Associations between family characteristics and parental empowerment in the family, family service situations and the family service system

Parent empowerment as a buffer between perceived stress and parenting self-efficacy in immigrant parents

U.S. immigrant parents encounter various challenges during the migration and resettlement process, such as acculturative stress and dissonance in parenting practices between the cultures in the U.S. and those in their country of origin. Although studies have established a link between increased perceived stress and reduced parenting self-efficacy in U.S.-born parents, which could be alleviated by levels of parental empowerment, little is known about this pathway in the context of migration. Guided by the Family Adjustment and Adaptation Response Model and with a focus on low-income immigrant parents of young children, we examined (1) the association between perceived stress and parenting self-efficacy, and (2) whether parental empowerment constitutes a buffer between perceived stress and parenting self-efficacy. Participants included foreign-born, low-income parents (n = 680) with preschool-aged children enrolled in Head Start of Greater Boston. Linear regression models were conducted to examine the relationship between perceived stress and parenting self-efficacy. An interaction term between perceived stress and empowerment was included to test the moderating effect of each dimension of parental empowerment (i.e., resource empowerment, critical awareness, and relational empowerment). Results showed higher perceived stress was associated with lower parenting self-efficacy and this relationship was moderated by relational empowerment. Findings suggest that relational empowerment can be an important resource for immigrant parents with high stress and a protective factor to improve self-efficacy in their parenting. These results pose important implications regarding how healthcare professionals and clinicians may support parents, for example, through the development of culturally sensitive parenting interventions and the creation of safe environments for parent-to-parent relationships.

Embedding Technology-Assisted Parenting Interventions in Real-World Settings to Empower Parents of Children With Adverse Childhood Experiences: Co-Design Study

BACKGROUND

Adverse childhood experiences are strongly associated with mental disorders in young people. Parenting interventions are available through community health settings and can intervene with adverse childhood experiences that are within a parent's capacity to modify. Technology can minimize common barriers associated with engaging in face-to-face parenting interventions. However, families experiencing adversity face unique barriers to engaging with technology-assisted parenting interventions. Formative research using co-design methodology to provide a deep contextual understanding of these barriers can help overcome unique barriers and ensure these families can capitalize on the benefits of technology-assisted parenting interventions.

OBJECTIVE

This study aims to innovate the parenting support delivered by a community health and social service with technology by adapting an existing, evidence-based, technology-assisted parenting intervention.

METHODS

Staff (n=3) participated in dialogues (n=2) and co-design workshops (n=8) exploring needs and preferences for a technology-assisted parenting intervention and iteratively developing a prototype intervention (Parenting Resilient Kids [PaRK]-Lite). Parents (n=3) received PaRK-Lite and participated in qualitative interviews to provide feedback on their experience and PaRK-Lite's design.

RESULTS

PaRK-Lite's hybrid design leverages simple and familiar modes of technology (podcasts) to deliver intervention content and embeds reflective practice into service provision (microcoaching) to enhance parents' empowerment and reduce service dependency. A training session, manuals, session plans, and templates were also developed to support the delivery of microcoaching. Feedback data from parents overall indicated that PaRK-Lite met their needs, suggesting that service providers can play a key role in the early phases of service innovation for parents.

CONCLUSIONS

The co-designed technology-assisted parenting intervention aims to offer both parents and clinicians a novel and engaging resource for intervening with maladaptive parenting, contributing to efforts to respond to childhood adversity and improve child mental health. Future research in the field of human-computer interaction and health service design can consider our findings in creating engaging interventions that have a positive impact on the well-being of children and families.

Parental Worries, Child Maltreatment Risk and Empowerment: How Are They Noticed in Child and Family Services?

Parental empowerment has been related to their well-being and self-efficacy. Learning more about the signs describing child maltreatment risk are crucial for the welfare of children and families. The aim of this study was to assess the risk of child maltreatment (CM) and related worrying factors of parents and associations between the CM risk, worries and parental empowerment. The study is based on self-report surveys administered to parents in primary health care and hospital settings. The risk of CM and related worrying factors were measured by the Brief Child Abuse Potential Inventory (BCAP) from 453 parents. Family empowerment was measured by The Generic Family Empowerment Scale (G-FES). Parents expressed worries such as loneliness and distress (20%), feelings of persecution (9%), family conflict (17%), rigidity (21%) and financial insecurity (4%). The BCAP found 27 parents with increased risk. Parents with CM risk expressed more empowerment in connection to services for their child and family. It is crucial to discuss worries in child and family services before they raise the risk level. Tools such as the BCAP are useful in systematically identifying the child maltreatment risk and parental worries under discussion, offering possibilities for preventing child maltreatment and increasing well-being of children.

Development and Psychometric Analysis of the Transgender Family Acceptance To Empowerment (TransFATE) Scale

PURPOSE

Parent and caregiver support can reduce health disparities experienced by gender diverse youth (GDY). Parent and caregiver empowerment improves health outcomes for children with medical and mental health diagnoses, but no existing scale measures this construct in families of GDY. We aimed to develop a scale measuring empowerment in parents and caregivers of GDY.

METHODS

We adapted two existing scales and added investigator-derived items to create a survey instrument. We revised using input from focus groups and experts assessing face and content validity. Using the revised scale, we surveyed parents and caregivers of GDY from across the U.S. to assess the construct validity through exploratory and confirmatory factor analyses, internal consistency, and convergent validity.

RESULTS

The initial 67 items were reduced to 42 items after face and content validity analyses. Parents and caregivers (n = 309) from 31 states completed the revised measure. Most participants were white (81.4%), mothers (69.3%), and parenting a gender diverse child who identifies on the binary (transmasculine, male, transfeminine, or female; 91.3%). Exploratory factor analyses showed a two-factor solution: Factor 1 having 10 items (Cronbach's alpha = .86) and Factor 2 having six items (Cronbach's alpha = .86). Our confirmatory factor analysis demonstrated good fit (Comparative Factor Index = .972, Tucker-Lewis Index = .968, Root Mean Square Error of Approximation = .060 [90% confidence interval = .410-.078], and Standardized Root Mean Square Residual = .062).

CONCLUSIONS

The Transgender Family Acceptance To Empowerment (TransFATE) scale demonstrates face, content, and construct validity among a geographically diverse sample of GDY's parents and caregivers. This scale has the potential to aid in developing and evaluating programs focused on building stronger social supports for GDY through increased family empowerment.

The relationship between the Family Empowerment Scale and Gross Motor Function Measure-66 in Young Children with cerebral palsy

BACKGROUND

Cerebral palsy (CP) is the most common cause of motor disability in children. A concept to consider in order to meet the needs of children with CP and their families is family empowerment. Family empowerment can be defined as the process by which families acquire the skills, knowledge and resources to allow them to gain control and improve the quality of their lives. The relationship between gross motor function and family empowerment may be important because children with CP vary so widely in their ability to perform motor skills, which may affect their family's levels of empowerment. The purpose of this research was to investigate the relationship between the Family Empowerment Scale (FES) and Gross Motor Function Measure-66 (GMFM-66) in children with CP who were under 3 years of age.

METHODS

Forty-one children with a mean age of 23.8 months participated in this study. The FES was completed by the participants' parents or regular caregivers and includes a total score and subscales of empowerment in the family, in service situations and in community/political environments. The GMFM-66 was administered by a physical therapist and consists of a total score of gross motor function (GMFM-66) and subscores for Dimension B (sitting), Dimension C (crawling and kneeling), Dimension D (standing) and Dimension E (walking, running and jumping).

RESULTS

Statistically significant positive correlations were found between the FES total and GMFM (total score and Dimensions B-E) with coefficients varying from 0.43-0.62. Significant relationships were also found between most subscales of the FES and the GMFM-66.

CONCLUSIONS

This study provides evidence of a relationship between family empowerment and gross motor function in young children with CP and suggests that caregivers of children with higher gross motor function report higher levels of self-efficacy.

Community Intervention Self-Efficacy Scale for Parent Leaders (CONNECTED): Parents' Empowerment to Prevent Adolescent Alcohol Use

Empowering parents by actively engaging them in environmental prevention strategies is a promising approach that only a few programs use. Evidence suggests that when families and the wider community are engaged, alcohol prevention is more efficient. However, due to the novelty of this approach, no specific assessment tools for measuring this type of engagement are available. The objective of this study is to design a parental empowerment measurement tool to evaluate parents’ self-efficacy when engaging in environmental and community actions and to analyze its psychometric properties. A total of 132 parents active in in-school parent associations from Spain (n = 77; 58.4%) and Portugal (n = 55; 41.7%) completed a pencil and paper battery of four questionnaires, including the developed scale COmmuNity iNtervention SElf-Efficacy SCale for ParenT LEaDers (CONNECTED). The scale showed a good reliability and good test-retest stability in a three-month period. The convergent validity with other well-established instruments that assess similar constructs was significant. A preliminary confirmatory factor analysis (CFA) showed an acceptable fit. Environmental prevention supported by families is a promising preventive strategy because the participation and involvement of families is an effective way to address some risks in adolescence; however, new assessment tools are needed in this field. The developed scale could be a first step to identify the areas of need in a community and to monitor the progress and evaluate the outcomes of the preventive interventions implemented.

Multi-Children Parents' Experiences of Parental Support by Attending Parental Group for Multi-Children Parents in Sweden

This study investigated multi-children parents' (MCPs) experiences of support in their parental role by participating in parental group for MCPs. Focus group interviews were performed with 20 MCPs consisting of 9 mothers and 11 fathers, with a mean number of children of 2.35 per family. Each interview lasted about 1 hour, and it was analyzed by content analysis method. One theme was revealed: parental group for MCPs gives access to reflection and development on MCP issues. This related to 2 categories: support in the MCPs' role through internal development and support in the MCPs' role through external influences. The study's conclusion highlights the support of MCPs in their parental role by attending a parental group for MCPs and should be offered to achieve empowerment. Clinical implications are that a mix of men and women with different numbers of children of various ages of siblings should compose parental groups for MCPs.

Empowerment in families raising a child with cerebral palsy during early childhood: Associations with child, family and service characteristics

BACKGROUND

Insight into family empowerment is important in order to develop and offer services that support and strengthen parents caring for a child with disability. The aims of this study were to describe empowerment trajectories among parents caring for a young child with cerebral palsy (CP) and to explore associations between parental empowerment and characteristics of the child and family and the services they receive.

METHODS

58 children (median age at first assessment 28 months, range 12-57) and their parents were included in a longitudinal cohort study based on registry data from follow-up programs for children with CP in Norway. Parental empowerment trajectories were described by averaging scores in the three subscales of the Family Empowerment Scale (FES) (family, service situations and community) at enrollment and at semi-annual/annual assessments. A linear mixed model was used to explore associations.

RESULTS

Parental empowerment scores on the FES in family and service situations were high and stable during early childhood, while considerably lower in the community context. In service situations, perceived empowerment was significantly associated with both child, family and service characteristics, whereas empowerment in family situations was only associated with family characteristics. The service factor having a multidisciplinary support team was positively associated with perceived empowerment in both service situations and in the community.

CONCLUSION

Knowledge about parental empowerment in different contexts and associations with characteristics of the child and family and the services they receive can contribute to further reinforcing family empowerment and identifying parents in need of additional support.

Parental empowerment-Lesbian, gay, bisexual, trans or queer parents' perceptions of maternity and child healthcare

AIM

Describe empowerment in maternity and child healthcare from the perspective of self-identified lesbian, gay, bisexual, trans, or queer (LGBTQ) parents in Finland.

BACKGROUND

Parental empowerment is a core aspect of maternity and child healthcare. However, knowledge about LGBTQ parents' perceptions about empowerment is still lacking.

METHOD

Qualitative design, 22 parents participating. The interviews were conducted in between July and September 2016 and analysed using inductive content analysis.

FINDINGS

Three core categories emerged as follows: (a) recognition and acknowledgment, particularly being treated as a parent, irrespective of any biological or legal ties to a child; (b) cooperation and interaction, such as working together, respecting parents' autonomy, and supporting parents' full involvement; (c) equitable care, such as parents' trust in services, but also a health-care professional's knowledge of a family's special needs.

CONCLUSION

Empowerment was perceived as the parents' sense of being visible and recognized as a parent. This recognition requires education and structures that are inclusive of all families. In addition, the language used by professionals was a key indicator for promoting positive feelings of comfort and safety for all families.

Family empowerment and associated factors in Japanese families raising a child with severe motor and intellectual disabilities

Objectives

Family caregivers raising children with severe motor and intellectual disabilities (SMID) experience the enormous burden of care. The concept of family empowerment is one of the important assessment indexes of family nursing from the perspective of providing comprehensive support for these families. The objective of this study was to identify the factors associated with the empowerment of families raising a child with SMID in Japan.

Methods

We conducted a nationwide questionnaire survey involving 1659 primary caregivers raising a child with SMID through 89 special schools. We assessed the main outcomes using the Family Empowerment Scale (FES). We then conducted a multiple linear regression analysis to reveal the factors associated with family empowerment.

Results

In total, 1362 primary caregivers were included in our study. Our results show that factors contributing to high FES scores are higher age of the primary caregiver, higher education, greater recognition of regional support, lower childcare burden, higher utilization of home visit services, higher usage of a childcare institution, higher household income, and stronger family bonding.

Conclusion

Healthcare professionals should carefully assess the state of family empowerment of the primary caregivers who are younger and those who have low education, low household income, high childcare burden, and fragile bonding with the family. Second, they should encourage such families to use regional support resources for childcare. That is, policy makers should consider ways to promote home visits and institutional services for the care of children with SMID, aiming especially for the provision of well-coordinated care and services.

Family management affecting transition readiness and quality of life of Chinese children and young people with chronic diseases

Transition from pediatric to adult health care is a key milestone for children and young people (CYP) with chronic conditions. Family management (FM) and self-management are two important concepts during the process. This study aimed to explore the relationships between FM, self-management and transition readiness, and quality of life (QoL), and identify the potential CYP or family factors influencing the relationships. Data about FM, self-management and transition readiness, QoL, and various contextual factors were collected from 268 caregiver-child pairs. Structural equation modeling was used to examine the relationships between all variables. Results revealed that the easy aspects of FM mediated the relationships between the challenging aspects of FM, self-management and transition readiness, and QoL of CYP. Self-management and transition readiness mediated the relationship between the easy aspects of FM and QoL. Contextual factors indirectly influenced CYP's transition readiness and QoL through different aspects of FM. The results imply that to ensure the smooth transition from pediatric to adult health care and improve the CYP's QoL, strengthening CYP's independence and self-management competencies, combined with the support of the easy aspects of FM, seem to be useful strategies to increase CYP's readiness for transfer.

Approaches to better engage parent-child in health home-visiting programmes: A content analysis

Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000-2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.

[Obstacles for the use of early childhood prevention services : The role of expected ability to control sources]

BACKGROUND

It is well established that preventive measures for pregnant women and families with small children do not reach all families alike. Often enough, it is those families, who due to heightened stresses and strains might gain the most from these measures, who cannot be reached (dilemma of prevention).

GOAL

This investigation explores whether parents can be grouped according to their views on health, prevention and measures available to young families, and whether belonging to one of the identified groups explains differences in the use of (primary and secondary) preventive measures for pregnant women and young families.

METHOD

In the context of home visits, parents of children aged two to four years (N = 273) completed questionnaires. Additionally, 203 parents took part in qualitative interviews.

RESULTS AND DISCUSSION

Based on interview data, parents from different sociocultural backgrounds could be grouped along their expected ability to control sources for parental support (Steuerungskompetenz). Parents high and low in Steuerungskompetenz differ regarding their knowledge of, use of, and satisfaction with (primary) preventive measures. Steuerungskompetenz explains the use of primary preventive measures above and beyond socioeconomic control variables as well as family stresses and strains. The use of secondary preventive measures is better explained by family stresses and strains. Results are discussed in terms of untapped services, needs and possibilities of target group-oriented approach.

Strategies for parenting by mothers and fathers with a mental illness

WHAT IS KNOWN ON THE SUBJECT?: The combination of coping with their mental health problems and caring for children makes parents vulnerable. Family-centred practice can help to maintain and strengthen important family relationships, and to identify and enhance the strengths of a parent with a mental illness, all contributing to the recovery of the person with the mental illness. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE?: Taking the strength and the opportunities formulated by parents themselves as a starting point is fairly new. Parents with severe mental illness find strength for parenting in several ways. They feel responsible, and this helps them to stay alert while parenting, whereas parenthood also offers a basis for social participation through school contacts and the child's friendships. Dedication to the parent role provides a focus; parents develop strengths and skills as they find a balance between attending to their own lives and caring for their children; and parenting prompts them to find adequate sources of social support. In this study these strategies were found to be the fundamentals of recovery related to parenting. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can support and coach patients who are identified as parents, and self-chosen parenting related goals are set and addressed. A family-focused approach by nurses can be used to prevent problems for children and their families, identify their strengths as well as vulnerabilities, and address the challenges to build resilience.

INTRODUCTION

Understanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new.

QUESTION

What are the strategies of parents with a mental illness to be successful?

METHOD

Experiences of 19 mothers and eight fathers with a mental illness were explored with in-depth interviews. Data were content analysed, using qualitative methods.

RESULTS

Next to feelings of inadequacy, interviewees also describe how children enrich and structure their lives and are not only a burden but serve as distraction from problems. Developing activities that interest both child and parent provides avenues for emerging strength. Mental illness constrains fathers, but also gives opportunities to develop a meaningful relation with their children.

DISCUSSION

Strategies like being fully dedicated to the parental role, finding a balance between attention for one's own life and parenting and finding adequate sources of support are found to be fundamental for recovery in the parent role. Implications for practice Peer groups can be of valuable help and mental health workers can support parents to set self-chosen parenting related goals.