Parenting programs during adolescence: Outcomes from universal and targeted interventions offered in real-world settings

Swedish parents' satisfaction and experience of facilitators and barriers with Family Check-up: A mixed methods study

Family Check-up (FCU) was introduced in Sweden more than a decade ago. Little is known about what parents experience as FCU's key mechanisms leading to changes in parenting. The aim of this study was to investigate Swedish parents' satisfaction with FCU, and their experiences of facilitators and barriers for making changes in their parenting. A mixed methods approach was employed using a parent satisfaction questionnaire (n = 77) and focus groups (n = 15). General satisfaction with FCU was adequate, with an average rating of 4 on a five-point scale (range 3.1-4.6). The analysis of quantitative and qualitative data resulted in eight themes representing facilitators and four themes representing barriers, organized into three categories: (1) access and engagement; (2) therapeutic process; and (3) program components. Ease of access to FCU facilitated initial engagement. Individual tailoring and access to FCU during different phases of change facilitated sustained engagement and change. Therapeutic process facilitators were a meaningful, supportive relationship with the provider, psychological benefits for parents and benefits for the whole family. Program components that facilitated change in parenting were new learning of parenting strategies and use of helpful techniques such as videotaping and home practice. Negative experiences with service systems prior to starting FCU, parent psychological barriers, and parent-provider mismatch were described as potential barriers. Some parents desired other program formats that were not offered, and some felt that new learning was insufficient to improve child behavior. Understanding the parent perspective can contribute to successful future work with implementing FCU.

How are parenting practices associated with bullying in adolescents? A cross-sectional study

BACKGROUND

Parenting styles have been previously associated with bullying, but some parenting practices have not received strong attention in the literature. We aimed to assess how parenting practices are associated with cyberbullying and traditional bullying involvement in adolescents.

METHOD

A cross-sectional survey of 2,218 secondary-school students in London (UK) was conducted. The Olweus Bully/Victim Questionnaire and the Alabama Parenting Questionnaire (APQ-child form) were used.

RESULTS

Positive parenting significantly protected against cyberbullying involvement but not against traditional bullying. Inconsistent discipline was associated with being a cyberbully but not being a traditional one. Lower levels of monitoring were associated with being a cyberbully, a cyberbully-victim, a traditional bully, or a traditional bully-victim.

CONCLUSIONS

Parenting practices seem to be more relevant in cyberbullying than traditional bullying. Effective parenting practices such as positive parenting deserve attention as a potentially modifiable factor to protect against cyberbullying involvement. Ineffective parenting practices such as inconsistent discipline are relevant in cyberaggression, whereas poor monitoring is associated with both cyberbullying and traditional bullying. Clinical and research implications are discussed.

Parenting dimensions/styles and emotion dysregulation in childhood and adolescence: a systematic review and Meta-analysis

Emotion dysregulation is a transdiagnostic factor in the development of various mental and behavioral disorders, thus requiring ample evidence for prevention and intervention approaches. The aim of the current systematic review and meta-analysis was to investigate the association between parenting dimensions/styles and emotion dysregulation in childhood and adolescence. Following the PRISMA guidelines, the review was registered (PROSPERO CRD42021251672) and search terms were entered in Web of Science, Scopus, PsycINFO, and PubMed in May 2021. Articles needed to report on empirical studies that examined the association between parenting dimensions/styles and emotion dysregulation in children/adolescents with primary data, and be published in English in a peer-reviewed journal. Additionally, articles were excluded based on certain designs and focus on special populations. The narrative synthesis includes 30 articles, and of which 27 are included in the meta-analysis. An NHLBI tool with 14 items (e.g., validity) was utilized for assessing the quality of the included studies. General trends indicate that positive parenting (e.g., warmth, supportiveness) is negatively associated with emotion dysregulation, whilst negative parenting (e.g., psychological control, authoritarian) is positively associated. The meta-analysis reveals an overall small yet significant effect, however, the heterogeneity of the studies is moderate to high. A funnel plot demonstrated no evidence of publication bias. Limitations include the varying conceptualizations of emotion dysregulation, as well as a lacking focus on specific types of emotion. Although more research is needed, addressing factors such as culture, gender, and age, the review provides first indications of the significance of parenting dimensions/styles for emotion dysregulation.

Feasibility and effect of adding a concurrent parental component to a school-based wellness program using two modes of mobile-based technology - mixed methods evaluation of RCT

BACKGROUND

This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.

METHODS

Two three-armed, randomized, controlled feasibility studies were conducted. In each trial, four schools with a total of 418 students in grade 5th, mean age 10.1 years, were randomly allocated to the control arm, youth-only arm, or youth & parental component arm. Only the data of those that completed all three assessments (pre, post and 3 months post program) were analyzed: 133 in the first trial and 137 in the second. In the youth-only arm, students participated in an interactive age-tailored prevention program delivered in 10 weekly, 90-min sessions on self-care behaviors, media literacy, self-esteem, and positive body image. The control groups in both studies received three health- and nutrition-related sessions. In the parental arm, in addition to the 'Favoring-Myself-Young's ten sessions program, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent via WhatsApp, and in the following year via "Favoring Myself" smartphone application. Facilitators were third year undergraduate students. They used a detailed semi-structured guide and received 4-weekly hours of didactic and group dynamic supervision. Mixed-methods assessments were performed using semi-structured interviews with ten parents and five school staff members each year, as well as a computerized self-report questionnaire.

RESULTS

Feasibility of parent-adolescent shared assignments in both digital modes was lower than expected. The use of WhatsApp had higher feasibility and uptake than the use of the special application. The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the smartphone application demonstrated superior improvement compared to those in the youth and parental component arm.

CONCLUSIONS

Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, under the chosen structure and population, it did not prove to add statistically significant value to the youth-only arm.

TRIAL REGISTRATIONS

NCT03216018 (12.7.2017) and NCT03540277 (26.4.2018).

The cost-effectiveness of a culturally tailored parenting program: estimating the value of multiple outcomes

Background

Parenting programs can be economically attractive interventions for improving the mental health of both parents and their children. Few attempts have been made to analyse the value of children’s and parent’s outcomes simultaneously, to provide a qualified support for decision making.

Methods

A within trial cost-effectiveness evaluation was conducted, comparing Ladnaan, a culturally tailored parenting program for Somali-born parents, with a waitlist control. Quality-adjusted life years (QALY) for parents were estimated by mapping the General Health Questionnaire-12 to Euroqol’s EQ-5D-3L to retrieve utilities. Behavioural problems in children were measured using the Child Behaviour Checklist (CBCL). Intervention costs were estimated for the trial. A net benefit regression framework was employed to study the cost-effectiveness of the intervention, dealing with multiple effects in the same analysis to estimate different combinations of willingness-to pay (WTP) thresholds.

Results

For a WTP of roughly €300 for a one point improvement in total problems on the CBCL scale (children), Ladnaan is cost-effective. In contrast, the WTP would have to be roughly €580,000 per QALY (parents) for it to be cost-effective. Various combinations of WTP values for the two outcomes (i.e., CBCL and QALY) may be used to describe other scenarios where Ladnaan is cost-effective.

Conclusions

Decision-makers interested in multiple effects must take into account combinations of effects in relation to budget, in order to obtain cost-effective results. A culturally adapted parenting program may be cost-effective, depending on the primary outcome, or multiple outcomes of interest.

Trial registration clinicaltrials.gov, NCT02114593. Registered 15 April 2014—prospectively registered, https://www.clinicaltrials.gov/ct2/results?recrs=&cond=&term=NCT02114593&cntry=&state=&city=&dist=

How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study

BACKGROUND

This study explored the rewards and difficulties of raising an adolescent and investigated parents' level of interest in receiving guidance from healthcare providers on parenting and adolescent health topics. Additionally, this study investigated whether parents were interested in parenting programs in primary care and explored methods in which parents want to receive guidance.

METHODS

Parents of adolescents (ages 12-18) who attended an outpatient pediatric clinic with their adolescent were contacted by telephone and completed a short telephone survey. Parents were asked open-ended questions regarding the rewards and difficulties of parenting and rated how important it was to receive guidance from a healthcare provider on certain parenting and health topics. Additionally, parents reported their level of interest in a parenting program in primary care and rated how they would like to receive guidance.

RESULTS

Our final sample included 104 parents, 87% of whom were interested in a parenting program within primary care. A variety of parenting rewards and difficulties were associated with raising an adolescent. From the list of parenting topics, communication was rated very important to receive guidance on (65%), followed by conflict management (50%). Of health topics, parents were primarily interested in receiving guidance on sex (77%), mental health (75%), and alcohol and drugs (74%). Parents in the study wanted to receive guidance from a pediatrician or through written literature.

CONCLUSIONS

The current study finds that parents identify several rewarding and difficult aspects associated with raising an adolescent and are open to receiving guidance on a range of parenting topics in a variety of formats through primary care settings. Incorporating such education into healthcare visits could improve parents' knowledge. Healthcare providers are encouraged to consider how best to provide parenting support during this important developmental time period.