803-022-05493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/03/2022]
Abstract
Children with autism spectrum disorder (ASD) often exhibit challenging behaviors. Existing behavioral parent trainings (BPT) address ASD symptomology, but are lengthy and associated with significant attrition. In the current pilot study, a longitudinal randomized controlled trial was used to evaluate a novel brief BPT targeting caregivers of children with ASD ages 5–9. The 6-session BPT, delivered in a group format, focused on high-frequency challenging behaviors (e.g., problem behaviors, feeding and sleep issues). Caregivers who received BPT (n = 29), relative to an active control (psychoeducation/supportive therapy; n = 9), reported higher treatment satisfaction and acceptability. Challenging behaviors were reduced in the BPT and active control groups. The novel BPT was a feasible and acceptable intervention to target challenging behaviors in youth with ASD.
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Gupta M, Malik T, Sinha C. Delivery of a Mental Health Intervention for Chronic Pain Through an Artificial Intelligence-Enabled App (Wysa): Protocol for a Prospective Pilot Study. JMIR Res Protoc 2022; 11:e36910. [PMID: 35314423 PMCID: PMC9015778 DOI: 10.2196/36910] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with chronic pain often suffer from coexisting, long-term and debilitating mental health comorbidities such as depression and anxiety. Artificial Intelligence Supported Cognitive Behavioral Therapy or AI-CBT interventions could offer cost-effective, accessible, and potentially effective resources to tackle this problem. However, there is not enough research conducted about the efficacy of AI-CBT interventions for chronic pain. OBJECTIVE This prospective cohort study aims to examine the efficacy and usage of an AI-CBT intervention for chronic pain (Wysa for Chronic Pain app), using a conversational agent (with no human intervention). To the best of our knowledge, this is the first such study for chronic pain using a fully-automated, free-text-based conversational agent (CA). METHODS Participants with self-reported chronic pain (N = 500) will be recruited online on a rolling basis from April 2022 through posts on US-based internet communities within this prospective cohort. Informed consent is taken from the participants within the app and the Wysa intervention is delivered remotely for 8 weeks. Outcome measures including NPRS (Numeric Pain Rating Scale), PROMIS PI (Patient-Reported Outcomes Measurement Information System Pain Interference), GAD-7 (Generalized Anxiety Disorder), and PHQ-9 (Patient Health Questionnaire) questionnaires will be administered to test the effectiveness of the intervention on reducing levels of pain interference, depression, and anxiety. The therapeutic alliance created with the conversational agent will be assessed through the WAI-SR (Working Alliance Inventory-Short Revised). Retention and usage statistics will be observed for adherence and engagement. RESULTS The study will open for recruitment in April 2022 and data collection is expected to be completed by August 2022. The results for the primary outcomes are expected to be published by late-2022. CONCLUSIONS Mental health conversational agents driven by artificial intelligence (AI) could be effective in helping patients with chronic pain learn to self-manage their pain and deal with common comorbidities like depression and anxiety. The Wysa for Chronic Pain app is one such digital intervention that can potentially serve as a solution to the problems of affordability and scalability associated with interventions with a human therapist in loop. This prospective study examines the efficacy of the app as a treatment solution for chronic pain. It aims to inform future practices and digital mental health interventions for individuals with chronic pain. CLINICALTRIAL
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Agazzi H, Hayford H, Thomas N, Ortiz C, Salinas-Miranda A. A nonrandomized trial of a behavioral parent training intervention for parents with children with challenging behaviors: In-person versus internet-HOT DOCS. Clin Child Psychol Psychiatry 2021; 26:1076-1088. [PMID: 34156883 DOI: 10.1177/13591045211027559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are the first-line interventions for childhood disruptive behaviors. In light of the COVID-19 pandemic, adapting these programs to telehealth modalities is necessary to ensure continued services to children and families. This study evaluates the use of telehealth versus in-person modality to deliver the Helping Our Toddlers, Developing Our Children's Skills (HOT DOCS) BPT. The study design was quasi-experimental with two nonequivalent groups: in-person HOT DOCS (n = 152) and internet-HOT DOCS (n = 46). Participants were caregivers of children ages 2-5 exhibiting disruptive behaviors. Pre- and post-intervention outcome measures were collected for child disruptive behavior and parenting stress and post-test only for consumer satisfaction. Multiple linear and Poisson regression models were performed to assess the effect of class modality on the outcomes. Child disruptive behavior and parenting stress post-test scores for in-person and telehealth groups were not significantly different, even after adjusting for baseline characteristics. Consumer satisfaction scores were significantly more positive for the in-person group. The results of this study provide preliminary evidence for the i-HOT DOCS modality as being as effective as the in-person program. Study findings may be beneficial to practitioners utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics & Psychiatry, 33697University of South Florida, Tampa, FL, USA
| | - Holland Hayford
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Nicholas Thomas
- Harrell Center for the Study of Family Violence, College of Public Health, 27117University of South Florida, Tampa, FL, USA
| | - Cristina Ortiz
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence & USF Center of Excellence in Maternal and Child Health Education, Science and Practice, University of South Florida, Tampa, FL, USA
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Roos LE, Salisbury M, Penner-Goeke L, Cameron EE, Protudjer JLP, Giuliano R, Afifi TO, Reynolds K. Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic. PLoS One 2021; 16:e0251720. [PMID: 34029311 DOI: 10.2139/ssrn.3685933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/01/2021] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Supportive parenting is critical for promoting healthy child development in the face of stressors, such as those occurring during COVID-19. Here, we address a knowledge gap regarding specific household risk factors associated with parenting quality during the pandemic and incorporate first-person accounts of family challenges and needs. METHODS Mixed methods were applied to data collected between April 14th - 28th, 2020 from the "Parenting During the Pandemic" survey. Participants included 656 primary caregivers (e.g., mothers, fathers, foster parents) of least one child age 1.5-8 years of which 555 (84.6%) responded to at least one parenting questionnaire. Parenting quality was assessed across stressful, negative, and positive parenting dimensions. Household risk was examined across pandemic- linked (e.g., caregiver depression, unmet childcare needs) and stable factors (i.e., annual income, mental illness history). Significant correlates were examined with regressions in Mplus. Thematic analysis identified caregiver challenges and unmet needs from open-ended questions. FINDINGS Caregiver depression, higher child parity, unmet childcare needs, and relationship distress predicted lower-quality parenting. Caregiver depression was the most significant predictor across every parenting dimension, with analyses indicating medium effect sizes, ds = .39 - .73. Qualitative findings highlighted severe strains on parent capacities including managing psychological distress, limited social supports, and too much unstructured time. INTERPRETATIONS Lower quality parenting during COVID-19 is associated with multiple household and pandemic risk factors, with caregiver depression consistently linked to parent- child relationship disruptions. Focused efforts are needed to address caregiver mental health to protect child health as part of the pandemic response.
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Affiliation(s)
- Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Marlee Salisbury
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Lara Penner-Goeke
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychology, University of Winnipeg, Winnipeg, Canada
| | - Emily E Cameron
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Ryan Giuliano
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Tracie O Afifi
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
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Roos LE, Salisbury M, Penner-Goeke L, Cameron EE, Protudjer JLP, Giuliano R, Afifi TO, Reynolds K. Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic. PLoS One 2021; 16:e0251720. [PMID: 34029311 PMCID: PMC8143383 DOI: 10.1371/journal.pone.0251720] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/01/2021] [Indexed: 01/02/2023] Open
Abstract
Background Supportive parenting is critical for promoting healthy child development in the face of stressors, such as those occurring during COVID-19. Here, we address a knowledge gap regarding specific household risk factors associated with parenting quality during the pandemic and incorporate first-person accounts of family challenges and needs. Methods Mixed methods were applied to data collected between April 14th - 28th, 2020 from the “Parenting During the Pandemic” survey. Participants included 656 primary caregivers (e.g., mothers, fathers, foster parents) of least one child age 1.5–8 years of which 555 (84.6%) responded to at least one parenting questionnaire. Parenting quality was assessed across stressful, negative, and positive parenting dimensions. Household risk was examined across pandemic- linked (e.g., caregiver depression, unmet childcare needs) and stable factors (i.e., annual income, mental illness history). Significant correlates were examined with regressions in Mplus. Thematic analysis identified caregiver challenges and unmet needs from open-ended questions. Findings Caregiver depression, higher child parity, unmet childcare needs, and relationship distress predicted lower-quality parenting. Caregiver depression was the most significant predictor across every parenting dimension, with analyses indicating medium effect sizes, ds = .39 - .73. Qualitative findings highlighted severe strains on parent capacities including managing psychological distress, limited social supports, and too much unstructured time. Interpretations Lower quality parenting during COVID-19 is associated with multiple household and pandemic risk factors, with caregiver depression consistently linked to parent- child relationship disruptions. Focused efforts are needed to address caregiver mental health to protect child health as part of the pandemic response.
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Affiliation(s)
- Leslie E. Roos
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
- * E-mail:
| | - Marlee Salisbury
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Lara Penner-Goeke
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Psychology, University of Winnipeg, Winnipeg, Canada
| | - Emily E. Cameron
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Jennifer L. P. Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Ryan Giuliano
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Tracie O. Afifi
- Department of Psychology, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
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Flujas-Contreras JM, García-Palacios A, Gómez I. Effectiveness of a Web-Based Intervention on Parental Psychological Flexibility and Emotion Regulation: A Pilot Open Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2958. [PMID: 33805835 PMCID: PMC7998718 DOI: 10.3390/ijerph18062958] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 01/07/2023]
Abstract
"Parenting Forest" is an informed contextual therapy parenting program for improving parental emotion regulation strategies and psychological flexibility. The aim of this study was to evaluate the preliminary effectiveness of a self-guided web-based intervention of the Parenting Forest program. The intervention program consists of six self-applied sequential modules that use strategies from contextual therapies for providing a parenting style open to experience, mindful and committed to its actions. A pilot controlled open trial was conducted. Eligible parents (n = 12) enrolled in the web-based intervention completed baseline (T1) and post-intervention (T2) assessment instruments. Parental psychological flexibility, avoidance, emotional regulation, parental stress, satisfaction with life, children's psychological adjustment and client satisfaction were measured to assess the effects of the intervention. Mood, coping, and value-related actions were assessed as measures of progress. The results showed positive effects on the parents' psychological flexibility and emotion regulation. Parents' mood and coping skills improved throughout the intervention program. These results provide preliminary evidence of the web-based Parenting Forest's efficacy, although further research is needed to assess its effectiveness for prevention and in clinical populations.
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Affiliation(s)
- Juan M. Flujas-Contreras
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
| | - Azucena García-Palacios
- Department of Psychology, University Jaume I, 12071 Castellon, Spain;
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Inmaculada Gómez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
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Florean IS, Dobrean A, Păsărelu CR, Georgescu RD, Milea I. The Efficacy of Internet-Based Parenting Programs for Children and Adolescents with Behavior Problems: A Meta-Analysis of Randomized Clinical Trials. Clin Child Fam Psychol Rev 2020; 23:510-528. [DOI: 10.1007/s10567-020-00326-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 01/25/2023]
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Bennett SD, Cuijpers P, Ebert DD, McKenzie Smith M, Coughtrey AE, Heyman I, Manzotti G, Shafran R. Practitioner Review: Unguided and guided self-help interventions for common mental health disorders in children and adolescents: a systematic review and meta-analysis. J Child Psychol Psychiatry 2019; 60:828-847. [PMID: 30775782 DOI: 10.1111/jcpp.13010] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 11/28/2022]
Abstract
Mental health problems are common in children and adolescents, yet evidence-based treatments are hard to access. Self-help interventions can increase such access. The aim of this paper was to conduct a systematic review and meta-analysis of the use of guided and unguided self-help for children and young people with symptoms of common mental health disorders. In contrast to previous reviews of self-help in children, all types of self-help and multiple mental health disorders were investigated in order to increase power to investigate potential moderators of efficacy. Importantly, studies with control arms as well as those comparing against traditional face-to-face treatments were included. Fifty studies (n = 3396 participants in self-help/guided self-help conditions) met the inclusion criteria. Results demonstrated a moderate positive effect size for guided and unguided self-help interventions when compared against a control group (n = 44; g = 0.49; 95% CI: 0.37 to 0.61, p < .01) and a small but significant negative effect size when compared to other therapies (n = 15; g = -0.17; 95% CI: -0.27 to -0.07, p < .01). Few potential moderators had a significant effect on outcome. Most comparisons resulted in significant heterogeneity and therefore results are interpreted with caution.
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Affiliation(s)
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Grazia Manzotti
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
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