Positive parenting for healthy living (Triple P) for parents of children with type 1 diabetes: protocol of a randomised controlled trial

Triple-P: Interaction of mother-adolescent with intellectual and developmental disability

This study aimed to investigate the effect of a Positive Parenting Program (Triple-P) on the interaction of the mother-adolescent with intellectual disability. The pre-test and post-test randomized experimental design was used for this research. Thirty-four mothers of adolescents with intellectual disability took part in the present research and were assigned to experimental and control groups, each comprised of 17 people. The experimental group took part in an 8-session Triple-P and each session lasted 75 minutes, but the control group did not participate in this intervention. The data were analyzed using MANCOVA. The findings revealed that Triple-P intervention significantly influenced dependency, closeness, conflict, and positive interaction between the mother and the child with intellectual disability. The present study emphasized that Triple-P will improve the interaction of mother-adolescent with intellectual disability; therefore, Triple-P is a useful intervention.

Young Children with Type 1 Diabetes: Recent Advances in Behavioral Research

PURPOSE OF REVIEW

This review provides a recent update of behavioral research pertinent to young children with T1D and addresses current priorities and future directions.

RECENT FINDINGS

Rates of type 1 diabetes (T1D) in young children (ages 1-7) are continuing to rise. Since 2014, changes to diabetes care and management have impacted young children and reinforced the need for increased attention and interventions to support diabetes management, especially in caregivers who are primarily responsible for their young child's diabetes management. T1D is associated with unique physiologic challenges in young children, with constant management demands elevating parental diabetes-related stress and fear of hypoglycemia. Diabetes technology use has significantly increased in young children, contributing to improvements in glycemic levels and parent and child psychosocial functioning. Yet despite the positive outcomes demonstrated in select clinical behavioral interventions, research with this young child age group remains limited in scope and quantity.

A systematic review of parenting interventions for child chronic health conditions

This systematic review summarizes the parenting intervention literature for parents of children with chronic health conditions and evaluates intervention effects on parenting (parenting skills and parenting efficacy) and child (behaviour, illness severity/control and quality of life) outcomes. Systematic searches using seven electronic databases (including CINHAL, MEDLINE and PsycINFO) were used to identify relevant papers published in English between 1997 and 2017, and reference lists were searched for additional relevant articles. Ten papers reporting on eight separate studies met inclusion criteria: three studies evaluated stand-alone parenting interventions, while the remaining five studies included parenting components in broader interventions that also targeted medically oriented aspects of illness management. Results suggest that parenting interventions may lead to improved parent self-efficacy, parenting behaviour, illness severity/control, child quality of life and child behaviour; however, intervention effects were mixed and confined to parent-report outcome measures. A paucity of studies using rigorous randomized controlled trial study designs limits the conclusions that can be drawn regarding intervention efficacy. Achieving adequate enrolment and retention of families in parenting intervention trials appears to be problematic within these clinical groups. Larger samples and more diverse clinical populations will support the reliability of future evaluations of parenting interventions in this context and improve generalizability of results.

Parental levels of stress managing a child diagnosed with type 1 diabetes in Riyadh: a cross sectional study

BACKGROUND

Caring for a child with Type 1 Diabetes (T1D) pose a significant burden on parents especially when they struggle with their child's T1D management. The experience of not coping or struggling to cope increases the level of stress in parents, which may adversely affect their child's diabetic control (Al Dubayee et al, Horm Res Paediatr 88:2019). In this study, we assessed the level of stress parents experience in caring for a child diagnosed with T1D in four different domains.

METHODS

This was a cross-sectional study conducted in two specialized diabetic centers in Riyadh, Saudi Arabia, from February to May 2015 (Al Dubayee et al, Horm Res Paediatr 88:2019). We used an Arabic translation of the validated Pediatric Inventory for Parents (PIP) questionnaire. The frequency and perceived difficulty of stressful events were rated by interviewing parents caring for children with T1D using two 5-point Likert scales.

RESULTS

The sample realized as 390 parents. The level of stress increased in separated and unemployed parents. The frequency (mean 64.9/210, SD 7.529) and difficulty (mean 65.3/210, SD 9.448) indices of the parental level of stress were compared with variables possibly associated with stress. Both of the frequency difficulty indices correlated with the marital status, the father's level of education and occupation as well as HbA1c level (P-value < 0.05). In addition, the frequency index correlated with the frequency of hypoglycemia and the difficulty index correlated with the number of children in the family (P-value < 0.05).

CONCLUSION

Parents of children with T1D in Riyadh experience a significant level of stress that may affect the child's glycemic control (Al Dubayee et al, Horm Res Paediatr 88:2019). Assessing the level of stress and providing support for these families has the potential to improve the clinical outcome.

An eHealth Program for Parents of Adolescents With T1DM Improves Parenting Stress: A Randomized Control Trial

PURPOSE

The purpose of this study was to evaluate the short-term effects of the Type 1 Teamwork program for parents of adolescents with type 1 diabetes mellitus (T1DM) on the primary outcome of psychosocial stress.

METHODS

The study was a randomized wait-list control trial evaluating an eHealth program to reduce parenting stress around T1DM management during adolescence through interactive sessions on the safe transfer of responsibility, positive communication, and stress management. The primary outcome was psychosocial stress (parenting stress specific to child illness and general stress). Secondary outcomes included depressive and anxiety symptoms, parent support for adolescent autonomy, family conflict, and adolescent metabolic control (A1C). Data were collected at baseline, 3 months, and 6 months online. Mixed-model analyses were conducted, using intent-to-treat procedures.

RESULTS

Parents (n = 162) had a mean age of 45.6 (±5.3) years, were 98% female, 91% white, 91% married/partnered, 51% of high income, and geographically dispersed around the United States. Parents reported that adolescents had a mean A1C of 7.9% (±1.2%) and T1DM duration of 5.08 (±3.62) years. At 6 months, parents in the Type 1 Teamwork group demonstrated less parenting stress compared with the control group. There were no differences between groups on general stress or secondary outcomes. Attrition at 6 months was 32% in the treatment group and 11% in the control group.

CONCLUSIONS

An eHealth program for parents of adolescents with T1DM improves parenting stress in a sample of parents from across the United States.

The effect of positive parenting program on mental health in mothers of children with intellectual disability

The aim of this research was to examine the effectiveness of positive parenting program (Triple-P) on the mental health of mothers of children with intellectual disability (ID). This study was a quasi-experimental research with pretest, posttest design, and a control group. Thirty-six mothers of students with ID participated in this study and were divided into two groups (intervention group and control group). Each group consisted of 18 participants. The intervention group received a parent training program during 12 sessions, each session lasting for 80 min, while the control group did not receive any special training. Multivariate analysis of covariance test was applied to analyze the obtained data using SPSS software. The results of this study indicated that Triple-P had significant effect on the somatic symptoms, anxiety, depression, social dysfunction, and mental health of mothers of children with ID. As a result, this research emphasized that parenting skills training will improve the mental health of mothers of children with ID, and therefore, planning for Triple-P training is of particular importance.

Improving health, wellbeing and parenting skills in parents of children with special health care needs and medical complexity - a scoping review

Background

Parenting children with special health care needs can be challenging particularly if children have complex conditions. Parents may struggle to manage their child’s health and their own emotions, contributing to poorer health outcomes for the family. Frequent healthcare contact presents opportunities to intervene, but current evidence review is limited. This review scopes and synthesizes interventions to improve health, wellbeing and parenting skills.

Methods

Using formal scoping review methodology MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, ERIC, ASSIA, HMIC and OpenGrey were searched to February 2017. Citations were double screened according to predetermined eligibility criteria. Data were extracted and synthesized on study design, population, measurement tools, and results.

Results

Sixty-five studies from 10,154 citations were included spanning parenting programs, other parent behavior change interventions, peer support, support for hospital admission and discharge and others. Interventions for parents of children with a wide range of conditions were included. These targeted a broad selection of parent outcomes, delivered by a wide variety of professionals and lay workers. Most studies reported positive outcomes. No serious adverse events were noted but issues identified included group and peer relationship dynamics, timing of interventions in relation to the child’s disease trajectory, the possibility of expectations not fulfilled, and parent’s support needs following intervention. Children with medical complexity were not identified explicitly in any studies.

Conclusions

The range of interventions identified in this review confirms that parents have significant and diverse support needs, and are likely to benefit from a number of interventions targeting specific issues and outcomes across their child’s condition trajectory. There is much scope for these to be provided within existing multi-disciplinary teams during routine health care contacts. Careful tailoring is needed to ensure interventions are both feasible for delivery within routine care settings and relevant and accessible for parents of children across the complexity spectrum. Further review of the existing literature is needed to quantify the benefits for parents and assess the quality of the evidence. Further development of interventions to address issues that are relevant and meaningful to parents is needed to maximize intervention effectiveness in this context.

Electronic supplementary material

The online version of this article (10.1186/s12887-019-1648-7) contains supplementary material, which is available to authorized users.