Evaluation of effectiveness of (elements of) parenting support in daily practice of preventive youth health care; design of a naturalistic effect evaluation in 'CIKEO' (consortium integration knowledge promotion effectiveness of parenting interventions)

The association between perceived social support and parenting self-efficacy among parents of children aged 0-8 years

Strengthening social support has been recognized as a potentially effective strategy to enhance parenting self-efficacy, but empirical evidence is limited. This study examined the association between perceived social support and parenting self-efficacy.Data of 647 parents of children aged 0-8 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Data were collected between October 2017 and December 2019. Multivariable linear regression models were used to examine the association between social support and parenting self-efficacy. The mean age of the participants was 33.8 years (SD = 4.9); 94.9% mothers. At the start of the study, 15.1% parents perceived low to moderate social support. Parents who experienced lower levels of social support at the start of the study reported lower parenting self-efficacy at follow-up (β: 0.13; 95% CI: 0.05, 0.21), independent of potential socio-demographic confounders. Experiencing an increase in perceived social support during the study period was associated with an increase in parenting self-efficacy (β: 0.15; 95% CI: 0.10, 0.21). Our findings indicate perceived social support is associated with parenting self-efficacy among parents of children aged 0-8 years. Future longitudinal studies need to confirm our findings and may examine which social support interventions are effective in strengthening parenting self-efficacy.

Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study

BACKGROUND

Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia.

METHODS

Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children.

RESULTS

The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05).

CONCLUSIONS

Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.

Socio-demographic characteristics associated with perceived social support among parents of children aged 0-7 years: the CIKEO study

BACKGROUND

Social support has been associated with numerous positive outcomes for families' health, wellbeing and empowerment. This study examined which socio-demographic characteristics are associated with perceived social support among parents of children aged 0-7 years.

METHOD

Cross-sectional data of 1007 parents of children aged 0-7 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Social support was assessed with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to examine associations between socio-demographic characteristics and perceived social support.

RESULTS

The mean age of the participants was 34.1 years (SD = 5.1); 92.9% were mothers. The multivariable regression model showed that fathers (β: -0.15, 95% CI: - 0.22, - 0.08), parents with a low educational level (β: -0.12, 95% CI: 0.18, - 0.06), parents with a low income (β: -0.10, 95% CI: - 0.19, - 0.01), unemployed parents (β: -0.14, 95% CI: - 0.20, - 0.07), and parents of older children (β: -0.07; 95% CI: - 0.13, 0.00) perceived lower levels of social support. Interaction analyses showed that parents with a migration background and a low educational level were particularly susceptible to perceiving lower levels of support (β: -0.34, 95% CI: - 0.52, - 0.15).

CONCLUSION

Fathers, parents with a low educational level, parents with a low income, unemployed parents, parents of older children, and parents with both a migration background and a low educational level are at increased risk of perceiving lower levels of social support.

IMPLICATIONS

We recommend to develop, implement and evaluate intervention strategies to strengthen perceived social support among the abovementioned subgroups of parents, in order to improve families' health, wellbeing and empowerment.

TRIAL REGISTRATION

NTR7607 in the Netherlands trial registry.

A prospective study on the association between social support perceived by parents of children aged 1-7 years and the use of community youth health care services

Aim

This study examined the association between social support perceived by parents of children aged 1-7 years and the use of additional community youth health care services.

Methods

Data of 749 parents of children aged 1-7 years, gathered in the CIKEO cohort study in the Netherlands, were analyzed. Social support was assessed with the Multidimensional Scale of Perceived Social Support. Data on the use of additional community youth health care services during a period of 1.5 years were obtained from the electronic records of participating youth health care organizations. Multivariable logistic regression models were used to examine the association between perceived social support and the use of additional youth health care services and to explore moderation by the parent's educational level.

Results

The mean age of the responding parents was 33.9 years (SD = 5.1); 93.6% were mothers. Parents who perceived low to moderate levels of social support had 1.72 (95% CI: 1.11, 2.66) times higher odds of using one or more additional youth health care services during the study period compared to parents who perceived high levels of social support at baseline. This association was independent of predisposing factors, but not independent of need factors (p > 0.05). Furthermore, the association was moderated by the educational level of the parent (p = 0.015). Among parents with a high educational level, low to moderate levels of perceived social support at baseline were associated with 2.93 (95% CI: 1.47, 5.83) times higher odds of using one or more additional youth health care services during the study period independent of predisposing and need factors. Among parents with a low or middle educational level the association between perceived social support and use of additional youth health care services was not significant.

Conclusion

Our findings provide evidence that low to moderate levels of perceived social support are associated with a higher use of additional community youth health care services among parents of children aged 1-7 years, especially among high educated parents. Recommendations for policy and practice are provided.

The Association between Stressful Life Events and Emotional and Behavioral Problems in Children 0-7 Years Old: The CIKEO Study

Background: Stressful life events (SLEs) are recognized risk factors for emotional and behavioral problems, but the association is understudied among young children. Our aim was to examine the association between exposure to SLEs and emotional and behavioral problems in young children up to 7 years old. Methods: We analyzed baseline data from 959 children (mean age = 3.3 years; SD = 1.9; 47.5% girls) in the CIKEO study, a community-based longitudinal study in the Netherlands. Linear regression was used to assess the associations between the total as well as the individual exposure to SLEs experienced in the past 12 months, and emotional and behavioral problems assessed by CBCL 1.5-5. Interactions of SLEs and child age, sex, ethnic background, and socioeconomic status were explored. Results: Higher total exposure to SLEs, as indicated by the number of SLEs, was significantly associated with higher CBCL total, internalizing and externalizing problem scores (p for trend < 0.05). The results did not differ by child age, sex, ethnic background, or family SES. Six out of the 12 SLEs explored were independently associated with greater CBCL total/externalizing/internalizing scores (p < 0.05). Conclusions: Exposure to SLEs is associated with higher levels of emotional and behavioral problems in young children, and the impact of SLEs may vary depending on the types of events. Stressful life events might be a useful target for interventions to improve emotional and behavioral well-being among young children.

Parental, child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0-7 years old: the CIKEO study

BACKGROUND

A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE.

OBJECTIVE

To investigate factors associated with PSE in parents of children aged 0-7 years old, and to explore whether the associations were different between mothers and fathers.

METHODS

We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE.

RESULTS

Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (- 2.05, 0.87), and 0.23 (- 0.46, 3.29), respectively.

CONCLUSIONS

A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care.

TRIAL REGISTRATION

Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

Factors associated with media use for parenting information: A cross-sectional study among parents of children aged 0-8 years

Aim

Media use may strengthen parents’ capacities to deal with parenting issues. This study examined which factors are associated with media use for parenting information.

Design

Cross‐sectional data of 658 parents of children aged 0–8 years, gathered in the CIKEO cohort study in the Netherlands, were analysed.

Methods

Multivariable logistic regression models were used to examine which factors were associated with media use for parenting information.

Results

The mean age of the participants was 33.8 years (SD = 5.0); 94.7% were mothers; 77.4% used media for parenting information. Parents with more questions or concerns (OR: 1.40, 95% CI: 1.23, 1.59), and parents who received parenting information from their social contacts (OR: 5.57, 95% CI: 3.22, 9.61), had higher odds of media use for parenting information. Older parents (OR: 0.95, 95% CI: 0.91, 1.00), and parents of older children (OR: 0.84, 95% CI: 0.74, 0.95), had lower odds of media use for parenting information.

Rethinking respite in Australia: A naturalistic effect study of a multicomponent community program to promote respite knowledge, attitudes and behaviours of carers of people with dementia

'Rethink Respite' was a prospective, naturalistic cohort study conducted in the Illawarra-Shoalhaven (NSW, Australia) to improve knowledge, attitudes and uptake of respite strategies in carers of people with dementia. A convenience sample of n = 70 carers were recruited in 2014-15 to establish a baseline for knowledge, attitudes and use of respite for a cohort of carers in the region. Carer perceived need for respite, burden and self-efficacy were also assessed. A co-designed multi-component community-based intervention was subsequently rolled at in the region from 2015 to 2016. The intervention supported: awareness raising media; carer education sessions; access to web and print respite information resources; and an option to participate in a tailored one-on-one in-home coaching program. At program completion, a follow-up survey was administered to the cohort, with n = 44/70 responding. All n = 44 respondents reported participation in and exposure to 'Rethink Respite' media, information and education during the intervention period. Eighteen of the 44 also self-selected to receive the active tailored coaching support. At follow-up, few positive results were reported on the assessed carer variables for the cohort over time. However, post hoc sub-group analyses found those who also self-selected to receive active support (provided through coaching) (n = 18), showed improvements to their respite knowledge, attitudes and self-efficacy (p < .05). Intention to use respite, and levels of personal gain from caring in this sub-group also increased (p < .05). In contrast, carers who only participated in the informational/educational aspects of the program (and did not self-select to the respite coaching), experienced negative changes over time to their respite beliefs and 'role captivity'. Overall, this pilot study suggests that passive respite information and educational strategies are insufficient, without more active supports (tailored respite coaching) to address observed carer decline over time. Future research should seek to replicate these results using a larger sample and an experimental design.

A Parental Competence Scale: Dimensions and Their Association With Adolescent Outcomes

Positive family functioning during adolescence is usually studied analyzing parents' competences and children's relationship abilities. We present an instrument for the assessment of parental competence, which encompasses both educational style and transmission of values. The objective of the study was to analyze its factor structure and to assess its value in predicting adolescent outcomes. We recruited 2,459 high school students, aged 12–15, in 40 schools from Spain, Peru, Mexico, and Chile. They responded to the instrument and to other questions regarding lifestyles. Exploratory and confirmatory factor analyses were carried out in order to assess the internal structure of the instrument, and internal consistency of the resulting dimensions was calculated. Finally, regression analyses were performed to establish associations between the parenting dimensions and adolescent outcomes. Factor analyses showed a consistent structure, with good fit indices in the four countries. The final four factors include parenting styles (Warmth and Demandingness) and education in values (Fortitude and Privacy). Regression analyses showed associations with adolescent outcomes. For example, adolescents' life satisfaction was best predicted by Warmth and Education in fortitude. Practical implications are suggested.