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Iuliano A, Burgess RA, Shittu F, King C, Bakare AA, Valentine P, Haruna I, Colbourn T. Linking communities and health facilities to improve child health in low-resource settings: a systematic review. Health Policy Plan 2024; 39:613-635. [PMID: 38619140 PMCID: PMC11145907 DOI: 10.1093/heapol/czae028] [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] [Received: 05/04/2023] [Revised: 02/22/2024] [Accepted: 04/12/2024] [Indexed: 04/16/2024] Open
Abstract
Community-facility linkage interventions are gaining popularity as a way to improve community health in low-income settings. Their aim is to create/strengthen a relationship between community members and local healthcare providers. Representatives from both groups can address health issues together, overcome trust problems, potentially leading to participants' empowerment to be responsible for their own health. This can be achieved via different approaches. We conducted a systematic literature review to explore how this type of intervention has been implemented in rural and low or lower-middle-income countries, its various features and how/if it has helped to improve child health in these settings. Publications from three electronic databases (Web of Science, PubMed and Embase) up to 03 February 2022 were screened, with 14 papers meeting the inclusion criteria (rural setting in low/lower-middle-income countries, presence of a community-facility linkage component, outcomes of interest related to under-5 children's health, peer-reviewed articles containing original data written in English). We used Rosato's integrated conceptual framework for community participation to assess the transformative and community-empowering capacities of the interventions, and realist principles to synthesize the outcomes. The results of this analysis highlight which conditions can lead to the success of this type of intervention: active inclusion of hard-to-reach groups, involvement of community members in implementation's decisions, activities tailored to the actual needs of interventions' contexts and usage of mixed methods for a comprehensive evaluation. These lessons informed the design of a community-facility linkage intervention and offer a framework to inform the development of monitoring and evaluation plans for future implementations.
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Affiliation(s)
- Agnese Iuliano
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Rochelle Ann Burgess
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, CW23+FJV University College Hospital, Queen Elizabeth I I Road, Agodi, Ibadan, Oyo 00285, Nigeria
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
| | - Carina King
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
| | - Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
- Department of Community Medicine, University of Ibadan, CW22+H4W, Queen Elizabeth I I Road, Agodi, Ibadan, Oyo 200285, Nigeria
| | - Paula Valentine
- Save the Children, 1 St John’s Ln, London EC1M 4AR, United Kingdom
| | - Ibrahim Haruna
- Save the Children International, Plot 773 Cadastral Zone B03, Wuye District, Ankuru 902101, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
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Murray-Perdue SA, Conway A, Feinberg ME. Couple relationship functioning and social adjustment during the transition to parenthood among fathers with a history of maltreatment. FAMILY PROCESS 2024. [PMID: 38813791 DOI: 10.1111/famp.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024]
Abstract
Study of fathers has gained significant traction over recent decades. However, the experience for men over the transition to parenthood remains focused on high-socioeconomic and socially advantaged fathers. Researchers have yet to thoroughly investigate how fathers may uniquely experience this transition period with a history of childhood maltreatment, given that childhood abuse is known to impact several components of development and relationship functioning into adulthood. The current study endeavored to fill this gap by evaluating the associations between fathers' childhood experiences of physical and emotional abuse and their relationship functioning over the transition to parenthood in terms of both the couple relationship and social adjustment in relationships with others. Using data from 399 fathers who participated in a randomized control trial during pregnancy, the results from stepwise regressions indicate fathers with a history of emotional abuse experience particular declines in their external relationships (reductions in social support and increases in social stress) from prenatal (Wave 1) to postpartum (Wave 2) reports. However, no significant association emerged between fathers' history of maltreatment and their relationship functioning with their partners. These results underscore the importance of investigating the impact of different types of abuse on men in fatherhood. Moreover, we emphasize the need to study further fathers' social adjustment over the transition to parenthood beyond the couple relationship and broad social support to address the needs of men with a history of maltreatment in their new role as fathers.
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Affiliation(s)
- Samantha A Murray-Perdue
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Andrew Conway
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania, USA
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Jukes LM, Di Folco S, Kearney L, Sawrikar V. Barriers and Facilitators to Engaging Mothers and Fathers in Family-Based Interventions: A Qualitative Systematic Review. Child Psychiatry Hum Dev 2024; 55:137-151. [PMID: 35763177 PMCID: PMC10796537 DOI: 10.1007/s10578-022-01389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/03/2022]
Abstract
The current systematic review examined the similarities and differences between mothers' and fathers' reported barriers and facilitators to engaging in family-based interventions for child and adolescent behavioural problems (aged 2-17 years). Systematic searches of six electronic databases and grey literature alongside a two-way screening process identified twenty eligible qualitative studies from 2004 to 2019. A thematic meta-synthesis identified similarities in major themes of psychological, situational, knowledge/awareness, programme/intervention, co-parenting, practitioner, and beliefs/attitudes factors, alongside group experiences and stages of engagement. However, differences emerged in subthemes related to parental, treatment, and service delivery factors that included individual ideologies of parenting, parental roles, and treatment participation; the role of mothers in facilitating engagement; and individual preferences for treatment content and delivery. Overall, findings suggest that while mothers and fathers experience similar challenges to engagement, they can also experience distinct challenges which need to be addressed at the treatment outset to maximise engagement.
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Affiliation(s)
- Laura M Jukes
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Simona Di Folco
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Lisa Kearney
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Vilas Sawrikar
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK.
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Rathi N, Kansal S, Worsley A. Indian fathers are involved in nurturing healthy behaviours in adolescents: A qualitative inquiry. BMC Public Health 2024; 24:88. [PMID: 38178085 PMCID: PMC10768344 DOI: 10.1186/s12889-024-17634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/01/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents' dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers' engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers' views on instilling healthy behaviours in their children. METHODS Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10-19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches. RESULTS A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents' sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge. CONCLUSIONS The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents.
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Affiliation(s)
- Neha Rathi
- Department of Home Science, Mahila Maha Vidyalaya, Banaras Hindu University, 221005, Varanasi, Uttar Pradesh, India.
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, Uttar Pradesh, India
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 3220, Geelong, VIC, Australia
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Chazan-Cohen R, Von Ende A, Lombardi C. Parenting and family self-sufficiency services contribute to impacts of Early Head Start for children and families. Front Psychol 2023; 14:1302687. [PMID: 38155689 PMCID: PMC10752921 DOI: 10.3389/fpsyg.2023.1302687] [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: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction There is evidence that two-generation early childhood programs, those that strive to support not only child development, but also optimal parenting and family wellbeing, help to foster resilience for young children and their families in the face of adversity. Methods Using data from a large experimental evaluation, the Early Head Start Research and Evaluation Project, this paper explores how parenting and family self-sufficiency services embedded in Early Head Start (EHS), a federally funded, nationally implemented two-generation early childhood program for low-income families lasting from pregnancy and until children are three, contribute to the impacts of the program for both the children and their families. Results Parenting support in any modality (home visiting, case management or parent education) contributed to program impacts on important child and family outcomes, but not parent employment. Somewhat surprisingly, family receipt of employment services did not lead to any of the impacts of the program, while education and job training services did. When EHS parents received education or job training services, it led to impacts not only on mother employment, but also on other important family and child outcomes. Discussion These findings validate and reinforce the two-generation approach of EHS, specifically supporting the focus on parenting and parent education and job training.
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Affiliation(s)
- Rachel Chazan-Cohen
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Adam Von Ende
- Division of Developmental Medicine, Brazelton Touchpoints Center, Boston Children’s Hospital, Boston, MA, United States
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
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Button AM, Paluch RA, Schechtman KB, Wilfley DE, Geller N, Quattrin T, Cook SR, Eneli IU, Epstein LH. Parents, but not their children, demonstrate greater delay discounting with resource scarcity. BMC Public Health 2023; 23:1983. [PMID: 37828503 PMCID: PMC10568819 DOI: 10.1186/s12889-023-16832-z] [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] [Received: 02/06/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Individuals with obesity tend to discount the future (delay discounting), focusing on immediate gratification. Delay discounting is reliably related to indicators of economic scarcity (i.e., insufficient resources), including lower income and decreased educational attainment in adults. It is unclear whether the impact of these factors experienced by parents also influence child delay discounting between the ages of 8 and 12-years in families with obesity. METHODS The relationship between indices of family income and delay discounting was studied in 452 families with parents and 6-12-year-old children with obesity. Differences in the relationships between parent economic, educational and Medicaid status, and parent and child delay discounting were tested. RESULTS Results showed lower parent income (p = 0.019) and Medicaid status (p = 0.021) were differentially related to greater parent but not child delay discounting among systematic responders. CONCLUSIONS These data suggest differences in how indicators of scarcity influence delay discounting for parents and children, indicating that adults with scarce resources may be shaped to focus on immediate needs instead of long-term goals. It is possible that parents can reduce the impact of economic scarcity on their children during preadolescent years. These findings suggest a need for policy change to alleviate the burden of scarce conditions and intervention to modify delay discounting rate and to improve health-related choices and to address weight disparities.
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Affiliation(s)
- Alyssa M Button
- Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Rocco A Paluch
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA
| | - Kenneth B Schechtman
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nancy Geller
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Teresa Quattrin
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA
| | - Stephen R Cook
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Ihouma U Eneli
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 3435 Main Street, Building #26, Buffalo, NY, 14214, USA.
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Kristen A, Salari R, Moretti M, Osman F. Attachment and trauma-informed programme to support forcibly displaced parents of youth in Sweden: feasibility and preliminary outcomes of the eConnect Online programme. BMJ Open 2023; 13:e072368. [PMID: 37550024 PMCID: PMC10407377 DOI: 10.1136/bmjopen-2023-072368] [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: 01/31/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES To assess the feasibility, acceptability and the impact of an online parenting programme for forcibly displaced parents of adolescents. DESIGN The study was a single-arm feasibility study using pre-intervention post-intervention and follow-up assessments. SETTING Participants were recruited from municipality-based activities for refugee parents in a small city in the south of Sweden. PARTICIPANTS Participants were forcibly displaced parents (n=23; 47.8% maternal figures) of youth (n=23; 8-17 years old; 26.1% female) from Syria, Afghanistan and Somalia participating in an online parenting programme (eConnect). INTERVENTION eConnect is an attachment-based and trauma-informed parenting intervention and was delivered over the course of 10 weekly sessions. PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility was assessed by programme enrolment, attendance, completion and acceptability of the online platform and cultural fit of the programme. Primary outcome measures were programme impact on youth mental health problems. Secondary outcome measures were programme impact on family functioning and parent-child attachment insecurity. RESULTS The eConnect programme was highly feasible in terms of overall enrolment (100%), attendance (89.6%) and retention rates (100%). The online platform was acceptable, with mixed feedback primarily related to the access and usage of technology. Cultural fit of the programme was acceptable. Youth mental health problems (η 2=0.29) and family functioning significantly improved (η 2=0.18) over the course of the programme. Unexpectedly, parent reports of youth attachment insecurity significantly worsened (η 2=0.16). CONCLUSIONS The findings suggest that the online delivery of Connect was a promising way to reduce barriers to service access and improve mental health problems and family functioning among forcibly displaced parents and their children during COVID-19. Future research is needed to explore the acceptability and impact of this programme post-COVID-19, and to develop culturally tailored and psychometrically sound measures for parent and youth reports of attachment.
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Affiliation(s)
- Anna Kristen
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Raziye Salari
- Child Health and Parenting, Department of Public Health and Caring Sciences, Uppsala Universitet Institutionen for folkhalso- och vardvetenskap, Uppsala, Sweden
| | - Marlene Moretti
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Fatumo Osman
- School of Health and Welfare, Hogskolan Dalarna, Falun, Sweden
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Xie EB, Jung JW, Kaur J, Benzies KM, Tomfohr-Madsen L, Keys E. Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies. J Med Internet Res 2023; 25:e43219. [PMID: 37494086 PMCID: PMC10413237 DOI: 10.2196/43219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. OBJECTIVE This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. METHODS A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. CONCLUSIONS New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
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Affiliation(s)
| | - James Wonkyu Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jasleen Kaur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- School of Nursing, The University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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Smith L, Hunt K, Parker S, Camp J, Stewart C, Morris A. Parent and Carer Skills Groups in Dialectical Behaviour Therapy for High-Risk Adolescents with Severe Emotion Dysregulation: A Mixed-Methods Evaluation of Participants' Outcomes and Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6334. [PMID: 37510567 PMCID: PMC10379026 DOI: 10.3390/ijerph20146334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND There is an established evidence-base for dialectical behaviour therapy for adolescents (DBT-A) in the treatment of young people with severe emotion dysregulation and related problems, including repeated self-harm and suicidal behaviours. However, few studies have reported on parental involvement in such treatments. This study aims to explore the outcomes and experiences of participants of a dedicated skills group for parents and carers embedded within an adapted DBT-A programme in the United Kingdom. METHOD This study was conducted within a specialist outpatient Child and Adolescent Mental Health Services (CAMHS) DBT programme in the National Health Service (NHS) in London. Participants were parents and carers of adolescents engaged in the DBT-A programme. Participants attended a 6-month parent and carer skills group intervention and completed self-report measures relating to carer distress, communication and family functioning, at pre-intervention and post-intervention. Following the intervention, semi-structured interviews were also completed with a subgroup of participants to explore their experiences of the skills group and how they perceived its effectiveness. Quantitative and qualitative methods were used to analyse the data collected from participants. RESULTS Forty-one parents and carers completed the intervention. Participants reported a number of statistically significant changes from pre- to post-intervention: general levels of distress and problems in family communication decreased, while perceived openness of family communication and strengths and adaptability in family functioning increased. A thematic analysis of post-intervention interviews examining participant experiences identified six themes: (1) experiences prior to DBT; (2) safety in DBT; (3) experiences with other parents and carers; (4) new understandings; (5) changes in behaviours; and (6) future suggestions. DISCUSSION Parents and carers who attended a dedicated DBT skills groups, adapted for local needs, reported improvements in their wellbeing, as well as interactions with their adolescents and more general family functioning, by the end of the intervention. Further studies are needed which report on caregiver involvement in DBT.
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Affiliation(s)
- Lindsay Smith
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Katrina Hunt
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Sam Parker
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Jake Camp
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Catherine Stewart
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Andre Morris
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
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Nagao-Sato S, de Davila SA, Baltaci A, Reyes AOP, Reicks M, Linares R, Zhang Y, Choque GAH. Factors Associated with Fathers' Attendance in a Latino Family Obesity Prevention Program. JOURNAL OF HUMAN SCIENCES AND EXTENSION 2023; 11:2. [PMID: 38274858 PMCID: PMC10810162 DOI: 10.55533/2325-5226.1451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Community-based programs may contribute to Latino pediatric obesity prevention; however, attendance remains low. This study aimed to identify factors associated with Latino father/male caregiver attendance in family-based adolescent obesity prevention programs conducted as part of a randomized controlled trial. The study used cross-sectional data from 137 fathers in the program, involving eight weekly sessions to improve their children's energy balance-related behaviors. Evaluation data were collected at baseline and post-intervention. Fathers in a waitlisted control group attended sessions after post-intervention data collection. Attendance patterns were identified using cluster analysis: consistently high attendance (50% of fathers), declining attendance (19%), and non-attendance (31%) clusters. Multinomial logistic regression was used to examine associations between attendance patterns and variables. Compared to consistently high attendance, fathers in the non-attendance cluster were more likely to have been assigned to the control group (odds ratio [OR] = 7.86, p < 0.001), tended to have lower household income (OR = 2.50, p = 0.098), and attended the program at a site where the program occurred weekdays (OR = 0.35, p = 0.094). Maintaining contact during waiting periods and providing sessions online or during weekends could reduce non-attendance by enhancing convenience for low-income fathers working multiple jobs.
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Fongaro E, Aouinti S, Picot MC, Pupier F, Omer H, Franc N, Purper-Ouakil D. Non-violent resistance parental training versus treatment as usual for children and adolescents with severe tyrannical behavior: a randomized controlled trial. Front Psychiatry 2023; 14:1124028. [PMID: 37215679 PMCID: PMC10195028 DOI: 10.3389/fpsyt.2023.1124028] [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: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Objective This single-blinded, randomized, parallel group superiority trial evaluates whether the Non-Violent Resistance (NVR) program, a 10-session parental-group intervention, was more effective in reducing stress in parents of children aged 6-20 years and displaying severe tyrannical behavior (STB) compared to a treatment as usual (TAU) intervention that provided supportive counseling and psychoeducation. Methods Eighty two parents of youth aged 6-20 years with STB were enrolled by the Child and Adolescent Psychiatry Department at the University Hospital of Montpellier (France). A random block and stratified by age (6-12 and 13-20 years) randomization, was performed. All participants were interviewed by independent, blinded to group assignments, research assistants, and completed their assessments at baseline and treatment completion (4 months from baseline). Since this program has not been previously evaluated in this population, the study primarily evaluated the efficacy, using the Parenting Stress Index/Short Form (PSI-SF). The primary outcome was the change from baseline to treatment completion of the PSI-SF total score. Results Seventy three participants completed the study and were available for analysis (36 NVR and 37 TAU). At completion, between-groups comparison of the change (completion minus baseline) in the total score of PSI-SF was not significant (NVR: -4.3 (± 13.9); TAU: -7.6 (± 19.6); two-sample t-test p = 0.43; effect size of -0.19 [-0.67, 0.28]). Conclusion Contrary to our expectation, NVR was not superior to TAU in reducing parental stress at completion for parents of children with STB. However, NVR showed positive outcomes in the follow-up, pointing to the importance to implement parental strategies and following this population over longer time periods in future projects.Clinical trial registration: Clinicaltrials.gov, identifier NCT05567276.
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Affiliation(s)
- Erica Fongaro
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- CESP INSERM U 1018 UVSQ Psychiatry Development and Trajectories, Villejuif, France
| | - Safa Aouinti
- Centre Hospitalier Universitaire de Montpellier, Unité de Recherche Clinique and Epidémiologie, DIM, Montpellier, France
| | - Marie-Christine Picot
- CESP INSERM U 1018 UVSQ Psychiatry Development and Trajectories, Villejuif, France
- Centre Hospitalier Universitaire de Montpellier, Unité de Recherche Clinique and Epidémiologie, DIM, Montpellier, France
| | - Florence Pupier
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Haim Omer
- Department of Psychology, Tel Aviv University, Tel Aviv, Israel
| | - Nathalie Franc
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Diane Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- CESP INSERM U 1018 UVSQ Psychiatry Development and Trajectories, Villejuif, France
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12
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McLean RK, Roach A, Tully L, Dadds MR. Toward evidence-informed child rearing: Measurement of time-out implementation in a community sample. Clin Child Psychol Psychiatry 2023; 28:417-433. [PMID: 35133906 DOI: 10.1177/13591045221076644] [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
BACKGROUND Time-out (TO) is a widely used parental discipline strategy with strong research support in programmes that promote positive child development. Concerns have been raised, however, regarding adverse impact on child mental health (CMH) in part driven by evidence of widespread variability in appropriate implementation. There are no existing measures of TO. We present the first measure of procedural implementation of TO in a community sample of parents of children aged 6-8 years. METHODS A nationally representative sample (N = 474) of parents completed a survey on the implementation of TO, parent-child relationships, and emotional and behavioural difficulties. The scale of TO use was used to test the convergent validity between TO implementation and parenting practices/family adjustment and CMH. RESULTS Consistent with international research, >70% of parents have used TO with their children. There was high variability in the levels of appropriate implementation of TO. Scale reliability (Cronbach's alpha) was acceptable and tests of convergent validity indicated that as expected, less appropriate implementation of TO was associated with worse CMH and poorer parenting and family adjustment. CONCLUSIONS The current findings suggest that the scale is a psychometrically sound instrument for measuring the appropriate procedural implementation of TO with young children.
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Affiliation(s)
| | - Alex Roach
- 4334The University of Sydney, Sydney, AU-NSW, Australia
| | - Lucy Tully
- 4334The University of Sydney, Sydney, AU-NSW, Australia
| | - Mark R Dadds
- 4334The University of Sydney, Sydney, AU-NSW, Australia
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13
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Latomme J, Morgan PJ, Chastin S, Brondeel R, Cardon G. Effects of a family-based lifestyle intervention on co-physical activity and other health-related outcomes of fathers and their children: the 'Run Daddy Run' intervention. BMC Public Health 2023; 23:342. [PMID: 36793044 PMCID: PMC9930712 DOI: 10.1186/s12889-023-15191-z] [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: 07/28/2021] [Accepted: 02/02/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Fathers are important in establishing healthy behaviors in their children, but are rarely engaged in lifestyle programs. Focusing on physical activity (PA) of both fathers and their children by engaging them together in PA (i.e. "co-PA") is therefore a promising novel strategy for interventions. The study aim was to investigate the effect of the 'Run Daddy Run' on co-PA and PA of fathers and their children, and secondary outcomes such as weight status and sedentary behaviour (SB). METHODS This study is a non-randomized controlled trial (nRCT), including 98 fathers and one of their 6 to 8 years old children (intervention = 35, control = 63). The intervention was implemented over a 14-week period, and consisted of six (inter)active father-child sessions and an online component. Due to COVID-19, only 2/6 sessions could be implemented as planned, the remaining sessions were delivered online. In November 2019-January 2020 pre-test measurements took place, and post-test measurements in June 2020. Additional follow-up test was conducted in November 2020. PA (i.e. LPA, MPA, VPA and volume) of fathers and children were objectively measured using accelerometry, co-PA and the secondary outcomes were questioned using an online questionnaire. RESULTS Significant intervention effects were found for co-PA (+ 24 min./day in the intervention compared to the control group, p = 0.002), and MPA of the father (+ 17 min./day, p = 0.035). For children, a significant increase in LPA (+ 35 min./day, p < 0.001) was found. However, an inverse intervention effect was found for their MPA and VPA (-15 min./day, p = 0.005 and - 4 min./day, p = 0.002, respectively). Also decreases in fathers' and children's SB were found (-39 min./day, p = 0.022 and - 40 min./day, p = 0.003, respectively), but no changes in weight status, the father-child relationship, and the PA-family health climate (all p > 0.05). CONCLUSION The Run Daddy Run intervention was able to improve co-PA, MPA of fathers and LPA of children, and decreasing their SB. Inverse intervention effects were however found for MPA and VPA of children. These results are unique given their magnitude and clinical relevance. Targeting fathers together with their children might be a novel and potential intervention strategy to improve overall physical activity levels, however, further efforts should however be made to target children's MPA and VPA. Last, replicating these findings in a randomized controlled trial (RCT) is recommended for future research. TRIAL REGISTRATION NUMBER This study is registered as a clinical trial (clinicaltrials.gov, ID number: NCT04590755, date: 19/10/2020).
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Affiliation(s)
- Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, 9000, Ghent, Belgium.
| | - Philip J. Morgan
- grid.266842.c0000 0000 8831 109XPRCPAN (Priority Research Centre for Physical Activity and Nutrition), School of Education, University of Newcastle, 2308 Newcastle, Australia
| | - Sebastien Chastin
- grid.5214.20000 0001 0669 8188Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK
| | - Ruben Brondeel
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
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Opie J, Hooker L, Gibson T, McIntosh J. My Early Relational Trust-Informed Learning (MERTIL) for Parents: A study protocol for a brief, universal, online, preventative parenting program to enhance relational health. PLoS One 2023; 18:e0272101. [PMID: 36928036 PMCID: PMC10019699 DOI: 10.1371/journal.pone.0272101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Early relational health is a key determinant of childhood development, while relational trauma in the parent-infant dyad can instigate a cascading pattern of infant risk. Fortunately, early relational trauma is detectable and modifiable. In 2018, Australian Maternal and Child Health (MCH) nurses participated in MERTIL (My Early Relational Trauma-Informed Learning), a program to identify and prevent relational trauma. Program evaluations revealed nurses felt competent and confident to identify and respond to relational trauma; however, response capacity was inhibited by inadequate parent referral options. In response, MERTIL for Parents (My Early Relational Trust-Informed Learning) was developed, which is an online, evidence-based, self-paced parenting program that focuses on enhancing parental knowledge of relational trust and its significance for infant development. This low-cost, accessible prevention resource targets emerging relational concerns to reduce later service system engagement. The potential for universal preventative online programs that target parental and relational wellbeing remains under-explored. This paper reports on a protocol for implementing a MERTIL for Parents pilot study describing practitioners' and parents' perspectives on program feasibility and efficacy. METHODS This study is a mixed methods, parallel armed, uncontrolled, repeated measures design. We aim to recruit 48 Australian MCH practitioners from the states of Victoria and New South Wales. These professionals will in turn recruit 480 parents with a child aged 0-5 years. All parents will receive MERTIL for Parents, which entails a 40-minute video, tipsheets, posters, and support resources. Parent data will be obtained at three periods: pre-program, program exit, and program follow-up. Practitioner data will be collected at two periods: pre-parent recruitment and program follow-up. Data collection will occur through surveys and focus groups. Primary parent outcomes will be socioemotional assessments of program efficacy. Practitioners and parents will each report on program feasibility. DISCUSSION This protocol describes the feasibility and efficacy of a new online parenting program, MERTIL for Parents, with pilot field studies commencing in March 2023. We anticipate that this resource will be a valuable addition to various child and family services, for use in individual support and group work.
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Affiliation(s)
- Jessica Opie
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
- * E-mail:
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Tanudja Gibson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Jennifer McIntosh
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
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15
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Strategic Priorities for Implementation of Father-Inclusive Practice in Mental Health Services for Children and Families: A Delphi Expert Consensus Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022:10.1007/s10488-022-01222-1. [DOI: 10.1007/s10488-022-01222-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 12/24/2022]
Abstract
AbstractThe aim of this study was to investigate expert consensus on barriers and facilitators to the organizational implementation of Father-Inclusive Practice (FIP) in child and family services to establish strategic priorities for implementation. An international panel of 56 experts in child and family service provision and father inclusion were surveyed using the Delphi technique. Three online questionnaires were used to gather opinions and measure experts’ levels of agreement in regard to factors that enable or hinder the organizational implementation of FIP. Survey design, analysis and interpretation was guided by the Consolidated Framework for Implementation Research (CFIR). Consensus was achieved for 46.4% (n = 13) statements. Eight barriers and five facilitators were identified as strategic priorities to organizational implementation of FIP. The key factors were related to the following CFIR themes: leadership engagement, access to information and knowledge, implementation climate, structural characteristics, networks and communication, client needs and resources, external policies and incentives, and reflecting and evaluating. The study findings suggest that issues related to central prioritization, top-down organizational processes and external policy context should represent priority areas for implementation. Our results prioritise methods for improving FIP by highlighting the key areas of organizational practice to be addressed by tailored implementation strategies.
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16
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Andrade BF, Aitken M, Brodkin S, Sawrikar V. Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood. Curr Opin Psychiatry 2022; 35:409-416. [PMID: 36125210 PMCID: PMC9594137 DOI: 10.1097/yco.0000000000000823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
PURPOSE OF REVIEW There are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes. RECENT FINDINGS This review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes. SUMMARY Thorough assessment of patients' needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.
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Affiliation(s)
- Brendan F. Andrade
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Madison Aitken
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
| | - Sabrina Brodkin
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Vilas Sawrikar
- School of Health in Social Science, University of Edinburgh, UK
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17
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Lange AMC, Visser MM, Scholte RHJ, Finkenauer C. Parental Conflicts and Posttraumatic Stress of Children in High-Conflict Divorce Families. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:615-625. [PMID: 35958703 PMCID: PMC9360253 DOI: 10.1007/s40653-021-00410-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 06/15/2023]
Abstract
UNLABELLED Parental conflicts consistently predict negative outcomes for children. Research suggests that children from high-conflict divorces (HCD) may also experience post-traumatic stress symptoms (PTSS), yet little is known about the association between parental conflicts in HCD families and child PTSS. We investigated this association, hypothesizing that parental conflicts would predict child PTSS. We also tested the moderating role of interparental contact frequency, hypothesizing that frequent contact would intensify the association between parental conflicts and child PTSS. This study was part of an observational study on the outcomes of No Kids in the Middle (NKM), a multi-family group intervention for HCD families. A total of 107 children from 68 families participated in the study with at least one parent. We used pre- (T1) and post-intervention (T2) data. Research questions were addressed cross-sectionally, using regression analyses to predict PTSS at T1, and longitudinally, using a correlated change (T1 to T2) model. The cross-sectional findings suggested that mother- and child-reported conflicts, but not father-reported conflicts, were related to the severity of child PTSS. Longitudinally, we found that change in father-reported conflicts, but not change in child- or mother-reported conflicts, were related to change in child PTSS. The estimated associations for the different informants were not significantly different from one another. The frequency of contact between ex-partners did not moderate the relationship between parental conflicts and child PTSS. We conclude that there is a positive association between parental conflicts and child PTSS in HCD families independent of who reports on the conflicts. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40653-021-00410-9.
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Affiliation(s)
- Aurelie M. C. Lange
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, Netherlands
- Viersprong Institute for Studies On Personality Disorders, Halsteren, Netherlands
| | | | - Ron H. J. Scholte
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Tranzo Tilburg University, Tilburg, Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science: Youth Studies, Utrecht University, Utrecht, Netherlands
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18
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Holzman JBW, Hawks JL, Kennedy SM, Anthony BJ, Anthony LG. Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth. Behav Modif 2022; 47:128-153. [PMID: 35707864 PMCID: PMC10076234 DOI: 10.1177/01454455221103226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.
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Affiliation(s)
- Jacob B W Holzman
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Jessica L Hawks
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Sarah M Kennedy
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Bruno J Anthony
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
| | - Laura G Anthony
- University of Colorado School of Medicine, Department of Psychiatry, Aurora, USA.,Pediatric Mental Health Institute at Children's Hospital of Colorado, Aurora, USA
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19
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Sanders MR, Mazzucchelli TG. Mechanisms of Change in Population-Based Parenting Interventions for Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:277-294. [PMID: 35133932 DOI: 10.1080/15374416.2022.2025598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Developing an effective population-level system of evidence-based parenting support capable of shifting (at a population level) rates of child maltreatment and social, emotional, and behavioral problems in children requires an integrated theory of change. This paper presents a systems-contextual model of change and identifies modifiable mechanisms that can potentially explain population-level changes in parenting and child outcomes. METHOD Using the Triple P-Positive Parenting Program as an exemplar of a tiered, multi-level system of evidence-based parenting interventions, we discuss the putative mechanisms of change necessary to produce change in child behavior, parenting, practitioner behavior, and organizational changes to support the sustained implementation of an intervention. RESULTS A model of change is proposed that blends theoretical perspectives derived from social learning theory, self-regulation theory, applied behavior analysis, cognitive behavior principles, developmental theory, and principles derived from the fields of public health, implementation science, and economics to explain change in the behavior at the community wide level. Different types of interventions targeting different populations and mechanisms are used to illustrate how sustainable change in child and parent outcomes can be achieved. CONCLUSIONS Evidence supporting specific mechanisms and moderators of intervention effects are discussed as well as directions for future research on mechanisms.
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Affiliation(s)
- Matthew R Sanders
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Australia
| | - Trevor G Mazzucchelli
- Parenting and Family Support Centre, The University of Queensland, Brisbane, Australia.,School of Population Health, Curtin University, Perth, Australia
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20
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Preuhs K, van Keulen H, Andree R, Wins S, van Empelen P. A Tailored Web-Based Video Intervention (ParentCoach) to Support Parents With Children With Sleeping Problems: User-Centered Design Approach. JMIR Form Res 2022; 6:e33416. [PMID: 35438640 PMCID: PMC9066318 DOI: 10.2196/33416] [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] [Received: 09/07/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Many parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool ParentCoach was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems. Objective The aim of this paper is to illustrate the user-centered development of ParentCoach. Methods We conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration. Results Iterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program. Conclusions This paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach.
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Affiliation(s)
- Katharina Preuhs
- Expertise Group Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Hilde van Keulen
- Expertise Group Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Rosa Andree
- Expertise Group Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Sophie Wins
- Expertise Group Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Pepijn van Empelen
- Expertise Group Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
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21
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Successful implementation of parenting support at preschool: An evaluation of Triple P in Sweden. PLoS One 2022; 17:e0265589. [PMID: 35417460 PMCID: PMC9007376 DOI: 10.1371/journal.pone.0265589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/05/2022] [Indexed: 12/05/2022] Open
Abstract
Although emotional and behavioural problems among young children are common and, if unaddressed, can lead to multi-facetted problems later in life, there is little research investigating the implementation of parenting programs that target these problems. In this study, the RE-AIM framework was used to evaluate the implementation of the Triple P parenting program in a preschool setting at a medium-sized municipality in Sweden. Reach increased over time, showing an overall increase in participating fathers and parents with lower education. Effectiveness outcomes showed an improvement in emotional and behavioural problems in children and less mental health-related symptoms and higher self-efficacy in parents. Adoption rate was 93.3%. To ensure staff “buy-in”, designated coordinators made changes in recruitment procedures, and provided supervision and training to all Triple P practitioners. Implementation adaptations were made, such as minor revisions of parenting strategies and other program content, as well as providing child care during seminars and groups, and setting up weekend-groups. Maintenance assessed through 12 month follow-up data suggested that several child and parent outcomes were maintained over time. Uppsala municipality continues to offer Triple P to parents. The reach, effectiveness, adoption, implementation and maintenance of the program were all satisfactory and demonstrated the suitability of delivering evidence-based parenting support using preschools as an arena.
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22
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Kara D, Sümer N. The Role of Paternal Parenting and Co-parenting Quality in Children's Academic Self-Efficacy. Front Psychol 2022; 13:772023. [PMID: 35386903 PMCID: PMC8978325 DOI: 10.3389/fpsyg.2022.772023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
This study explored the unique effect of fathers' parenting behaviors and the quality of co-parenting described as the degree of consistency between paternal and maternal parenting behaviors on children's academic self-efficacy. The power of both pancultural parenting behaviors (i.e., emotional warmth and rejection) and specific parenting controlling behaviors that are relatively common in Turkish culture (i.e., intrusion and guilt induction) in predicting academic self-efficacy was tested. A total of 1,931 children completed measures of parenting behaviors and academic self-efficacy in math and literature courses in their school. Overall, girls reported higher levels of literature self-efficacy, whereas boys reported higher levels of math self-efficacy. Compared to boys, girls perceived higher levels of positive parenting behaviors from both their fathers and mothers. The results of the regression analyses showed that, whereas father warmth had stronger effects on boys' math self-efficacy, mother warmth had stronger effects on girls' literature self-efficacy. Examination of the effects of co-parenting quality demonstrated that children with positively consistent parents (i.e., both parents having high positive and low negative parenting behaviors) reported the highest level of academic self-efficacy, whereas those having negatively consistent parents had the lowest level of academic self-efficacy. Analyses on inconsistent co-parenting, however, yielded compensatory effects, which were similar to positively consistent parents, and deterioration effects, which were similar to negatively consistent parents depending on the gender of parent and child, domain of parenting behavior, and academic efficacy. This study contributed to the current literature by showing the unique role of fathers over and beyond mothers, and confirmed the importance of positive parenting and parenting consistency in promoting children's academic efficacy. Cultural and practical implications of the findings were discussed.
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Affiliation(s)
- Demet Kara
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Nebi Sümer
- Faculty of Arts and Social Sciences, Sabancı University, Istanbul, Turkey
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23
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Whittaker A, Elliott L, Taylor J, Dawe S, Harnett P, Stoddart A, Littlewood P, Robertson R, Farquharson B, Strachan H. The Parents under Pressure parenting programme for families with fathers receiving treatment for opioid dependence: the PuP4Dads feasibility study. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/yowk7214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background
The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research.
Objective
To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted.
Design
A mixed-methods feasibility study.
Setting
Two non-NHS family support services for parents who use drugs in Scotland.
Participants
Fathers prescribed opioid substitution therapy (n = 25), their partners (n = 17) and children, as well as practitioners, supervisors, service managers and referrers.
Intervention
A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners.
Main outcome measures
Feasibility progression criteria included the recruitment target (n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events.
Data sources
The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers (n = 23), mothers (n = 14), practitioners (n = 8), supervisors (n = 2) and service managers (n = 7); conducted focus groups with referrers (n = 28); and held an ‘expert event’ with stakeholders (n = 39).
Results
The PuP4Dads was successfully delivered within non-NHS settings and was considered acceptable and suitable for the study population. Referrals (n = 44) resulted in 38 (86%) eligible fathers, of whom 25 (66%) fathers and 17 partners/mothers consented to participate. Most fathers reported no previous parenting support. A total of 248 sessions was delivered to the 20 fathers and 14 mothers who started the intervention. Fourteen fathers (and 10 mothers) completed ≥ 6 sessions and six fathers (and four mothers) completed ≤ 5 sessions. Father and mother attendance rates were equal (mean 71%). Median length of engagement for fathers was 26 weeks and for mothers it was 30 weeks. Twenty-three fathers completed interviews at baseline, 16 fathers completed interviews at follow-up 1 and 13 fathers completed interviews at follow-up 2. Outcome measures were well tolerated; however, the suitability of some measures was dependent on family circumstances. The researcher-administered questionnaires had few missing data. The perceived benefits of PuP4Dads reported by parents, practitioners and managers included the following: the therapeutic focus on fathers improved parental emotion regulation, there was improved understanding and responding to child’s needs, there was better multiagency working and the programme was a good fit with practice ‘ethos’ and policy agenda. Learning highlighted the importance of service-wide adoption and implementation support, strategies to improve recruitment and retention of fathers, managing complex needs of both parents concurrently, understanding contextual factors affecting programme delivery and variables affecting intervention engagement and outcomes.
Limitations
Lack of emotional availability and economic (service use) data.
Conclusions
A larger evaluation of PuP4Dads is feasible.
Future work
Further work is required to demonstrate the effectiveness of PuP4Dads and the cost implications. A better understanding is needed of how the intervention works, for whom, under what circumstances and why.
Trial registration
Current Controlled Trials ISRCTN43209618.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Anne Whittaker
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Lawrie Elliott
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Julie Taylor
- School of Nursing, University of Birmingham, Birmingham Women’s and Children’s NHS Trust, Birmingham, UK
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Paul Harnett
- School of Criminology and Criminal Justice, Griffith University, QLD, Australia
| | - Andrew Stoddart
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Peter Littlewood
- Substance Use Psychology Service, Astley Ainslie Hospital, NHS Lothian, Edinburgh, Scotland, UK
| | - Roy Robertson
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Barbara Farquharson
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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O’Byrne R, Thompson R, Friedmann JS, Lumley MN. Parent Engagement with an Online, School-Based, Character Strengths Promotion Program. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 7:355-377. [PMID: 35971433 PMCID: PMC9366792 DOI: 10.1007/s41042-022-00072-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 02/02/2023]
Abstract
Schools are increasingly bolstering student character strengths to promote academic success and well-being. Schools' character-promotion efforts would benefit from involving students' caregivers. Online resources may be an accessible way to engage students' families, but further research is needed to maximize accessibility and engagement. A brief character strengths program was developed and integrated within online accounts accessed by parents of kindergarten students. Content analysis of parent focus groups (N = 14, 86% women) indicated that access to and engagement with the program was improved by several factors, including visuals, intuitive navigation, strength-based content, and school-based recruitment. Content analysis of caregivers' (N = 54, 91% women, M age = 36.52, SD age = 4.40) responses to the program's reflection questions indicated that parents prefer highly applicable content, particularly information about noticing and developing character strengths in their child. Finally, exploratory descriptive statistics indicated that single parents, fathers, and parents of racial minority children were less likely to engage with the program which alludes to the additional barriers faced by these socio-demographic groups. The results provide specific suggestions for involving parents in school-based character promotion efforts, as well as highlight the importance of additional research to better understand the needs of diverse families. Supplementary Information The online version contains supplementary material available at 10.1007/s41042-022-00072-4.
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Affiliation(s)
- Ryan O’Byrne
- grid.34429.380000 0004 1936 8198Department of Psychology, University of Guelph, 50 Stone Road East, N1G 2W1 Guelph, ON Canada
| | - Rochelle Thompson
- grid.34429.380000 0004 1936 8198Department of Psychology, University of Guelph, 50 Stone Road East, N1G 2W1 Guelph, ON Canada
| | - Jordan S. Friedmann
- grid.34429.380000 0004 1936 8198Department of Psychology, University of Guelph, 50 Stone Road East, N1G 2W1 Guelph, ON Canada
| | - Margaret N. Lumley
- grid.34429.380000 0004 1936 8198Department of Psychology, University of Guelph, 50 Stone Road East, N1G 2W1 Guelph, ON Canada
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Hansen A, Brown SD, Yap MBH. Enhancing Engagement of Fathers in Web-Based Preventive Parenting Programs for Adolescent Mental Health: A Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12340. [PMID: 34886063 PMCID: PMC8656658 DOI: 10.3390/ijerph182312340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 11/22/2022]
Abstract
Few fathers enrol in web-based preventive parenting programs for adolescent mental health, despite the evidence of the benefits associated with their participation. To inform the development of father-inclusive programs, this study used a discrete choice experiment (DCE) design to determine (a) the relative influence of number of sessions, program benefits, program participants, and user control over program content on fathers' preferences for web-based preventive parenting programs; and (b) whether selected father characteristics were associated with their preferences. One hundred and seventy-one fathers completed the DCE survey, which comprised 25 choices between hypothetical programs. Programs that included the participant's adolescent child (z = 10.06, p < 0.0001), or parenting partner (z = 7.30, p < 0.001) were preferred over those designed for fathers only. Participants also preferred program content that was recommended for them by experts (z = -4.31, p < 0.0001) and programs with fewer sessions (z = -2.94, p < 0.01). Program benefits did not predict fathers' choice of program. Prior use of a parenting program, level of education, perceived role of parenting for adolescent mental health, and being part of a dual-working family were associated with preferences. Application of these findings may improve paternal enrolment in web-based preventive parenting programs.
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Affiliation(s)
- Ashlyn Hansen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia;
| | - Scott D. Brown
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Marie B. H. Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia;
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3000, Australia
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26
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Sawrikar V, Plant AL, Andrade B, Woolgar M, Scott S, Gardner E, Dean C, Tully LA, Hawes DJ, Dadds MR. Global Workforce Development in Father Engagement Competencies for Family-Based Interventions Using an Online Training Program: A Mixed-Method Feasibility Study. Child Psychiatry Hum Dev 2021; 54:758-769. [PMID: 34800248 PMCID: PMC10140122 DOI: 10.1007/s10578-021-01282-8] [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] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Global access to practitioner training in the clinical engagement of fathers in family-based interventions is limited. The current study evaluated the feasibility of training practitioners in Canada and UK using online training developed in Australia by examining improvements in practitioner confidence and competence in father engagement, training satisfaction, qualitative feedback, and benchmarking results to those from an Australian sample. Practitioners were recruited to participate in a 2-h online training program through health services and charity organisations. The online program required practitioners to watch a video and complete self-reflection exercises in a digital workbook. Pre- and post-training measures were collected immediately before and after the online training program. The results indicated significantly large improvements in self-reported confidence and competence in engaging fathers following training, with levels of improvement similar to those found in Australia. Training satisfaction was high and qualitative feedback suggested providing local resources and increasing representation of social diversity could improve training relevance in local contexts. The findings suggest online training in father engagement can contribute to global workforce development in improving practitioners' skills in engaging fathers in family-based interventions.
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Affiliation(s)
- Vilas Sawrikar
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
| | - Alexandra L Plant
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Brendan Andrade
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Matt Woolgar
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Stephen Scott
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | | | | | - Lucy A Tully
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - David J Hawes
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Mark R Dadds
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
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Unmet Needs of Male Caregivers of Children and Youth with Special Health Care Needs. Matern Child Health J 2021; 25:1992-2001. [PMID: 34652597 PMCID: PMC8518270 DOI: 10.1007/s10995-021-03248-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The caregiving experiences and unique health needs of male caregivers of children and youth with special health care needs (CYSHCN) are not well described. This study seeks to understand potential unmet health needs and attitudes toward supportive resources from the perspective of a sample of male caregivers of CYSHCN. METHODS This mixed-methods study recruited a convenience sample of 30 men with CYSHCN who receive care for a chronic medical condition from primary care medical homes in Pennsylvania. We conducted semi-structured interviews (SSI), administered quantitative surveys to caregivers, and produced a thematic analysis. The SSI explored the health needs of male caregivers, assessed attitudes toward and preferences regarding supportive resources, and garnered their advice to other caregivers regarding parenting and health care system navigation. RESULTS Participants' median age is 41 years (IQR: 33, 44), and most (80%) reside full time with their CYSHCN. Most male caregivers deprioritized their own emotional, mental, and physical health needs to support the needs of their families. Many male caregivers articulated interest in seeking emotionally supportive resources (not time-intensive). They advised other male caregivers to remain involved in the medical care and wellbeing of their CYSCHN and to openly seek and receive emotional support despite the daily challenges they face. CONCLUSIONS FOR PRACTICE Male caregivers of CYSHCN experience intense daily stress and express the need for emotionally supportive resources. Programs designed to facilitate such support may benefit from flexible formats (time and location) and involve male caregivers of CYSHCN as both facilitators and participants.
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Hawes DJ, Dadds MR. Practitioner Review: Parenting interventions for child conduct problems: reconceptualising resistance to change. J Child Psychol Psychiatry 2021; 62:1166-1174. [PMID: 33543502 DOI: 10.1111/jcpp.13378] [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] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
Parenting interventions based on social learning theory have received extensive empirical support in the treatment of child conduct problems; yet, they fail to produce lasting gains in as many as a third of cases. Perspectives on these poor outcomes have been informed by numerous lines of research, and practitioner recommendations for improving such outcomes have often emphasized processes related to clinical engagement. In this Practitioner Review, we examine recent theory and evidence pertaining to these processes, including emerging research into the therapeutic relationship across face-to-face and eHealth treatment modalities, and the clinical engagement of both mothers and fathers. The concept of resistance to change is examined in light of these developments, and it is argued that the process of overcoming such resistance can be characterized as one of reflective practice. A novel process model based on this perspective is presented, comprising practical clinical strategies that are designed to be initiated from the earliest contacts with a family and build on one another across treatment.
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Affiliation(s)
- David J Hawes
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Mark R Dadds
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Parents' Experience in Children's Friendship Training Programme for Their Children with Autism Spectrum Disorder: A Qualitative Inquiry. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090763. [PMID: 34572194 PMCID: PMC8466490 DOI: 10.3390/children8090763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/19/2022]
Abstract
Background: Children’s Friendship Training (CFT) is a parent-assisted intervention programme that introduces children to basic sets of social rules to help them understand social contexts with specific guidance from their parents. It has been reported in several empirical studies that the friendship skills of children with autism spectrum disorder were enhanced after participating in CFT. However, previous studies only focused on the effectiveness of the training without exploring it from the parent’s perspective. As such, the objective of this study is to highlight the parents’ experience in assisting in the implementation of CFT. Purpose: To explore the parents’ experiences with autism spectrum disorder (ASD) in CFT and examine the experiences using the CFT as a theoretical framework. Methodology: In this study, eight parents and their school-aged children with ASD participated in 12 CFT sessions. Upon completing the CFT, the parents participated in a focus group interview. The interview session was video recorded and transcribed with the parents’ consent. Thematic analysis was employed in analysing the collected data as outlined in six different phases. Results: The generated data revealed the similarities and differences in parents’ experiences in the CFT. The current study has identified four main themes: (1) fear and resistance; (2) awareness, learning, and adjustment; (3) change is hard; and (4) identifying support. Conclusions: The findings highlighted the processes that these parents experienced and encountered while attending the CFT programme, it is important to consider these processes based on how they might impact the effectiveness of the programme. The programme’s effectiveness is reliant on the ability to work closely with parents to understand their challenges and explore the type of support they need. This study has analysed the crucial factors that provide an overview of parents’ encounters in their participation in CFT.
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Lange AMC, Delsing MJMH, van Geffen M, Scholte RHJ. Alliance Between Therapist and Multi-stressed Families During the COVID-19 Pandemic: The Effect of Family-Based Videoconferencing. CHILD & YOUTH CARE FORUM 2021; 51:593-611. [PMID: 34421286 PMCID: PMC8370056 DOI: 10.1007/s10566-021-09644-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
Background A strong therapeutic alliance or working relationship is essential for effective face-to-face family-based psychotherapy. However, little is known about the use of VC on alliance in family-based therapy. The recent COVID-19 pandemic led to a national lockdown during which most family-based therapy transferred to VC. Objective The current study analyzed the development and strength of alliance prior and during lockdown for multi-stressed families participating in Multisystemic Therapy (MST). Method Alliance with the therapist was reported monthly by 846 caregivers (81% female). Using latent growth curve models (longitudinal approach), the development of alliance was estimated for families participating in MST prior to the lockdown, transferring to VC early in treatment or late in treatment. Using regression analyses (cross-sectional approach), lockdown (yes/no) was included as predictor of alliance. In these analyses, type of family (regular; intellectual disability; concerns regarding child abuse or neglect) and gender of caregiver were included as moderators. Results Both analytical approaches showed that alliance was not affected by VC, except for families with concerns of child abuse, who reported lower alliances during lockdown. However, these results where no longer significant when controlling for multiple testing. Conclusions Strong alliances can be developed and maintained during family-based VC sessions with multi-stressed families. However, for some subgroups, such as families with concerns of child abuse, VC might not be suitable or sufficient. Future research needs to investigate the potential and limitations of using VC with families.
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Affiliation(s)
- Aurelie. M. C. Lange
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | | | - Marieke van Geffen
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Ron. H. J. Scholte
- Praktikon, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Tranzo, Tilburg University, Tilburg, The Netherlands
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31
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Metcalfe RE, Matulis JM, Cheng Y, Stormshak EA. Therapeutic alliance as a predictor of behavioral outcomes in a relationally focused, family-centered telehealth intervention. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:473-484. [PMID: 33855726 PMCID: PMC8830893 DOI: 10.1111/jmft.12517] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
This study evaluates therapeutic alliance as a mediator of the relationship between dosage and clinical outcomes for the Family Check-Up (FCU) Online, a telehealth adaptation of an evidence-based parenting intervention for parents of middle school youth. The sample consisted of N = 111 parents with children in middle school who received the FCU Online as part of an ongoing clinical trial. They were randomly assigned to receive telehealth coaching and participated in the intervention and follow-up assessment 12 months later. Data was collected using parent and child questionnaires as well as engagement data collected as part of the online intervention, using both parents and children as reporters of parent behavioral change. Using parent report measures, there was clear support for a mediation model, with parent report of alliance predicting parent self-report ratings of clinical progress (parent behavior change) at 12-month follow-up. However, for the child-report data, there was no clear relationship between dosage or therapeutic alliance with child reports of parenting. Clinical implications and future research directions are discussed.
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Affiliation(s)
- Robyn E Metcalfe
- Department of Counseling and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Jordan M Matulis
- Department of Counseling and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Yijun Cheng
- Department of Counseling and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Elizabeth A Stormshak
- Department of Counseling and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA
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32
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Ong SY, Roslan S, Ahmad NA, Ayub AFM, Ping CL, Zaremohzzabieh Z, Ahrari S. A Mixed-Methods Evaluation of Parent-Assisted Children's Friendship Training to Improve Social Skills and Friendship Quality in Children with Autism in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2566. [PMID: 33806563 PMCID: PMC7967648 DOI: 10.3390/ijerph18052566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
Background: This study evaluates the effectiveness of parent-assisted children's friendship training intervention for enhancing friendship quality and social skills among children with autism spectrum disorders (ASD). We conducted a quasi-experimental study to investigate the effective outcomes of social skills and friendship quality in the pre-and post-parent-assisted CFT intervention phases; Methods: to conduct a 12-week field session, 30 children with their parents were selected. The Social Skills Improvement System Rating Scales and the Quality of Play Questionnaire-Parent were used to assess the effectiveness of the parent-assisted children's friendship training during pre-and post-intervention. A semi-structured interview with parents was conducted at the end of the session; Results: findings revealed that intervention improved the social skills of these children. Additionally, the friendship quality of children with ASD improved before and after the intervention, however, engagement remained unchanged. Parents also showed some sort of improvement after the session as they reported a heightened sense of fear and resistance, awareness, learning and adjustment, change is not easy, and identifying support; Conclusions: there was clear evidence that children with ASD benefitted from parent-assisted CFTs in terms of social skills and friendship quality. However, larger and controlled studies are required to draw firm conclusions about this kind of intervention.
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Affiliation(s)
- Sing Yee Ong
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Samsilah Roslan
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Nor Aniza Ahmad
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Ahmad Fauzi Mohd Ayub
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Chen Lee Ping
- Department of Psychology, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Zeinab Zaremohzzabieh
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
| | - Seyedali Ahrari
- Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia; (S.Y.O.); (N.A.A.); (A.F.M.A.); (Z.Z.); (S.A.)
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A Family-Based Lifestyle Intervention Focusing on Fathers and Their Children Using Co-Creation: Study Protocol of the Run Daddy Run Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041830. [PMID: 33668562 PMCID: PMC7918485 DOI: 10.3390/ijerph18041830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/18/2022]
Abstract
Fathers play a unique and important role in shaping their children’s physical activity (PA), independent from the mother. Lifestyle interventions focusing simultaneously on PA of fathers and their children (“co-PA”) are therefore a novel and promising way to improve PA of both. A theory-based lifestyle intervention was co-created with fathers (i.e., the Run Daddy Run intervention), using the behavior change wheel as a theoretical framework. The aim of the present study is to describe the protocol of the Run Daddy Run intervention study, focusing on improving (co-)PA of fathers and children, and the prospected outcomes. The developed intervention consists of six (inter)active father-child sessions and an eHealth component, delivered over a 14-week intervention period. Baseline measurements will be conducted between November 2019–January 2020, post-test measurements in June 2020, and follow-up measurements in November 2020, with (co-)PA as the primary outcome variable. Outcomes will be measured using accelerometry and an online questionnaire. To evaluate the intervention, multilevel analyses will be conducted. This study will increase our understanding on whether a theory-based, co-created lifestyle intervention focusing exclusively on fathers and their children can improve their (co-)PA behavior and has important implications for future research and health policy, where targeting fathers might be a novel and effective approach to improve (co-)PA and associated health behaviors of both fathers and their children.
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Hansen A, Broomfield G, Yap MBH. A systematic review of technology‐assisted parenting programs for mental health problems in youth aged 0–18 years: Applicability to underserved Australian communities. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12250] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ashlyn Hansen
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
| | - Grace Broomfield
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
| | - Marie B. H. Yap
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia,
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35
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Lechowicz ME, Jiang Y, Tully LA, Burn MT, Collins DAJ, Hawes DJ, Lenroot RK, Anderson V, Doyle FL, Piotrowska PJ, Frick PJ, Moul C, Kimonis ER, Dadds MR. Enhancing Father Engagement in Parenting Programs: Translating Research into Practice Recommendations. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12361] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | | | - Rhoshel K. Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales,
| | - Vicki Anderson
- Murdoch Children's Research Institute, Royal Children's Hospital,
- Department of Psychology, University of Melbourne,
- Department of Paediatrics, University of Melbourne,
| | | | | | - Paul J. Frick
- Learning Sciences Institute of Australia, Australian Catholic University,
- Department of Psychology, Louisiana State University, and
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Dedousis-Wallace A, Drysdale SA, McAloon J, Ollendick TH. Parental and Familial Predictors and Moderators of Parent Management Treatment Programs for Conduct Problems in Youth. Clin Child Fam Psychol Rev 2020; 24:92-119. [PMID: 33074467 DOI: 10.1007/s10567-020-00330-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 11/30/2022]
Abstract
Despite the established efficacy of Parent Management Training (PMT) for conduct problems in youth, evidence suggests that up to half of all treated youth still display clinical levels of disruptive behavior post-treatment. The reasons for these unsatisfactory outcomes are poorly understood. The aim of the present review was to provide an updated analysis of studies from the past 15 years that examined parental and familial predictors and moderators of improvement in PMT for conduct problems. A systematic literature review of indicated prevention (children with conduct problem symptoms) and intervention (children with clinical diagnoses) studies published between 2004 and 2019 was conducted. This 15-year time period was examined since the last systematic reviews were reported in 2006 and summarized studies completed through mid-2004 (see Lundahl et al. in Clin Psychol Rev 26(1):86-104, 2006; Reyno and McGrath in J Child Psychol Psychiatry 47(1):99-111, 2006). Risk of bias indices was also computed (see Higgins et al. in Revised Cochrane risk of bias tool for randomized trials (RoB 2.0), University of Bristol, Bristol, 2016) in our review. A total of 21 studies met inclusion criteria. Results indicated that a positive parent-child relationship was most strongly associated with better outcomes; however, little additional consistency in findings was evident. Future PMT research should routinely examine predictors and moderators that are both conceptually and empirically associated with treatment outcomes. This would further our understanding of factors that are associated with poorer treatment outcome and inform the development of treatment components or modes of delivery that might likely enhance evidence-based treatments and our clinical science. Protocol Registration Number: PROSPERO CRD42017058996.
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Affiliation(s)
- Anna Dedousis-Wallace
- The Kidman Centre, University of Technology Sydney, Randwick, NSW, 2031, Australia. .,Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Sophia A Drysdale
- The Kidman Centre, University of Technology Sydney, Randwick, NSW, 2031, Australia
| | - John McAloon
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Thomas H Ollendick
- Department of Psychology, Virginia Polytechnic Institute & State University, Blacksburg, VA, USA
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Seymour M, Peace R, Wood CE, Jillard C, Evans K, O'Brien J, Williams LA, Brown S, Giallo R. "We're in the background": Facilitators and barriers to fathers' engagement and participation in a health intervention during the early parenting period. Health Promot J Austr 2020; 32 Suppl 2:78-86. [PMID: 33051918 DOI: 10.1002/hpja.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 11/09/2022] Open
Abstract
ISSUES ADDRESSED Little is known about the barriers and facilitators associated with engaging fathers in interventions targeting their physical and mental health. The current research therefore aimed to explore fathers' perceived barriers and facilitators to engagement and participation in a health intervention delivered during the early parenting period. METHODS Eleven fathers of young children (0-4 years) were interviewed about their perceptions and experiences of facilitators and barriers to engaging and participating in an intervention (Working Out Dads) to target their mental and physical health. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis. RESULTS Fathers identified a number of program-related and father-related facilitators and barriers which impacted their engagement and participation. Program-related facilitators included: accessibility of the program; father advocacy of the program; group fitness/exercise component; and having a father-specific program. Facilitating factors related to fathers included: making social connections; learning how to be a better dad/partner; and partner support and encouragement to attend. Program-related barriers included: travel; lack of awareness; and gender roles. While father-related barriers included: being time poor; sacrifices to family; and apprehension. CONCLUSIONS The current findings identified many areas that facilitate, encourage and motivate men to participate in interventions which support their mental and physical health during the early parenting period. RELEVANCE Generating evidence on barriers and facilitators to health interventions is important to improving the current intervention along with informing the development of engaging and targeted health interventions for fathers in early parenthood.
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Affiliation(s)
- Monique Seymour
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Ryan Peace
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Catherine E Wood
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Chris Jillard
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Kirsty Evans
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Jacquie O'Brien
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Le Ann Williams
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Stephanie Brown
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia.,Department of General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC, Australia.,South Australia Health and Medical Research Institute, Adelaide, SA, Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia
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38
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Okyar E, Görker I. Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents. BMC Psychiatry 2020; 20:285. [PMID: 32503560 PMCID: PMC7275391 DOI: 10.1186/s12888-020-02703-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/28/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two of the most frequently-observed neurodevelopmental disorders. Autistic traits are detected frequently in children who have ADHD. This study aimed to examine autism symptoms in children diagnosed with ADHD and their parents; and also, to investigate parental risk factors that increase autistic traits in children. Besides the risk factors related to pregnancy, birth and developmental history were examined. METHODS Two groups were created consisting of 66 children diagnosed with ADHD and 33 children not diagnosed with ADHD and their parents. Autism symptoms were screened with the Autism Behavior Checklist (ABC) in children, and Autism Spectrum Quotient (AQ) in parents. Also, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale and Wender Utah Rating Scale (WURS) were used to determine ADHD symptoms in parents. RESULTS It was determined that there were more autism symptoms in children who were diagnosed with ADHD than in the control group without ADHD. There were more autistic symptoms in boys and the presence of Oppositional Defiant Disorder (ODD). Although there were more ADHD symptoms in the parents of children diagnosed with ADHD, it was determined that they did not differ from parents in the control group in terms of autism symptoms. It was also determined that maternal and paternal ADHD symptoms were predictive for autism symptoms in children. It was also shown that maternal smoking during pregnancy is associated with more autistic traits. CONCLUSION ASD and ADHD show high levels of comorbidity. The etiology remains unclear. Both ADHD and ASD show strong hereditary transition. We found that maternal and paternal ADHD symptoms predict autism symptoms in children with ADHD. However, more studies are needed to reveal the etiology.
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Affiliation(s)
- Esra Okyar
- Department of Child and Adolescent Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey.
| | - Işık Görker
- grid.411693.80000 0001 2342 6459Department of Child and Adolescent Psychiatry, Faculty of Medicine, Trakya University, Edirne, Turkey
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Morgan PJ, Young MD, Barnes AT, Eather N, Pollock ER, Lubans DR. Engaging Fathers to Increase Physical Activity in Girls: The "Dads And Daughters Exercising and Empowered" (DADEE) Randomized Controlled Trial. Ann Behav Med 2020; 53:39-52. [PMID: 29648571 DOI: 10.1093/abm/kay015] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Existing strategies to increase girls' physical activity levels have seen limited success. Fathers may influence their children's physical activity, but often spend more time with their sons and rarely participate in family-based programs. Purpose To test a novel program designed to increase the physical activity levels of fathers and their daughters. Methods In a two-arm RCT, 115 fathers (29-53 years) and 153 daughters (4-12 years) were randomized to (i) the "Dads And Daughters Exercising and Empowered" (DADEE) program, or (ii) a wait-list control. The 8-week program included weekly educational and practical sessions plus home tasks. Assessments were at baseline, 2 months (postintervention), and 9 months. The primary outcomes were father-daughter physical activity levels (pedometry). Secondary outcomes included screen-time, daughters' fundamental movement skill proficiency (FMS: perceived and objective), and fathers' physical activity parenting practices. Results Primary outcome data were obtained from 88% of daughters and 90% of fathers at 9 months. Intention-to-treat analyses revealed favorable group-by-time effects for physical activity in daughters (p = .02, d = 0.4) and fathers (p < .001, d = 0.7) at postintervention, which were maintained at 9 months. At postintervention and follow-up, significant effects (p < .05) were also identified for daughters' FMS competence (objective: d = 1.1-1.2; perceived: d = 0.4-0.6), a range of fathers' physical activity parenting practices (d = 0.3-0.8), and screen-time for daughters (d = 0.5-0.8) and fathers (d = 0.4-0.6, postintervention only). Program satisfaction and attendance were very high. Conclusions This study provided the first experimental evidence that efforts to increase physical activity behavior in preadolescent girls would benefit from a meaningful engagement of fathers. Clinical Trial information: Australian New Zealand Clinical Trials Registry: ACTRN12615000022561.
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Affiliation(s)
- Philip J Morgan
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Myles D Young
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Alyce T Barnes
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Narelle Eather
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - Emma R Pollock
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
| | - David R Lubans
- Priority Research Center for Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia.,Faculty of Education and Arts, University of Newcastle, New South Wales, Australia
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40
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Tomfohr-Madsen LM, Giesbrecht GF, Madsen JW, MacKinnon A, Le Y, Doss B. Improved Child Mental Health Following Brief Relationship Enhancement and Co-Parenting Interventions During the Transition to Parenthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E766. [PMID: 31991755 PMCID: PMC7038182 DOI: 10.3390/ijerph17030766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/16/2022]
Abstract
The transition to parenthood has been identified as a significant relationship stressor. Many couples report declines in relationship satisfaction and difficulty with individual stress and co-parenting-problems that have been associated with both child temperament as well as emotional and behavioral problems. Several parenting and relationship interventions have been developed to buffer against these difficulties. In the current study, we report secondary analyses of a randomized controlled trial of brief (6-hr) interventions that focused on improving either relationship satisfaction or co-parenting, delivered during pregnancy and the early postpartum period. In this trial, 90 opposite-sex couples (180 participants), who were pregnant with their first child, and were assessed as being at high risk for declines in relationship satisfaction, were randomized to receive either (1) a relationship intervention, (2) a co-parenting intervention, or (3) an information control. At 12 months postpartum, couples who received either the relationship or co-parenting intervention rated their infants as having lower negative emotionality and as having fewer externalizing symptoms compared to the information-only control. Lower externalizing symptoms at 12 months were, in turn, associated with reduced externalizing symptoms at 24 months postpartum. Whereas, lower ratings of child negative emotionality at 12 months were associated with reduced internalizing symptoms at 24 months postpartum. These results indicate that brief relationship or co-parenting interventions delivered during the transition to parenthood have secondary benefits for child mental health.
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Affiliation(s)
- Lianne M. Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (G.F.G.); (J.W.M.); (A.M.)
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB T3B 6A8, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Gerald F. Giesbrecht
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (G.F.G.); (J.W.M.); (A.M.)
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB T3B 6A8, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Joshua W. Madsen
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (G.F.G.); (J.W.M.); (A.M.)
| | - Anna MacKinnon
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (G.F.G.); (J.W.M.); (A.M.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Yunying Le
- Department of Psychology, University of Miami, Miami, FL 33124, USA; (Y.L.); (B.D.)
| | - Brian Doss
- Department of Psychology, University of Miami, Miami, FL 33124, USA; (Y.L.); (B.D.)
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41
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Piotrowska PJ, Tully LA, Collins DAJ, Sawrikar V, Hawes D, Kimonis ER, Lenroot RK, Moul C, Anderson V, Frick PJ, Dadds MR. ParentWorks: Evaluation of an Online, Father-Inclusive, Universal Parenting Intervention to Reduce Child Conduct Problems. Child Psychiatry Hum Dev 2020; 51:503-513. [PMID: 31650461 PMCID: PMC7347669 DOI: 10.1007/s10578-019-00934-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Evidence-based parenting interventions are effective in reducing conduct problems, yet these interventions have limited reach, and few involve the participation of fathers. This paper describes the outcomes of an open trial of ParentWorks, a universal, online, father-inclusive parenting intervention aiming to decrease childhood behavioural problems and promote positive parenting in mothers and fathers. A total of 388 families (456 individual parents; 36.6% fathers) were included in the study. Mixed model analyses showed significant decreases in child emotional/behavioural problems, dysfunctional parenting, interparental conflict, and parental mental health problems. The baseline severity of child behavioural problems significantly moderated the effects on child outcomes so that children with higher levels of problems benefitted more from the program. Participation of both caregivers in two-parent families, as well as parent sex, did not significantly affect the program outcomes. Results provide initial empirical support for the universal, self-directed, online parenting intervention, in addressing both child behavioural problems and parenting outcomes. Trial registration: ACTRN12616001223426, registered 05/09/2016.
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Affiliation(s)
| | - Lucy A Tully
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Daniel A J Collins
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Vilas Sawrikar
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - David Hawes
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Eva R Kimonis
- School of Psychology, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Caroline Moul
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Vicki Anderson
- Royal Children's Hospital, Murdoch Children's Research Institute & Departments of Psychology & Paediatrics, University of Melbourne, Parkville Campus, Parkville, VIC, 3010, Australia
| | - Paul J Frick
- Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803, USA
- Learning Sciences Institute of Australia, Australian Catholic University, Banyo, QLD, 3010, Australia
| | - Mark R Dadds
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.
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42
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Keys EM, Norris JM, Cameron EE, Bright KS, Tomfohr-Madsen LM, Benzies KM. Recruitment and retention of fathers with young children in early childhood health intervention research: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:300. [PMID: 31787109 PMCID: PMC6886200 DOI: 10.1186/s13643-019-1215-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fathers are under-represented in research and programs addressing early childhood health and development. Recruiting fathers into these interventions can be hampered for multiple reasons, including recruitment and retention strategies that are not tailored for fathers. The primary aim of this systematic review and meta-analysis is to determine the effectiveness of recruitment and retention strategies used to include fathers of children (from conception to age 36 months) in intervention studies. The secondary aim is to investigate study-level factors that may influence recruitment and retention. METHODS We will conduct searches for scholarly peer-reviewed randomized controlled trials, quasi-experimental studies, and pre-post studies that recruited fathers using the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), and CINAHL. English-language articles will be eligible if they recruited self-identified fathers of children from conception to age 36 months for health-promoting interventions that target healthy parents and children. Two reviewers will independently screen titles/abstracts and full texts for inclusion, as well as grading methodological quality. Recruitment and retention proportions will be calculated for each study. Where possible, we will calculate pooled proportional effects with 95% confidence intervals using random-effects models and conduct a meta-regression to examine the impact of potential modifiers of recruitment and retention. DISCUSSION Findings from this review will help inform future intervention research with fathers to optimally recruit and retain participants. Identifying key factors should enable health researchers and program managers design and adapt interventions to increase the likelihood of increasing father engagement in early childhood health interventions. Researchers will be able to use this review to inform future research that addresses current evidence gaps for the recruitment and retention of fathers. This review will make recommendations for addressing key target areas to improve recruitment and retention of fathers in early childhood health research, ultimately leading to a body of evidence that captures the full potential of fathers for maximizing the health and wellbeing of their children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018081332.
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Affiliation(s)
- Elizabeth M. Keys
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Jill M. Norris
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Emily E. Cameron
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
| | - Katherine S. Bright
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Lianne M. Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Karen M. Benzies
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
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43
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Tully LA, Piotrowska PJ, Collins DAJ, Frick PJ, Anderson V, Moul C, Lenroot RK, Kimonis ER, Hawes D, Dadds MR. Evaluation of 'The Father Effect' Media Campaign to Increase Awareness of, and Participation in, an Online Father-Inclusive Parenting Program. HEALTH COMMUNICATION 2019; 34:1423-1432. [PMID: 29985642 DOI: 10.1080/10410236.2018.1495160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is substantial evidence that parenting programs are effective in improving parenting and child mental health outcomes. While there is increasing focus on delivering parenting interventions online to increase their reach and dissemination, fathers are underrepresented in all formats of parenting programs. However, research suggests that father participation is important for intervention effectiveness. This study evaluated the effectiveness of a media campaign for increasing awareness of, and participation in, an online father-inclusive parenting program called 'ParentWorks'. An 8-week campaign was conducted in Australia via social media channels, digital display advertising, digital television, and radio. To assess the impact of the campaign, data were obtained from caregivers registering for ParentWorks during the campaign period (n = 848) and an 8-week comparison period that occurred 3 months later (n = 254). Additionally, a nationally representative sample of 2021 caregivers of children aged 2-16 years completed an online survey. Survey questions asked about exposure to the campaign, registration for participation in ParentWorks, and knowledge of the importance of father participation in parenting programs. Three times as many caregivers registered during the 8-week media campaign compared to the comparison period, and a significantly greater proportion of male caregivers registered in the campaign versus the comparison period. The online survey found that 11% of caregivers reported exposure to the campaign, and significantly more fathers than mothers reported exposure. Results showed that those who were exposed to the campaign were significantly more likely to endorse the importance of father participation in parenting programs, than those not exposed to the campaign. The findings indicate that media campaigns appear to be an effective method of increasing awareness of online parenting programs and enhancing rates of father involvement.
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Affiliation(s)
| | | | | | - Paul J Frick
- Learning Sciences Institute of Australia, Australian Catholic University & Department of Psychology, Louisiana State University
| | - Vicki Anderson
- Royal Children's Hospital, Murdoch Children's Research Institute, & Departments of Psychology & Paediatrics, University of Melbourne
| | | | - Rhoshel K Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales
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44
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Smythe T, Duttine A, Vieira ACD, Castro BDSMD, Kuper H. Engagement of Fathers in Parent Group Interventions for Children with Congenital Zika Syndrome: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203862. [PMID: 31614765 PMCID: PMC6843372 DOI: 10.3390/ijerph16203862] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/27/2019] [Accepted: 10/09/2019] [Indexed: 12/20/2022]
Abstract
We aimed to explore the engagement of fathers in a community-based group intervention (Juntos) for children with congenital Zika syndrome (CZS) and their caregivers in Brazil. Six Juntos groups were facilitated from August 2017 to May 2018. We conducted a qualitative study to evaluate the feasibility and acceptability of the intervention for fathers of children with CZS. Methods included participant observation, focus group discussions, and semi-structured interviews of fathers with a child enrolled in the program. Data collected were transcribed, coded and thematically analyzed to explore father preference for, and beliefs about the intervention and to assess potential barriers and enablers to their involvement. Forty-nine families (61 participants) enrolled, of whom 20% (12/61) were fathers. Seven (58%) fathers attended more than 7 out of 10 sessions. The content of Juntos was found to be acceptable to those fathers who attended. Participation in the group offered fathers the opportunity to share experiences of caring for their child and demonstrate their importance as care agents. Work commitments, and the view of mothers as primary caregivers were barriers to engagement of fathers. Facilitators to engagement included a presentation of clear objectives for fathers’ involvement and the opportunity to learn a practical skill related to caring for their child. A better understanding of the perspectives of fathers is crucial to help increase their involvement in parenting interventions.
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Affiliation(s)
- Tracey Smythe
- The London School of Hygiene & Tropical Medicine, London WC1E7HT, UK.
| | - Antony Duttine
- The London School of Hygiene & Tropical Medicine, London WC1E7HT, UK.
| | | | | | - Hannah Kuper
- The London School of Hygiene & Tropical Medicine, London WC1E7HT, UK.
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45
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Darling SJ, Hearps SJC, Muscara F, McCarthy M, Nicholson JM, Burke K, Dimovski A, Anderson V. Psychological trajectories of mothers and fathers following their child's diagnosis of a life-threatening illness or injury: A longitudinal investigation. J Clin Psychol 2019; 75:1930-1942. [PMID: 31254362 DOI: 10.1002/jclp.22829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Explore the mental health trajectories of parents following their child's life-threatening illness/injury. METHODS Participants were 217 parents (mean age: 34.9-40.0; 66 fathers) of 165 children who presented to a tertiary hospital with a life-threatening illness/injury. Parents completed questionnaires about their mental health and psychosocial stressors within 4 weeks of the child's illness/injury (T1), and 4 months (T2), 7 months (T3), and 19 months (T4) postdiagnosis. RESULTS For both mothers and fathers, mental health symptoms were elevated at diagnosis declining to normal levels by T3, with a pattern of increase at T4. Fathers demonstrated a faster decline in symptoms between T1 and T2, and fathers, but not mothers, experienced a relapse in depressive symptoms at T4. Fathers reported higher rates of work changes. CONCLUSIONS These findings have important implications for the design and timing of parental interventions to support families of children with life-threatening disease/injury.
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Affiliation(s)
- Simone J Darling
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Stephen J C Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Frank Muscara
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Maria McCarthy
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Kylie Burke
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, St. Lucia, Queensland, Australia
| | - Anica Dimovski
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Psychology Department, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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46
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Tully LA, Hawes DJ, Doyle FL, Sawyer MG, Dadds MR. A national child mental health literacy initiative is needed to reduce childhood mental health disorders. Aust N Z J Psychiatry 2019; 53:286-290. [PMID: 30654614 DOI: 10.1177/0004867418821440] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Half of all lifetime mental health disorders emerge in childhood, so intervening in the childhood years is critical to prevent chronic trajectories of mental health disorders. The prevalence of child mental health disorders is not decreasing despite the increased availability of evidence-based interventions. One key reason for the high prevalence and low treatment uptake may be low levels of child mental health literacy in the general community. Mental health literacy refers to knowledge and beliefs about mental health disorders that aid in their recognition, prevention and management. There is emerging evidence of poor recognition of child mental health problems in the community and low levels of parental knowledge about how to seek help, along with high levels of stigmatising attitudes. Although Australia has been a world leader in research and practice in improving mental health literacy for adolescent and adult mental health disorders, particularly depression and anxiety, mental health literacy for childhood disorders has been largely overlooked. In order to improve knowledge of child mental health disorders, reduce stigma, improve appropriate help-seeking and impact on the prevalence of child mental health disorders, we argue that a national initiative focussing on increasing mental health literacy for childhood disorders is urgently needed.
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Affiliation(s)
- Lucy A Tully
- 1 School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - David J Hawes
- 1 School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Frances L Doyle
- 1 School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Michael G Sawyer
- 2 School of Medicine, The University of Adelaide, North Adelaide, SA, Australia
- 3 Research and Evaluation Unit, Women's and Children's Hospital, Women's and Children's Health Network, North Adelaide, SA, Australia
| | - Mark R Dadds
- 1 School of Psychology, The University of Sydney, Camperdown, NSW, Australia
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Collins DA, Tully LA, Piotrowska PJ, Hawes DJ, Dadds MR. Perspectives on ParentWorks: Learnings from the development and national roll-out of a self-directed online parenting intervention. Internet Interv 2019; 15:52-59. [PMID: 30656140 PMCID: PMC6329694 DOI: 10.1016/j.invent.2018.12.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 11/24/2022] Open
Abstract
Online parenting interventions are an increasingly viable alternative to face-to-face programs, as they can potentially overcome barriers to participation and increase program reach. The current paper describes learnings from the design, development and dissemination of ParentWorks, a self-directed online parenting intervention designed to be inclusive of both mothers and fathers. ParentWorks was promoted via a national media campaign and was accessible to all Australian parents through a dedicated website. Participants created a user account, engaged in a series of video modules, and completed assessment measures at pre-, post-program and 3-month follow-up. For two-caregiver families, parents were encouraged to participate together using a shared account. There was no direct practitioner support, although a range of innovative automated features were included to enhance participant motivation and encourage program completion. Several key lessons emerged from program development and implementation. These relate primarily to design and content of the program website, user account functionality, program structure and features, and data collection. Further research is needed particularly with regard to methods for increasing participant retention in self-directed online programs. The learnings described here will be relevant to those researching and developing online parenting interventions as well as other online mental health interventions aiming to reach a large population sample.
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Affiliation(s)
| | - Lucy A. Tully
- School of Psychology, University of Sydney, NSW 2006, Australia
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A benchmarking study of father involvement in Australian child mental health services. PLoS One 2018; 13:e0203113. [PMID: 30153291 PMCID: PMC6112673 DOI: 10.1371/journal.pone.0203113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
Fathers are underrepresented in interventions focussing on child well-being, yet research suggests their involvement may be critical to enhancing intervention effectiveness. This study aimed to provide the first Australian benchmark of rates of father attendance across several child mental health services. Retrospective casefile reviews were conducted to obtain data on father and mother attendance at 10 Australian child mental health services. A total of 2128 casefile records were retrospectively examined to extract family-level data. The main outcome measures were rates of father and mother attendance at sessions involving parents, and rates of father- and mother-instigated referral to services. Across services, fathers attended on average 48.2% (range 39.7% to 72.0%) of total parent sessions, with an average of 68.4% (range 53.1% to 88.1%) of fathers attending at least one session. Mothers attended sessions at significantly higher rates; an average of 92.8% of total parent sessions and 96.9% attendance for at least one session. For self-referred families, on average 12.6% of referrals were from fathers, and 87.4% were from mothers. These results indicate that rates of father attendance at Australian child mental health services vary, but are significantly lower than attendance rates for mothers. This may compromise the quality and outcomes of child mental health services in Australia. Routine monitoring of rates of father attendance is needed, as are strategies to enhance father engagement.
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Dadds MR, Sicouri G, Piotrowska PJ, Collins DA, Hawes DJ, Moul C, Lenroot RK, Frick PJ, Anderson V, Kimonis ER, Tully LA. Keeping Parents Involved: Predicting Attrition in a Self-Directed, Online Program for Childhood Conduct Problems. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:881-893. [DOI: 10.1080/15374416.2018.1485109] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Paul J. Frick
- Department of Psychology, Louisiana State University
| | - Vicki Anderson
- Child Neuropsychology, Murdoch Children’s Research Institute Psychology, Royal Children’s Hospital
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Sicouri G, Tully L, Collins D, Burn M, Sargeant K, Frick P, Anderson V, Hawes D, Kimonis E, Moul C, Lenroot R, Dadds M. Toward Father-friendly Parenting Interventions: A Qualitative Study. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY 2018; 39:218-231. [PMID: 30008513 PMCID: PMC6033039 DOI: 10.1002/anzf.1307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Levels of father participation in parenting interventions are often very low, yet little is known about the factors which influence father engagement. We aimed to qualitatively explore perceived barriers to, and preferences for, parenting interventions in a community sample of fathers. Forty-one fathers across nine focus groups were interviewed using a semi-structured interview. Data were analysed using inductive thematic analysis. Key barriers to father participation identified included: the perception that interventions are mother-focused; beliefs about gender roles regarding parenting and help-seeking; mothers' role as 'gatekeeper'; lack of knowledge and awareness of parenting interventions; and lack of relevance of interventions. Fathers reported preferences for specific content and intervention features, facilitator characteristics, practical factors, and highlighted the need for father-targeted recruitment and advertising. Many of the barriers and preferences identified are consistent with previous research; however, fathers' beliefs and attitudes around gender roles and help-seeking, as well as the perception that interventions are predominantly mother-focused, may be key barriers for community fathers. Strategies to overcome these barriers and better meet the needs of fathers in promoting and delivering parenting interventions are discussed.
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Affiliation(s)
| | | | | | | | | | - Paul Frick
- Australian Catholic UniversityBrisbane & Louisiana State UniversityBaton Rouge
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