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Flaherty SC, Knobf MT, Holland ML, Slade A, Nelson L, Sadler LS. Parenting experiences and outcomes among former adolescent mothers: A mixed methods study. PLoS One 2024; 19:e0303119. [PMID: 38748745 PMCID: PMC11095697 DOI: 10.1371/journal.pone.0303119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
The purpose of this explanatory sequential mixed methods study was to examine parenting outcomes and experiences over time among marginalized adolescent mothers enrolled in randomized clinical trials (RCT) between 2002 and 2016 testing Minding the Baby® (MTB), an early home visiting program. The quantitative phase examined associations between measures of maternal experiences and parenting outcomes from 71 participants 2-8 years since RCT completion. MTB mothers reported less hostile parenting and fewer child behavior problems. The sequential qualitative phase involved interviews with a subsample (n = 31) and revealed six themes about their personal and parenting maturation. Through integration of quantitative and qualitative data, we generated metainferences, revealing a nuanced understanding of participants' experiences. Integrated findings revealed the complex personal and parenting experiences among former adolescent mothers during their developmental phases of emerging and early adulthood. Findings inform clinical and research approaches to promote personal growth and positive parenting outcomes over time among women who began childbearing in adolescence.
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Affiliation(s)
| | - M. Tish Knobf
- Yale University School of Nursing, Orange, CT, United States of America
| | | | - Arietta Slade
- Yale Child Study Center, New Haven, CT, United States of America
| | - LaRon Nelson
- Yale University School of Nursing, Orange, CT, United States of America
| | - Lois S. Sadler
- Yale University School of Nursing, Orange, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
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Gresko SA, Hink LK, Corley RP, Reynolds CA, Muñoz E, Rhee SH. An examination of early socioeconomic status and neighborhood disadvantage as independent predictors of antisocial behavior: A longitudinal adoption study. PLoS One 2024; 19:e0301765. [PMID: 38683790 PMCID: PMC11057761 DOI: 10.1371/journal.pone.0301765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
The present study examined early socioeconomic status (SES) and neighborhood disadvantage (ND) as independent predictors of antisocial behavior (ASB) and addressed the etiology of the associations (i.e., genes versus the environment) using a longitudinal adoption design. Prospective data from the Colorado Adoption Project (435 adoptees, 598 nonadopted children, 526 biological grandparents of adoptees, 481 adoptive parents, and 617 nonadoptive parents including biological parents of unrelated siblings of adoptees) were examined. SES and ND were assessed during infancy and ASB was evaluated from ages four through 16 using parent and teacher report. Associations between predictors and ASB were compared across adoptive and nonadoptive families and sex. Early SES was a nominally significant, independent predictor of antisocial ASB, such that lower SES predicted higher levels of ASB in nonadoptive families only. ND was not associated with ASB. Associations were consistent across aggression and delinquency, and neither SES nor ND was associated with change in ASB over time. Nominally significant associations did not remain significant after controlling for multiple testing. As such, despite nonsignificant differences in associations across sex or adoptive status, we were unable to make definitive conclusions regarding the genetic versus environmental etiology of or sex differences in the influence of SES and ND on ASB. Despite inconclusive findings, in nonadoptees, results were consistent-in effect size and direction-with previous studies in the literature indicating that lower SES is associated with increased risk for ASB.
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Affiliation(s)
- Shelley A. Gresko
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Laura K. Hink
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Chandra A. Reynolds
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, United States of America
- Department of Psychology, University of California Riverside, Riverside, California, United States of America
| | - Elizabeth Muñoz
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, United States of America
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, United States of America
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Donagh B, Taylor J, al Mushaikhi M, Bradbury-Jones C. Sibling Experiences of Adverse Childhood Experiences: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3513-3527. [PMID: 36382953 PMCID: PMC10594841 DOI: 10.1177/15248380221134289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adverse childhood experiences (ACEs) are traumatic events during childhood known to affect health and well-being across the life span. The detrimental impact ACEs have on children and young people is well-established. It is also known that 85 to 90% of children have at least one sibling. Using this as the foundation for our inquiry, the purpose of this scoping review was to understand what we currently know about the experiences of siblings living with ACEs. Sibling relationships are unique, and for some the most enduring of experiences. These relationships can be thought of as bonds held together by love and warmth; however, they can also provide scope for undesirable outcomes, such as escalation of conflicts and animosities. This scoping review was conducted following Arksey and O'Malley's (2005) methodological framework, complemented by the PAGER framework (Bradbury-Jones et al. 2021), offering a structured approach to the review's analysis and reporting through presenting the Patterns, Advances, Gaps, and Evidence for practice and Research. In June 2020, we searched 12 databases, with 11,469 results. Articles were screened for eligibility by the review team leaving a total of 148 articles meeting the inclusion criteria. Included articles highlighted overwhelming evidence of older siblings shielding younger siblings, and the likelihood that when one sibling experiences adversity, other siblings will be experiencing it themselves or vicariously. The implications of this in practice are that support services and statutory bodies need to ensure considerations are given to all siblings when one has presented with experiencing childhood adversity, especially to older siblings who may take far more burden as regards care-giving and protection of younger siblings. Given that more than half of the included articles did not offer any theoretical understanding to sibling experiences of ACEs, this area is of importance for future research. Greater attention is also needed for research exploring different types of sibling relationships (full, step, half), and whether these influence the impact that ACEs have on children and young people.
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Davis SL, Latimer M, Rice M. Biomarkers of Stress and Inflammation in Children. Biol Res Nurs 2023; 25:559-570. [PMID: 37010976 PMCID: PMC10626617 DOI: 10.1177/10998004231168805] [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] [Indexed: 04/04/2023]
Abstract
Background: Children are increasingly exposed to stressors that can affect their immune function. Given the possible negative effects of stress and inflammation on health, researchers need to use appropriate biomarkers to measure both the effects of stress and subsequent inflammatory responses. Purpose: The purpose of this paper is to briefly review stress and inflammatory pathways, identify biomarkers used to measure chronic stress and chronic inflammation particularly in children in clinical and community settings, and to discuss methodological considerations when measuring stress and inflammation in children. Discussion: Biomarkers of chronic stress can be classified as central, meaning they are made in the brain, or peripheral, meaning they are made in the peripheral tissues in response to central signals. The peripheral biomarker, cortisol, is most frequently used in the community setting. In addition, indirect measures, such as oxytocin, may complement the assessment of stress. Common biomarkers of chronic inflammation in children are C-reactive protein (CRP), TNF-α, and IL-6. Similarly, indirect biomarkers of chronic inflammation, such as IL-2 and IL-1β, may also be considered. Conclusions: Various types of specimens can be used to measure these biomarkers of stress and inflammation including blood, saliva, urine, sweat, hair, nails, and tears. Each type of specimen has different requirements for collection, storage, and assay. Future research would benefit from standardized biomarker levels across age and development in children and incorporation of other biomarkers.
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Affiliation(s)
- Sara L. Davis
- College of Nursing, University of South Alabama, Mobile, AL, USA
| | - Mary Latimer
- School of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marti Rice
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Wilton KS, Murphy KM, Mahmud A, Azam S, Habib A, Ibrahim I, Della Neve E, Pena G, Mehrin SF, Shiraji S, Hamadani JD. Adapting Reach Up and Learn in Crisis and Conflict Settings: An Exploratory Multiple Case Study. Pediatrics 2023; 151:191218. [PMID: 37125885 DOI: 10.1542/peds.2023-060221k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES In 2019, >71 million children aged <5 had spent their entire lives in conflict-affected settings. Compounding adversities including violence, poverty, and displacement have immediate and long-term effects on early childhood development, health, behavior, and well-being. In response, adaptations of Reach Up have been implemented in conflict and crisis settings. METHODS This article uses exploratory multiple case study methodology, drawing from implementation and qualitative data from 3 interventions: a mobile phone-based intervention promoting nurturing care among Rohingya and crisis-affected host communities in Bangladesh; Reach Up amid acute violence and displacement in Northeast Syria; and Reach Up group sessions and home visits integrated with health services for an indigenous population in Venezuela. RESULTS In Bangladesh, tailoring interactive voice response messages improved responsiveness to the developmental needs of young children, yet complementary in-person services were identified as a key program enhancement. In Syria, rapid adaptations of Reach Up addressed the needs of families in acute crisis, including social-emotional learning games for school-aged children. In Venezuela, Reach Up, coupled with complementary lactation counseling, yielded high rates of uptake and satisfaction, and children's language development was highlighted as a key area of growth. CONCLUSIONS Recommendations to promote early childhood development in crisis and conflict settings include: (1) cultural adaptation based on a holistic understanding of children and caregivers' needs; (2) the integration of child and family safety and linkages with complementary services on the basis of community needs and priorities, and (3) the importance of designing for scale through blended models and costing analyses.
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Affiliation(s)
| | | | - Ahsan Mahmud
- International Rescue Committee, New York, New York
| | - Syful Azam
- International Rescue Committee, New York, New York
| | - Anika Habib
- International Rescue Committee, New York, New York
| | - Iman Ibrahim
- International Rescue Committee, New York, New York
| | | | | | - Syeda Fardina Mehrin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
| | - Shamima Shiraji
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
| | - Jena Derakhshani Hamadani
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
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Silovsky J, Bard D, Owora AH, Milojevich H, Jorgensen A, Hecht D. Risk and Protective Factors Associated with Adverse Childhood Experiences in Vulnerable Families: Results of a Randomized Clinical Trial of SafeCare®. CHILD MALTREATMENT 2023; 28:384-395. [PMID: 35576407 DOI: 10.1177/10775595221100723] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Early adversity predicts increased risk for mental and physical health problems. As such, intervention efforts, such as home-based parenting programs, have been initiated with vulnerable families to reduce adversity exposure and promote child well-being. The present randomized clinical trial had a parallel design and 1:1 allocation ratio of SafeCare augmented for an urban high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine risk and protective factors proximal to child maltreatment. Parents (N=562) of young children (5 years or less) at risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. A significant program effect was found in favor of SC+ for parental depression and social support, as well as within-group improvements for both groups in depression, intimate partner victimization, family resources, and social support. Promising next steps include future trials examining how improvements in parental depression and social support impact child well-being over time and further augmentation of SafeCare to enhance healthy relationships and address cultural congruency of services.
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Affiliation(s)
| | - David Bard
- Pediatrics, 6186OUHSC, Oklahoma City, OK, USA
| | - Arthur H Owora
- Department of Epidemiology and Biostatistics, 41473Indiana University Bloomington School of Public Health, Bloomington, IN, USA
| | | | | | - Debra Hecht
- Pediatrics, 6186OUHSC, Oklahoma City, OK, USA
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Tobón AL, Condon E, Slade A, Holland ML, Mayes LC, Sadler LS. Participation in an Attachment-Based Home Visiting Program Is Associated with Lower Child Salivary C-Reactive Protein Levels at Follow-Up. J Dev Behav Pediatr 2023; 44:e292-e299. [PMID: 37126599 PMCID: PMC10353420 DOI: 10.1097/dbp.0000000000001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/21/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Exposure to early childhood adversity is associated with an increased risk for physiological disruption, including increased inflammation. Early interventions that support the mother-child relationship have been shown to potentially buffer negative psychosocial outcomes related to early adversity, but it is unclear whether these interventions have long-term biological effects. We evaluated whether prior participation in Minding the Baby® (MTB), an attachment-based home visiting intervention for young mother-infant dyads living in underserved communities, is associated with lower child salivary inflammatory biomarkers compared with controls at follow-up. METHODS Ninety-seven maternal-child dyads (n = 43 intervention and n = 54 controls) enrolled in a follow-up study of the MTB randomized controlled trial, an average of 4.6 years after RCT completion. Children provided salivary specimens. We used adjusted linear regression to examine the relationship between MTB participation and child salivary inflammatory biomarkers (C-reactive protein [CRP], interleukin [IL]-1β, IL-6, IL-8, and TNF-α). RESULTS Children were on average 6.6 years old, 48% female, and identified as non-Hispanic/Latino Black/African American (34%) and Hispanic/Latino (63%). Participation in MTB was associated with lower salivary CRP levels (β = -0.31, SE = 0.28, p = 0.003) compared with controls. Participation in MTB was not associated with salivary cytokine levels. DISCUSSION Participation in an intensive two-generation home visiting intervention such as MTB may reduce salivary inflammatory biomarkers associated with early childhood adversity. Replication and further research are needed to improve the understanding of the potential for early childhood interventions to buffer the biological embedding of early adversity.
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Affiliation(s)
- Amalia Londoño Tobón
- MedStar Georgetown University Hospital, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington, DC
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT CT
| | - Eileen Condon
- University of Connecticut School of Nursing, Storrs, CT
| | - Arietta Slade
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT CT
| | - Margaret L. Holland
- Department of Population Health & Leadership, University of New Haven, New Haven, CT
| | - Linda C. Mayes
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT CT
| | - Lois S. Sadler
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT CT
- Yale School of Nursing, New Haven, CT
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Zhou K, Chen J, Huang C, Tang S. Prevalence of and factors influencing depression and anxiety among Chinese adolescents: a protocol for a systematic review. BMJ Open 2023; 13:e068119. [PMID: 36958770 PMCID: PMC10040053 DOI: 10.1136/bmjopen-2022-068119] [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] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Depression and anxiety are common mental health disorders among adolescents and negatively impact their physical and mental health. Depression and anxiety also exert a tremendous economic burden to society. But in China, there is no systematic review to state the exact prevalence of adolescent depression and anxiety; there is also a lack of systematic reviews of factors that influence depression and anxiety. Hence, in this systematic review, we aim to summarise the current evidence of the prevalence of and factors influencing depression and anxiety among Chinese adolescents. METHODS AND ANALYSIS This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will comprehensively search four English databases (PubMed, Web of Science, CINAHL in EBSCO interface, PsycINFO in ProQuest interface) and three Chinese databases (China National Knowledge Infrastructure, WanFang and SinoMed) for studies from inception to 31 August 2022. Screening for eligible studies and data extraction will be conducted by two reviewers independently, and all discrepancies will be resolved through group discussion. ETHICS AND DISSEMINATION Because this is a review of published studies, no ethical approval is required. The results will be reported in a peer-reviewed journal or disseminated at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42022299943.
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Affiliation(s)
- Keyi Zhou
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiarui Chen
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Central South University, Changsha, China
| | - Chongmei Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Slade A. Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman. Infant Ment Health J 2023; 44:290-297. [PMID: 36938795 DOI: 10.1002/imhj.22051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/21/2023]
Abstract
Nancy Suchman is remembered as a pioneer whose mentalization-based intervention-Mothering from the Inside Out (MIO)-transformed the treatment of parents struggling with substance use disorders. Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent-child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.
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Affiliation(s)
- Arietta Slade
- Yale Child Study Center, New Haven, Connecticut, USA
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Davis SL, Soistmann HC. Child's perceived stress: A concept analysis. J Pediatr Nurs 2022; 67:15-26. [PMID: 35882112 PMCID: PMC10167593 DOI: 10.1016/j.pedn.2022.07.013] [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: 10/12/2021] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
PROBLEM Child's perceived stress is a term used widely in literature, yet it is poorly defined. Perceived stress in childhood has been linked to negative health outcomes throughout the lifespan. Therefore, the ability of researchers and healthcare providers to conceptualize child's perceived stress and form accurate measures of the concept is of utmost importance. ELIGIBILITY CRITERIA Following the eight steps identified by Walker and Avant, a literature review was conducted to identify studies that measured perceived stress in school-age children over the last 10 years. SAMPLE Of 914 records identified, 136 were screened, and 16 met inclusion criteria. RESULTS Child's perceived stress is best defined as any actual or imagined threat, personal and specific to childhood, which overwhelms the child and leads to changes in emotional, psychological, developmental, and/or physiological domains. CONCLUSIONS While the concept of child's perceived stress is understood similarly throughout studies, there is notable variation in the way child's perceived stress is measured. Because of the specificity of perceived stress to childhood, and the wide range of what may be perceived as stressful by the child, the child is the best reporter of child's perceived stress. IMPLICATIONS Researchers and clinicians must use child self-report tools to measure the concept of child's perceived stress. Opportunities exist for healthcare workers to intervene, educate, and help children and families recognize and manage child's perceived stress. This concept analysis includes many resources that practitioners may use to help alleviate stress in children.
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Affiliation(s)
- Sara L Davis
- University of South Alabama College of Nursing, 5721 Dr. N., Mobile, AL 36608, USA.
| | - Heather C Soistmann
- Penn State Health Children's Hospital, 500 University Dr, Hershey, PA 17033, USA.
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Fortuna LR, Tobón AL, Anglero YL, Postlethwaite A, Porche MV, Rothe EM. Focusing on Racial, Historical and Intergenerational Trauma, and Resilience: A Paradigm to Better Serving Children and Families. Child Adolesc Psychiatr Clin N Am 2022; 31:237-250. [PMID: 35361362 DOI: 10.1016/j.chc.2021.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research across populations demonstrates that intergenerational trauma can have lasting biological, psychological, and social consequences and affects groups of individuals in different ways. An appreciation of intergenerational trauma as experienced in diverse populations is important not only for understanding vulnerabilities and risk but also for cultivating opportunities for posttraumatic growth and healing. Understanding the contexts of trauma for children and families and the unveiling of structural inequities, both past and present, offers the opportunity to address these in using clinical and systems of care approaches in the public health spheres.
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Affiliation(s)
- Lisa R Fortuna
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA.
| | - Amalia Londoño Tobón
- National Institutes of Health, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Yohanis Leonor Anglero
- Boston Children's Hospital, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | | | - Michelle V Porche
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA
| | - Eugenio M Rothe
- Herbert Wertheim College of Medicine Florida International University, FIU Health Miami, 11200 Southwest 8th Street, Miami, FL 33199, USA
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Londono Tobon A, Condon E, Sadler LS, Holland ML, Mayes LC, Slade A. School age effects of Minding the Baby-An attachment-based home-visiting intervention-On parenting and child behaviors. Dev Psychopathol 2022; 34:55-67. [PMID: 32907642 DOI: 10.1017/s0954579420000905] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Multiple interventions have been developed to improve the caregiver-child relationship as a buffer to the effects of early life adversity and toxic stress. However, relatively few studies have evaluated the long-term effects of these early childhood interventions, particularly on parenting and childhood behaviors. Here we describe the early school-age follow-up results of a randomized controlled trial of Minding the Baby ® (MTB), a reflective, attachment-based, trauma-informed, preventive home-visiting intervention for first-time mothers and their infants. Results indicate that mothers who participated in MTB are less likely to show impaired mentalizing compared to control mothers two to eight years after the intervention ended. Additionally, MTB mothers have lower levels of hostile and coercive parenting, and their children have lower total and externalizing problem behavior scores when compared to controls at follow-up. We discuss our findings in terms of their contribution to understanding the long-term parenting and childhood socio-emotional developmental effects of early preventive interventions for stressed populations.
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Affiliation(s)
| | | | - Lois S Sadler
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
| | | | - Linda C Mayes
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Arietta Slade
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
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Roben CKP, Kipp E, Schein SS, Costello AH, Dozier M. Transitioning to telehealth due to COVID-19: Maintaining model fidelity in a home visiting program for parents of vulnerable infants. Infant Ment Health J 2021; 43:173-184. [PMID: 34964152 PMCID: PMC9015513 DOI: 10.1002/imhj.21963] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
Maintaining treatment fidelity when implementing evidence‐based interventions is a significant challenge. The inability to deliver in‐person services due to the COVID‐19 pandemic critically challenged the foundation of implementation fidelity for home visiting programs across the globe. The Attachment and Biobehavioral Catch‐Up (ABC) program is an evidence‐based home visiting intervention designed to increase sensitivity in parents of infants who have experienced early adversity. ABC's community effectiveness is due to rigorous fidelity monitoring and supervision. Fidelity is measured by microanalytic coding of parenting opportunities and “in‐the‐moment” commenting, the active ingredient of ABC. In this study, we examined intervention fidelity among parent coaches implementing ABC through telehealth. Random 5‐min clips from 510 telehealth ABC session videos conducted by 91 parent coaches at 48 agencies were coded for their frequency and quality of in‐the‐moment comments. On average, parent coaches were able to exceed in‐person commenting fidelity standards when implementing ABC through the telehealth format. The active fidelity monitoring and supervision inherent to ABC's dissemination afforded a smooth transition to implementing ABC through telehealth while adhering to fidelity standards. Procedural and clinical challenges to telehealth implementation are discussed, along with future directions for telehealth program effectiveness.
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Affiliation(s)
| | - Evan Kipp
- University of Delaware, Newark, Delaware, USA
| | | | | | - Mary Dozier
- University of Delaware, Newark, Delaware, USA
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Gandhi KD, Romanowicz M, Croarkin PE, Thapa P, Limbeck M, Desai J, Benarroch AJM, Shekunov J. Childhood psychiatric outcomes in the context of suspected neglect and abuse reports related and unrelated to parental substance use. CHILD ABUSE & NEGLECT 2021; 122:105344. [PMID: 34600277 PMCID: PMC8612970 DOI: 10.1016/j.chiabu.2021.105344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child maltreatment is prevalent in the United States and carries long-term consequences. Parental substance use may have associations with child maltreatment. It is unclear whether co-occurring parental substance use aggravates childhood psychiatric outcomes related to suspected maltreatment. OBJECTIVE To compare psychiatric and healthcare utilization outcomes in children with suspected abuse reports, with and without documented parental substance use. PARTICIPANTS AND SETTING Retrospective cohort study (n = 2831) of children with suspected abuse/neglect (SANC) reports filed in the electronic health record between January 1, 2000 and January 1, 2016. Children who had SANC reports referencing parental substance use (n = 458) were compared with those who had SANC reports that did not reference substance use (n = 2346). METHODS Outcome data included ICD-10 coded medical and psychiatric diagnoses and healthcare utilization. RESULTS Compared to children who had a SANC report filed without parental substance use, children with parental substance use in a SANC showed significantly lower age-adjusted odds of anxiety disorder, mood disorder and externalizing disorder, and higher odds of a substance use disorder diagnosis. They were also less likely to present to an emergency department visit for any reason in the year prior to the report. CONCLUSIONS Children with exposure to parental substance use in a household where parental abuse or neglect was suspected had lower odds of adverse psychiatric outcomes as compared to children with suspected report of abuse or neglect unrelated to parental substance use. The present findings highlight the complex interplay of psychosocial factors associated with outcomes of childhood maltreatment.
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Affiliation(s)
- Kriti D Gandhi
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Children's, National Takoma Theatre, 6833 4th Street NW, Washington, DC 20012, USA
| | - Magdalena Romanowicz
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Prabin Thapa
- Department of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Mara Limbeck
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; University of Minnesota, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA
| | - Jinal Desai
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; University of North Dakota School of Medicine & Health Sciences, Department of Psychiatry & Behavioral Science, 1919 Elm St N, Fargo, ND 58102-2416, USA
| | - Amanda J M Benarroch
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Julia Shekunov
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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15
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Condon EM, Londono Tobon A, Jackson B, Holland ML, Slade A, Mayes L, Sadler LS. Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention. Nurs Res 2021; 70:S43-S52. [PMID: 34173377 PMCID: PMC8405547 DOI: 10.1097/nnr.0000000000000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism. OBJECTIVE The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention. METHODS Ninety-seven maternal-child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention. RESULTS Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels. DISCUSSION Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.
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16
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Wulczyn F, Parolini A, Huhr S. Human capital and child protection: A research framework in the CRC context. CHILD ABUSE & NEGLECT 2021; 119:104610. [PMID: 32646607 DOI: 10.1016/j.chiabu.2020.104610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Since it was adopted November 1989, the Convention on the Rights of the Child has shaped the objectives for child protection systems around the world. Generally, those objectives fall along three dimensions: permanency, safety, and well-being. However, despite well-being receiving increasing attention in light of evidence that points to the importance of early childhood experiences on life course outcomes, child protection systems have so far struggled to find clear definition of well-being as a developmental construct. In this article, we propose a definition of child well-being that draws on the economic literature pertaining to skill formation and human capital. We argue that human capital, as a multidimensional concept that incorporates cognitive skills, non-cognitive skills, and health, should be added to the list of considerations policy makers contemplate when their attention turns to well-being provided there is research evidence for doing so. To that end, we discuss the several advantages the human capital framework offers within a child protection context. We then describe a theoretical framework and analytical approach to the study of skill formation. We are particularly interested in dynamic models wherein the skills one has influence the rate at which new skills are acquired, with specific emphasis on risk and protective factors across the life course of childhood. Overall, our discussion highlights how a dynamic model of human capital formation aligns with Convention on the Rights of the Child and notions that children in child protection systems have a right to develop the abilities they will need to be responsible adults.
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Affiliation(s)
- Fred Wulczyn
- Center for State Child Welfare Data, Chapin Hall Center for Children, University of Chicago.
| | - Arno Parolini
- Department of Social Work, University of Melbourne, 161 Barry Street, Carlton, VIC 3053, Australia
| | - Scott Huhr
- Center for State Child Welfare Data, Chapin Hall Center for Children, University of Chicago
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17
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Garner A, Yogman M. Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health. Pediatrics 2021; 148:peds.2021-052582. [PMID: 34312296 DOI: 10.1542/peds.2021-052582] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
By focusing on the safe, stable, and nurturing relationships (SSNRs) that buffer adversity and build resilience, pediatric care is on the cusp of a paradigm shift that could reprioritize clinical activities, rewrite research agendas, and realign our collective advocacy. Driving this transformation are advances in developmental sciences as they inform a deeper understanding of how early life experiences, both nurturing and adverse, are biologically embedded and influence outcomes in health, education, and economic stability across the life span. This revised policy statement on childhood toxic stress acknowledges a spectrum of potential adversities and reaffirms the benefits of an ecobiodevelopmental model for understanding the childhood origins of adult-manifested disease and wellness. It also endorses a paradigm shift toward relational health because SSNRs not only buffer childhood adversity when it occurs but also promote the capacities needed to be resilient in the future. To translate this relational health framework into clinical practice, generative research, and public policy, the entire pediatric community needs to adopt a public health approach that builds relational health by partnering with families and communities. This public health approach to relational health needs to be integrated both vertically (by including primary, secondary, and tertiary preventions) and horizontally (by including public service sectors beyond health care). The American Academy of Pediatrics asserts that SSNRs are biological necessities for all children because they mitigate childhood toxic stress responses and proactively build resilience by fostering the adaptive skills needed to cope with future adversity in a healthy manner.
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Affiliation(s)
- Andrew Garner
- Partners in Pediatrics, Westlake, Ohio.,School of Medicine, Case Western Reserve University, Cleveland, Ohio
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18
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Otto B, Kokkelink L, Brüne M. Borderline Personality Disorder in a "Life History Theory" Perspective: Evidence for a Fast "Pace-of-Life-Syndrome". Front Psychol 2021; 12:715153. [PMID: 34381406 PMCID: PMC8350476 DOI: 10.3389/fpsyg.2021.715153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 01/31/2023] Open
Abstract
"Borderline Personality Disorder" (BPD) is associated with heightened risk for cardiovascular disease and other stress-associated somatic consequences, which is poorly understood in terms of causal mechanisms, such as childhood trauma. Here, we tested the hypothesis suggesting that BPD reflects a fast "Pace-of-Life-Syndrome" (PoLS). Ninety-five women (44 diagnosed with BPD) were recruited to examine psychological correlates of PoLS, including life history features, personality dimensions, aggressiveness, chronic stress, borderline symptom severity, childhood trauma, and allostatic load (AL). In line with expectations, BPD patients had significantly higher scores suggestive of a fast PoLS than controls, they were more aggressive, more burdened with chronic stress and were exposed to more severe childhood adversity. Childhood trauma predicted PoLS, which in turn predicted AL. The present study thus provides direct evidence of psychological and somatic traits associated with the fast end of the PoLS spectrum in females with BPD. Findings are discussed with regard to clinical implications.
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Affiliation(s)
| | | | - Martin Brüne
- LWL University Hospital Bochum, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr-University Bochum, Bochum, Germany
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19
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [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: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
| | - Susan J Spieker
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
| | - Cathryn Booth-LaForce
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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20
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Demeusy EM, Handley ED, Manly JT, Sturm R, Toth SL. Building Healthy Children: A preventive intervention for high-risk young families. Dev Psychopathol 2021; 33:598-613. [PMID: 33757620 PMCID: PMC8105280 DOI: 10.1017/s0954579420001625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.
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Affiliation(s)
| | | | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Robin Sturm
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
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21
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Carbone JT, Jackson DB, Holzer KJ, Vaughn MG. Childhood adversity, suicidality, and non-suicidal self-injury among children and adolescents admitted to emergency departments. Ann Epidemiol 2021; 60:21-27. [PMID: 33932570 DOI: 10.1016/j.annepidem.2021.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This population-based study explored the associations between childhood adversity and admission to emergency departments (EDs) with non-suicidal self-injury (NSSI) and with a suicide attempt. METHODS A nationally representative cross-sectional sample of 5-17-year-olds admitted to EDs (N = 143,113,677) from 2006 to 2015 was utilized to assess the associations between childhood adversities, NSSIs, and suicide attempts. RESULTS ED admissions with NSSI and admissions with a suicide attempt were associated with greater odds of exposure to individual childhood adversities (aORs: 1.34 to 5.86; aORs: 2.37 to 15.69, respectively). ED admissions with a suicide attempt were associated with greater odds of exposure to childhood adversities that might be perceived as less extreme or harmful (separation or divorce aOR: 15.69) than other adversities (death of a family member aOR: 13.38; history of physical abuse aOR: 9.56) as well as greater odds of exposure to three or more childhood adversities (aOR: 20.98). CONCLUSION Early detection of childhood adversities is important for identifying potential risk factors for self-harm. ED admission data can provide population-level surveillance to aid in these efforts and lead to more targeted and effective interventions aimed at reducing the negative effects of toxic stress that can result from exposure to childhood adversities.
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Affiliation(s)
- Jason T Carbone
- Wayne State University, Wayne State University, School of Social Work, Integrative Biosciences (IBio) Center, Detroit, MI, United States.
| | - Dylan B Jackson
- Johns Hopkins University, Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, Baltimore, MD, United States
| | - Katherine J Holzer
- Washington University in St. Louis, School of Medicine, Division of Clinical and Translational Research, St. Louis, MO, United States
| | - Michael G Vaughn
- Saint Louis University, College for Public Health and Social Justice, School of Social Work, St. Louis, MO, United States; Yonsei University, Department of Social Welfare, Seoul, Korea
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22
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Doove BM, Feron FJM, van Os J, Drukker M. Preschool Communication: Early Identification of Concerns About Preschool Language Development and Social Participation. Front Public Health 2021; 8:546536. [PMID: 33585376 PMCID: PMC7874213 DOI: 10.3389/fpubh.2020.546536] [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] [Received: 03/28/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Adverse communication development in preschool children is a risk factor influencing child health and well-being with a negative impact on social participation. Language and social skills develop and maintain human adaptability over the life course. However, the accuracy of detecting language problems in asymptomatic children in primary care needs to be improved. Therefore, it is important to identify concerns about language development as a risk factor for child health. The association between parental and professional caregivers' concerns about language development and the level of preschool social participation was assessed, as well as the possible mediating/moderating effect of the perception of social competence. In addition, validity and predictive value of parental and professional caregivers' concerns about language development were tested. Methods: To identify emerging concerns about development and social participation, a community sample of 341 preschool children was systematically assessed with a comprehensive preventive child health care "toolkit" of instruments, including parent-completed tools like the Parents' Evaluation of Developmental Status (PEDS) and child competence Visual Analog Scales (VAS). At baseline, children were aged 3 years and at follow-up ~4 years. Results: There was a statistically significant association between parental and professional caregivers' concerns about language development and the level of preschool social participation, with a mediating effect of child social competence at the age of 3 years as well as 4 years. Negative predictive value of parental and professional caregiver language concerns at the age of 3 and 4 years were 99 and 97%, respectively. Furthermore, this article showed that while some preschool children grow out of language problems, others may develop them. Conclusion: Short but valid pediatric primary care tools like the PEDS and child competence VAS can support monitoring and early identification of concerns about language development and social competence as a risk factor for preschool social participation. Personalized health care requires continued communication between parents, professional caregivers and preventive child health care about parental and professional caregiver perceptions concerning preschool language development as well as the perception of a child's social competence.
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Affiliation(s)
- Bernice M Doove
- Youth Health Care Division, Regional Public Health Service South Limburg, Heerlen, Netherlands.,Department of Social Medicine, Care and Public Health Research Institute, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Frans J M Feron
- Department of Social Medicine, Care and Public Health Research Institute, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Jim van Os
- King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom.,Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, Maastricht, Netherlands.,Department Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, Maastricht, Netherlands
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23
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Stacks AM, Jester JM, Wong K, Huth-Bocks A, Brophy-Herb H, Lawler J, Riggs J, Ribaudo J, Muzik M, Rosenblum KL. Infant mental health home visiting: intervention dosage and therapist experience interact to support improvements in maternal reflective functioning. Attach Hum Dev 2021; 24:53-75. [PMID: 33427582 DOI: 10.1080/14616734.2020.1865606] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study examined changes in parental reflective functioning (PRF) among mothers enrolled in Infant Mental Health-Home Visiting (IMH-HV) and explored whether parental risk, treatment dosage or therapist experience predicted change in PRF. Participants included 75 mothers and their children who were enrolled in IMH-HV delivered by Community Mental Health therapists. Results indicated significant improvements in PRF from baseline to 12-months. Maternal demographic and psychosocial risk, therapist experience and treatment dosage were not directly associated with changes in PRF. However, Mothers who received more treatment sessions from therapists with six or more years of experience demonstrated the greatest improvements in PRF, while mothers who received more treatment sessions from therapists who had been practicing IMH for less than 15 months showed a decline in PRF. Therapists working with very high-risk families may need specific training and ongoing reflective supervision over a period of years to promote improvement in PRF.
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Affiliation(s)
- Ann M Stacks
- Merrill-Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
| | - Jennifer M Jester
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Kristyn Wong
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Alissa Huth-Bocks
- Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Holly Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Jamie Lawler
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Jessica Riggs
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Julie Ribaudo
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Maria Muzik
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
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24
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Brisson D, McCune S, Wilson JH, Speer SR, McCrae JS, Hoops Calhoun K. A Systematic Review of the Association between Poverty and Biomarkers of Toxic Stress. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:696-713. [PMID: 32657246 DOI: 10.1080/26408066.2020.1769786] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose: Toxic stress has been identified as a key mechanism by which poverty impacts health and empirical evidence on the relationship between poverty and biological markers of toxic stress is accumulating. This study synthesizes the empirical evidence of the relationship between poverty and biomarkers of toxic stress. Method: We conduct a systematic literature review using PRISMA guidelines to assess the relationship between poverty and toxic stress. A total of 56 articles are included in the review assessing 63 poverty and toxic stress relationships. Results: Seventeen of 30 reviewed relationships showed a statistically significant relationship between our measures of poverty and biomarker outcomes. Additionally, 12 of the remaining 13 studies demonstrated partially statistically significant relationship between our poverty measures and biomarker outcomes. Conclusion: Findings demonstrate evidence of the relationship between poverty and toxic stress. Consistently, poverty was related to biological stress and neighborhood poverty was related to physical stress outcomes.
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Affiliation(s)
- Daniel Brisson
- Graduate School of Social Work, University of Denver , Denver, CO, USA
| | - Sarah McCune
- Graduate School of Professional Psychology, University of Denver , Denver, CO, USA
| | - Jennifer H Wilson
- Graduate School of Social Work, University of Denver , Denver, CO, USA
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25
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Minding the Baby®: Enhancing parental reflective functioning and infant attachment in an attachment-based, interdisciplinary home visiting program. Dev Psychopathol 2020; 32:123-137. [PMID: 30636649 DOI: 10.1017/s0954579418001463] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In this article, we describe the results of the second phase of a randomized controlled trial of Minding the Baby (MTB), an interdisciplinary reflective parenting intervention for infants and their families. Young first-time mothers living in underserved, poor, urban communities received intensive home visiting services from a nurse and social worker team for 27 months, from pregnancy to the child's second birthday. Results indicate that MTB mothers' levels of reflective functioning was more likely to increase over the course of the intervention than were those of control group mothers. Likewise, infants in the MTB group were significantly more likely to be securely attached, and significantly less likely to be disorganized, than infants in the control group. We discuss our findings in terms of their contribution to understanding the impacts and import of intensive intervention with vulnerable families during the earliest stages of parenthood in preventing the intergenerational transmission of disrupted relationships and insecure attachment.
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26
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Tavalire HF, Budd EL, Natsuaki MN, Neiderhiser JM, Reiss D, Shaw DS, Ganiban JM, Leve LD. Using a sibling-adoption design to parse genetic and environmental influences on children's body mass index (BMI). PLoS One 2020; 15:e0236261. [PMID: 32687510 PMCID: PMC7371159 DOI: 10.1371/journal.pone.0236261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 07/01/2020] [Indexed: 12/13/2022] Open
Abstract
Dietary and physical activity behaviors formed early in life can increase risk for childhood obesity and have continued negative consequences for lifelong health. Previous research has highlighted the importance of both genetic and environmental (e.g., cultural environment or parental lifestyle) contributions to obesity risk, although these studies typically involve genetically-related individuals residing in the same household, where genetic similarity and rearing environment are inextricably linked. Here we utilize a sibling-adoption design to independently estimate genetic and environmental contributions to obesity risk in childhood and describe how these influences might vary as children age. As part of a prospective adoption study, the current investigation used data from biological siblings reared either apart or together, and nonbiological siblings reared together to estimate the contributions of genetics and environment to body mass indices (BMI) in a large cohort of children (N = 711). We used a variance partitioning model to allocate variation in BMI to that which is due to shared genetics, common environment, or unique environment in this cohort during middle childhood and adolescence. We found 63% of the total variance in BMI could be attributed to heritable factors in middle childhood sibling pairs (age 5-11.99; 95% CI [0.41,0.85]). Additionally, we observed that common environment explained 31% of variation in BMI in this group (95% CI [0.11,0.5]), with unique environment and error explaining the remaining variance. We failed to detect an influence of genetics or common environment in older sibling pairs (12-18) or pairs spanning childhood and adolescence (large sibling age difference), but home type (adoptive versus birth) was an important predictor of BMI in adolescence. The presence of strong common environment effects during childhood suggests that early interventions at the family level in middle childhood could be effective in mitigating obesity risk in later childhood and adolescence.
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Affiliation(s)
- Hannah F. Tavalire
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Instutite of Ecology and Evolution, University of Oregon, Eugene, Oregon, United States of America
| | - Elizabeth L. Budd
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, California, United States of America
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - David Reiss
- Child Study Center, Yale University, New Haven, Connecticut, United States of America
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jody M. Ganiban
- Department of Psychology, George Washington University, Washington, DC, United States of America
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
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27
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Tuke R, Sikorskii A, Zalwango SK, Webster KD, Ismail A, Pobee RA, Barkin JL, Boivin MJ, Giordani B, Ezeamama AE. Psychosocial Adjustment in Ugandan Children: Coping With Human Immunodeficiency Virus Exposure, Lifetime Adversity, and Importance of Social Support. New Dir Child Adolesc Dev 2020; 2020:55-75. [PMID: 32618425 DOI: 10.1002/cad.20354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cumulative lifetime adversity and social support were investigated as determinants of psychosocial adjustment (esteem, distress, hopefulness, positive outlook/future aspirations, and sense of purpose) over 12 months in 6-10-years-old HIV-infected, HIV-exposed uninfected and HIV-unexposed uninfected children from Uganda. Each determinant and psychosocial adjustment indicator was self-reported using standardized questionnaires administered at baseline, 6, and 12 months. Linear mixed effects models were used to relate time-varying lifetime adversity and social support to psychosocial adjustment over 12 months. Regardless of HIV status, higher adversity predicted lower esteem (coefficient b = -2.98, 95% confidence interval (CI): [-4.62, -1.35]) and increased distress (b =3.96, 95% CI: [1.29, 6.62]) but was not associated with hopefulness, positive outlook or sense of purpose. Low social support predicted higher distress (b =9.05, 95% CI: [7.36, 10.73]), lower positive outlook (b = -10.56, 95% CI: [-2.34, -8.79]) and low sense of purpose (b = -9.90, 95% CI: [-11.44, -8.36]) over 12 months. Pragmatic interventions that enhance coping with adversity and provide emotional/instrumental support should be tested for effectiveness in promoting resilient psychosocial adjustment trajectory in vulnerable children.
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Simkin-Tran K, Harman B, Nicolson S. Mentalisation Amongst Maternal and Child Health Nurses Using the Newborn Behavioural Observations With Infant-mother dyads: A Qualitative Study. J Pediatr Nurs 2020; 53:e21-e27. [PMID: 32057640 DOI: 10.1016/j.pedn.2020.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE This study explored Maternal and Child Health Nurses' (MCHN) mentalisation processes towards infant-mother dyads when using the Newborn Behavioural Observations (NBO) system in practice. DESIGN AND METHODS Ten Australian MCHNs (female; aged 31-66 years), who had used the NBO clinically within the last 12 months, were recruited from a database of NBO-trained practitioners. Interpretative phenomenological analysis of one-on-one semi-structured interviews explored MCHNs experiential meaning-making. RESULTS Analysis of the data produced four main themes: reflections regarding the dyad, personal reflections, reflection into action, and professional identity and future practice. MCHNs reported that the NBO's focus on the pre-verbal infant provided them with an added dynamic to consultations outside of the practitioner-caregiver relationship. Thus, they were able to provide holistic and collaborative relationship support to infant-mother dyads. Emotional satisfaction and pride in profession were also reported; in current literature, these factors have been found to reduce burnout in primary care providers. CONCLUSIONS The NBO appears to promote practitioner mentalisation, offering MCHNs a framework and confidence to apply infant mental health theory practically. PRACTICE IMPLICATIONS The NBO offers potential benefits to child and family health nursing practice, and other primary care providers, who offer infant mental health and relationship support as part of their work with families in the first three months. The NBO also provides a means to shift from prescriptive to mentalisation-based, infant-inclusive, and individualised practice.
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Affiliation(s)
- Kim Simkin-Tran
- School of Arts and Humanities, Edith Cowan University, WA, Australia; The Centre for Women's Mental Health, The Royal Women's Hospital, VIC, Australia.
| | - Bronwyn Harman
- School of Arts and Humanities, Edith Cowan University, WA, Australia
| | - Susan Nicolson
- The Centre for Women's Mental Health, The Royal Women's Hospital, VIC, Australia; University of Melbourne Department of Psychiatry, VIC, Australia
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Srivastav A, Davis RE, Strompolis M, Crouch E, Thrasher JF, Spencer M. Responding to Adverse Childhood Experiences: Understanding the Role of Safe, Stable, and Nurturing Relationships in Reducing Alcohol and Tobacco Related Risk Behaviors. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1774027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Aditi Srivastav
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Children’s Trust of South Carolina, Columbia, SC, USA
| | - Rachel E. Davis
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Elizabeth Crouch
- Department of Health Services, Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Mindi Spencer
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Srivastav A, Spencer M, Strompolis M, Thrasher JF, Crouch E, Palamaro-Munsell E, Davis RE. Exploring practitioner and policymaker perspectives on public health approaches to address Adverse Childhood Experiences (ACEs) in South Carolina. CHILD ABUSE & NEGLECT 2020; 102:104391. [PMID: 32018214 DOI: 10.1016/j.chiabu.2020.104391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/13/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We examined the perspectives of child and family-serving professionals (CFSP) and state policymakers on protective factors to develop policy and program recommendations including current and needed approaches for addressing ACEs. METHODS In 2018, we conducted semi-structured, in-depth interviews with 23 CFSP and 24 state policymakers in South Carolina. Data were analyzed applying the Multiple Streams Theory using thematic analyses. RESULTS CFSPs and policymakers had varying opinions on state government involvement and primary prevention for ACEs. Three protective factors emerged from their perspectives: 1) loving, trusting, and nurturing relationships; 2) safe home environments; and 3) opportunities to thrive. For each of these protective factors, participants suggested policy options that support existing community efforts, attempt to alleviate poverty, and improve child and family serving systems. CONCLUSION This study suggests that CFSPs and policymakers recognize the importance of protective factors in a child's life to buffer the effect of ACEs. More awareness is needed about the feasibility and significance of primary prevention of ACEs. The study's findings can be used to strengthen advocacy priorities for a wide range of public health outcomes associated with ACEs and help further bridge the gap between research and policy.
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Affiliation(s)
- Aditi Srivastav
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States; Children's Trust of South Carolina, Columbia, SC, United States.
| | - Mindi Spencer
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States
| | - Elizabeth Crouch
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC, United States
| | - Eylin Palamaro-Munsell
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Rachel E Davis
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States
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Rosenblum KL, Muzik M, Jester JM, Huth‐Bocks A, Erickson N, Ludtke M, Weatherston D, Brophy‐Herb H, Tableman B, Alfafara E, Waddell R. Community‐delivered infant–parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting. Infant Ment Health J 2020; 41:178-190. [DOI: 10.1002/imhj.21840] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Maria Muzik
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | | | - Alissa Huth‐Bocks
- University Hospitals Cleveland Medical CenterCase Western Reserve University Cleveland Ohio
| | - Nora Erickson
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | - Mary Ludtke
- Michigan Department of Health and Human Services Lansing Michigan
| | | | - Holly Brophy‐Herb
- Department of Family and Child EcologyMichigan State University East Lansing Michigan
| | - Betty Tableman
- The Guidance CenterMichigan Association for Infant Mental Health Southgate Michigan
| | - Emily Alfafara
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
| | - Rachel Waddell
- Department of PsychiatryUniversity of Michigan Ann Arbor Michigan
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Collazzoni A, Stratta P, Pacitti F, Rossi A, Santarelli V, Bustini M, Talevi D, Socci V, Rossi R. Resilience as a Mediator Between Interpersonal Risk Factors and Hopelessness in Depression. Front Psychiatry 2020; 11:10. [PMID: 32184740 PMCID: PMC7059212 DOI: 10.3389/fpsyt.2020.00010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/06/2020] [Indexed: 12/31/2022] Open
Abstract
Several studies investigated the role of resilience as a mediating factor for psychopathological phenotypes. The aim of the current study is to explore the putative role of resilience as a mediator between different vulnerability factors and depressive symptoms. One hundred and fifty patients with a major depressive disorder diagnosis have been evaluated on the basis of humiliation (Humiliation Inventory), adverse past family experiences (Risky Family Questionnaire), hopelessness (Beck Hopelessness Scale), and resilience (Resilience Scale for Adult) scores. A multiple regression analysis and a bootstrapping method were carried out to assess the hypothesis that resilience could mediate the relationships between these risk factors as predictors and hopelessness as a dependent variable. Our results show that resilience has a mediating role in the relationship between several risk factors that are specifically involved in interpersonal functioning and hopelessness. The main limitations of the study are the cross-sectional nature of the study, the use of self-report instruments, the lack of personality assessment, and the consideration of the resilience as a unique construct. The understanding of the mechanisms through which resilience mediates the effects of different interpersonal risk factors is crucial in the study of depression. In fact, future prevention-oriented studies can also be carried out considering the mediating role of resilience between interpersonal risk factors and depressive symptoms.
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Affiliation(s)
- Alberto Collazzoni
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | | | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.,Department of Mental Health, ASL 1, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.,Department of Mental Health, ASL 1, L'Aquila, Italy
| | | | - Massimiliano Bustini
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, ASL, Rieti, Italy
| | - Dalila Talevi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
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Purtle J, Lê-Scherban F, Wang X, Brown E, Chilton M. State Legislators' Opinions About Adverse Childhood Experiences as Risk Factors for Adult Behavioral Health Conditions. Psychiatr Serv 2019; 70:894-900. [PMID: 31272336 PMCID: PMC6773502 DOI: 10.1176/appi.ps.201900175] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) increase risk of adult behavioral health conditions. State legislators are an important audience to target with evidence about ACEs because they make policy decisions that can prevent ACE exposure and enhance resilience. This study sought to describe state legislators' opinions about ACEs as risk factors for adult behavioral health conditions and identify how opinions vary between legislators with different characteristics. METHODS A multimodal survey was conducted in 2017 (response rate, 16.4%; N=475). Dependent variables were the extent to which legislators thought that four ACEs-sexual abuse, physical abuse, witnessing domestic violence, and childhood neglect-increase risk of adult behavioral health conditions. Independent variables were legislator characteristics (e.g., ideology and gender). Rao-Scott chi-square tests and multivariable logistic regression were conducted. RESULTS Childhood sexual abuse was identified as a major risk factor by the largest proportion of respondents (77%), followed by childhood physical abuse (59%), witnessing domestic violence (39%), and childhood neglect (38%). The proportion identifying each ACE as a major risk factor was significantly higher among Democrats than among Republicans, liberals than among conservatives, and women than among men. For example, 56% of liberals identified witnessing domestic violence as a major risk factor, compared with 29% of conservatives (p<.001). CONCLUSIONS Opinions about ACEs as risk factors for adult behavioral health conditions varied between legislators with different characteristics, especially liberals and conservatives. To enhance the policy impact of evidence about ACEs, advocates might consider developing multiple versions of ACE evidence summaries that are tailored on the basis of these characteristics.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy (Purtle, Brown, Chilton), Department of Epidemiology and Biostatistics (Lê-Scherban), and Center for Hunger Free Communities (Brown, Chilton), all at Dornsife School of Public Health, Drexel University, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Wang)
| | - Félice Lê-Scherban
- Department of Health Management and Policy (Purtle, Brown, Chilton), Department of Epidemiology and Biostatistics (Lê-Scherban), and Center for Hunger Free Communities (Brown, Chilton), all at Dornsife School of Public Health, Drexel University, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Wang)
| | - Xi Wang
- Department of Health Management and Policy (Purtle, Brown, Chilton), Department of Epidemiology and Biostatistics (Lê-Scherban), and Center for Hunger Free Communities (Brown, Chilton), all at Dornsife School of Public Health, Drexel University, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Wang)
| | - Emily Brown
- Department of Health Management and Policy (Purtle, Brown, Chilton), Department of Epidemiology and Biostatistics (Lê-Scherban), and Center for Hunger Free Communities (Brown, Chilton), all at Dornsife School of Public Health, Drexel University, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Wang)
| | - Mariana Chilton
- Department of Health Management and Policy (Purtle, Brown, Chilton), Department of Epidemiology and Biostatistics (Lê-Scherban), and Center for Hunger Free Communities (Brown, Chilton), all at Dornsife School of Public Health, Drexel University, Philadelphia; PolicyLab, Children's Hospital of Philadelphia, Philadelphia (Wang)
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Solomonian L, Kwan V, Bhardwaj S. Group-Based Naturopathic Education for Primary Prevention of Noncommunicable Disease in Families and Children: A Feasibility Study. J Altern Complement Med 2019; 25:740-752. [PMID: 31314562 DOI: 10.1089/acm.2019.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: Naturopathic medicine has demonstrated efficacy at reducing risk factors for chronic disease. Targeting health behaviors of parents and caregivers in a group-based setting may improve the behaviors of children in their care. This study sought to assess the feasibility of such a program. Design: Participants of a six-session health education series were invited to respond to surveys and participate in a focus group about their health behaviors and their experience in the program. Subjects: Caregivers of children aged 0-6 attending publicly funded community centers in Ontario, Canada. Interventions: A 6-week group-based naturopathic education program to promote healthy lifestyle behaviors among caregivers. Outcome measures: Satisfaction with content and delivery, and frequency of healthy behaviors. Results: The majority of responses indicated satisfaction with the program, and an ongoing benefit 6 weeks and more after completion. There was a clear correlation between healthy behaviors of parents and children. Conclusions: A group-based naturopathic education program may be a feasible method of delivering primary-prevention education to caregivers, particularly in the domains of practicality and acceptability.
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Affiliation(s)
| | - Vivian Kwan
- Canadian College of Naturopathic Medicine, Toronto, Canada
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Condon EM, Holland ML, Slade A, Redeker NS, Mayes LC, Sadler LS. Associations Between Maternal Caregiving and Child Indicators of Toxic Stress Among Multiethnic, Urban Families. J Pediatr Health Care 2019; 33:425-436. [PMID: 30683581 PMCID: PMC6589109 DOI: 10.1016/j.pedhc.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/13/2018] [Accepted: 12/16/2018] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Our purpose was to examine associations between maternal caregiving and child indicators of toxic stress among multiethnic, urban families with children of early school age. METHOD We conducted an exploratory cross-sectional analysis of 54 maternal-child dyads. Mothers reported on parenting behaviors and parental reflective functioning (PRF). Child indicators of toxic stress included hair/salivary biomarkers, anthropometric characteristics, and maternally reported health and behavior. RESULTS Hostile/coercive parenting behaviors were associated with child externalizing behavioral problems (r = 0.43, p = .001, but lower interleukin (IL) 6 levels (r = 0.31, p = .03). High PRF was associated with fewer child emergency department visits (ρ = -0.43, p = .009), whereas impaired PRF was associated with more behavioral problems (ρ = 0.52, p < .0001). DISCUSSION PRF and supportive parenting behaviors may protect against toxic stress among vulnerable families, but additional research is needed to better understand these relationships. Resources are available to help clinicians screen for family risk factors and model responsive caregiving in pediatric settings.
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Crouch E, Probst JC, Radcliff E, Bennett KJ, McKinney SH. Prevalence of adverse childhood experiences (ACEs) among US children. CHILD ABUSE & NEGLECT 2019; 92:209-218. [PMID: 31003066 DOI: 10.1016/j.chiabu.2019.04.010] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) among children in the United States and to examine the relationship between child and family characteristics and the likelihood of reported exposure to ACEs. METHODS Data were drawn from the nationally representative 2016 National Survey of Children's Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs. RESULTS The study sample included 45,287 children. The most prevalent types of ACE exposure experienced by children were economic hardship (22.5%) and parent or guardian divorce or separation (21.9%). Older children (34.7%), Non-Hispanic African American children (34.7%), children with special health care needs (SHCN; 36.3%), children living in poverty (37.2%), and children living in rural areas (30.5%) were more likely to be exposed to parental divorce or separation than their counterparts. Five cross-cutting factors emerged as important across outcomes: child's age, family structure, poverty, type of health insurance, and SHCN status. CONCLUSIONS We found high prevalence rates of economic hardship on a national level. Our findings of higher prevalence among rural children further suggest the importance of the intersection of place and ACEs. Therefore, the geographic component of ACEs must be considered by policymakers. The identification of predictive factors related to high ACE exposure can inform early interventions at the national level.
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Affiliation(s)
- Elizabeth Crouch
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States.
| | - Janice C Probst
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Elizabeth Radcliff
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Kevin J Bennett
- University of South Carolina School of Medicine, Columbia, South Carolina, United States
| | - Selina Hunt McKinney
- University of South Carolina College of Nursing, Columbia, South Carolina, United States
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Condon EM. Maternal, Infant, and Early Childhood Home Visiting: A Call for a Paradigm Shift in States' Approaches to Funding. Policy Polit Nurs Pract 2019; 20:28-40. [PMID: 30791813 PMCID: PMC6600820 DOI: 10.1177/1527154419829439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Early home visiting is a vital health promotion strategy that is widely associated with positive outcomes for vulnerable families. To expand access to these services, the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was established under the Affordable Care Act, and over $2 billion have been distributed from the Health Resources and Services Administration to states, territories, and tribal entities to support funding for early home visiting programs serving pregnant women and families with young children (birth to 5 years of age). As of October 2018, 20 programs met Department of Health and Human Services criteria for evidence of effectiveness and were approved to receive MIECHV funding. However, the same few eligible programs receive MIECHV funding in almost all states, likely due to previously established infrastructure prior to establishment of the MIECHV program. Fully capitalizing on this federal investment will require all state policymakers and bureaucrats to reevaluate services currently offered and systematically and transparently develop a menu of home visiting services that will best match the specific needs of the vulnerable families in their communities. Federal incentives and strategies may also improve states' abilities to successfully implement a comprehensive and diverse menu of home visiting service options. By offering a menu of home visiting program models with varying levels of service delivery, home visitor education backgrounds, and targeted domains for improvement, state agencies serving children and families have an opportunity to expand their reach of services, improve cost-effectiveness, and promote optimal outcomes for vulnerable families. Nurses and nursing organizations can play a key role in advocating for this approach.
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Hastings PD, Kahle S, Fleming C, Lohr MJ, Katz LF, Oxford ML. An intervention that increases parental sensitivity in families referred to Child Protective Services also changes toddlers' parasympathetic regulation. Dev Sci 2019; 22:e12725. [PMID: 30156354 PMCID: PMC6294712 DOI: 10.1111/desc.12725] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/15/2018] [Indexed: 01/04/2023]
Abstract
Experiencing maltreatment in early childhood predicts poor parasympathetic regulation, characterized by low baseline parasympathetic activity and strong withdrawal of parasympathetic influence in response to tasks. The Promoting First Relationships® (PFR) program improves parental sensitivity toward young children in families identified as maltreating. Using a subsample from a randomized control trial, we examined whether parental participation in PFR had lasting effects on toddlers' parasympathetic regulation, as measured by respiratory sinus arrhythmia (RSA), relative to a resource and referral control condition. In addition, we examined whether parental sensitive and responsive behavior mediated or moderated associations between parent treatment group and children's RSA. More than 6 months after completing treatment, 29 families in the PFR condition and 30 families in the control condition were visited at home, and toddlers' RSA was assessed at baseline and during five moderately challenging tasks. Groups did not differ in baseline RSA, but differed in RSA reactivity to the tasks. Across tasks, toddlers of parents in the control condition manifested significantly larger RSA decreases than toddlers of parents in the PFR condition. Parental behavior showed divergent associations with RSA change for toddlers of parents in the PFR versus control condition, with PFR treatment predicting RSA change ranging from small decreases to increases in toddlers of parents who showed the most sensitive, responsive behavior in the 6 months following treatment. This preliminary study showed that the same intervention that improved parenting also improved toddlers' parasympathetic regulation in response to everyday activities, warranting further experimental investigation.
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Affiliation(s)
- Paul D. Hastings
- Center for Mind & Brain, Department of Psychology, University of California Davis
| | - Sarah Kahle
- Department of Pediatrics, School of Medicine, University of California Davis
| | - Charles Fleming
- Center for the Study of Health and Risk Behavior, Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Mary Jane Lohr
- Department of Family and Child Nursing, University of Washington
| | | | - Monica L. Oxford
- Department of Family and Child Nursing, University of Washington
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Treatment of Maternal Depression With In-Home Cognitive Behavioral Therapy Augmented by a Parenting Enhancement: A Case Report. COGNITIVE AND BEHAVIORAL PRACTICE 2018; 25:402-415. [PMID: 30174386 DOI: 10.1016/j.cbpra.2017.10.002] [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: 10/18/2022]
Abstract
Depression is prevalent among mothers who participate in home visitation programs. This case study describes In-Home Cognitive Behavior Therapy (IH-CBT), an empirically based treatment for depressed mothers that is strongly integrated with ongoing home visitation. The use of a Parenting Enhancement for Maternal Depression (PEMD) module was added to address parenting difficulties in a depressed mother. This case describes issues and challenges encountered in delivering treatment in the home with low-income, depressed mothers. Issues involving engagement, adaptation to the setting, responding to the unique needs of low-income mothers, and partnership with concurrent home visiting to optimize outcomes are considered. Long-term follow-up (18 months after the end of treatment) permits examination of sustainability of gains. Implications for treating this high-risk population are discussed.
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Affiliation(s)
- Heather Forkey
- Foster Children Evaluation Services (FaCES), UMASS Memorial Children's Medical Center, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
| | - Anne-Marie Conn
- Division of General Pediatrics, Department of Pediatrics, Strong Children's Research Center, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, 601 Elmwood Avenue, Box 777, Rochester, NY 14642, USA.
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Condon EM, Sadler LS. Toxic Stress and Vulnerable Mothers: A Multilevel Framework of Stressors and Strengths. West J Nurs Res 2018; 41:872-900. [PMID: 30019624 DOI: 10.1177/0193945918788676] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Toxic stress is associated with poor health outcomes that extend across the life span. Although caregivers can protect their children from toxic stress through supportive caregiving, this can be challenging for vulnerable mothers living in socioeconomically disadvantaged environments. We aim to advance the science of toxic stress prevention by exploring the stressors and strengths experienced by vulnerable mothers through application of a theoretical framework, Bronfenbrenner's bioecological model. Following Arksey and O'Malley's five-stage scoping study framework, 179 articles were included. Key information was abstracted and each article was reviewed for relevance to the bioecological model. Results revealed that the sources of stress and strength are multilayered, transactional, and have a complex influence on caregiving in families at risk of toxic stress. Future research should include empirical investigations of the complex relationships among these stressors and strengths, and the development of preventive interventions to support vulnerable families at risk of toxic stress.
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Affiliation(s)
| | - Lois S Sadler
- 1 Yale School of Nursing, Orange, CT, USA.,2 Yale Child Study Center, New Haven, CT, USA
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Munns A, Toye C, Hegney D, Kickett M, Marriott R, Walker R. Aboriginal parent support: A partnership approach. J Clin Nurs 2018; 27:e437-e450. [PMID: 28771868 DOI: 10.1111/jocn.13979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. BACKGROUND The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. DESIGN This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. METHODS Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. RESULTS Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. CONCLUSIONS Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. RELEVANCE TO CLINICAL PRACTICE Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.
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Affiliation(s)
- Ailsa Munns
- School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Christine Toye
- Older Persons' Health Care, School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Desley Hegney
- Research Division, Central Queensland University, Brisbane, Queensland, Australia.,School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia.,School of Nursing, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Rhonda Marriott
- Aboriginal Health and Wellbeing, School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia.,Maternal and Newborn Health, Aboriginal Health and Wellbeing, Nursing and Midwifery Office, Department of Health Western Australia, Perth, Western Australia, Australia
| | - Roz Walker
- Aboriginal Maternal Health and Child Development, Telethon Kids Institute, Subiaco Western Australia, Australia.,University of Western Australia, Crawley, Western Australia, Australia
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43
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Crouch E, Radcliff E, Nelson J, Strompolis M, Martin A. The experience of adverse childhood experiences and dental care in childhood. Community Dent Oral Epidemiol 2018; 46:442-448. [DOI: 10.1111/cdoe.12389] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Crouch
- Department of Health Services Policy and Management; South Carolina Rural Health Research Center; Arnold School of Public Health; University of South Carolina; Columbia SC USA
| | - Elizabeth Radcliff
- Department of Health Services Policy and Management; South Carolina Rural Health Research Center; Arnold School of Public Health; University of South Carolina; Columbia SC USA
| | - Joni Nelson
- Department of Stomatology; Division of Population Oral Health; Medical University of South Carolina; Charleston SC USA
| | | | - Amy Martin
- Department of Stomatology; Division of Population Oral Health; Medical University of South Carolina; Charleston SC USA
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44
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Condon EM, Sadler LS, Mayes LC. Toxic stress and protective factors in multi-ethnic school age children: A research protocol. Res Nurs Health 2018; 41:97-106. [PMID: 29441597 PMCID: PMC5989308 DOI: 10.1002/nur.21851] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/28/2017] [Accepted: 12/01/2017] [Indexed: 12/25/2022]
Abstract
Exposure to stressful environments in early childhood can cause a toxic stress response and lead to poor health outcomes, including obesity, cardiac disease, diabetes, and mental illness. In animals and maltreated children, the presence of a nurturing caregiver can buffer against the physiological disruptions associated with a toxic stress response; however, the specific caregiver and parenting characteristics that best promote a protective relationship in humans remain largely unexplored, particularly in families living in high-risk environments. In this study, framed in an ecobiodevelopmental (EBD) model, a cross-sectional design is being used to study 54 multi-ethnic, urban maternal-child dyads with children at early school age (4-9 years). Mothers' past experiences, mental health, and caregiving patterns and children's hair cortisol, C-reactive protein, pro-inflammatory cytokines, blood pressure, BMI, behavior, and school performance are being analyzed to identify maternal characteristics that may protect against children's toxic stress response in families at high risk for exposure to stressors such as poverty, trauma, or exposure to violence.
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Affiliation(s)
| | - Lois S. Sadler
- Yale School of Nursing, Orange, Connecticut
- Yale Child Study Center, New Haven, Connecticut
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45
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Ransone SH, Graff JC, Bush AJ, Oxford M, Wicks MN. Psychometric evaluation of the nursing child assessment teaching (NCAT) scale in a community-based sample. Res Nurs Health 2018; 41:301-311. [PMID: 29493795 DOI: 10.1002/nur.21867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/11/2018] [Indexed: 11/06/2022]
Abstract
The effect of the mother-child relationship on long-term child development has received research attention for decades. Because the quality and quantity of mother-infant interactions have been established as important predictors of the child's development, early identification of areas in the relationship requiring support and intervention is essential for promoting positive child outcomes. The Nursing Child Assessment Teaching Scale (NCAT) is an instrument long used to quantify the quality of interaction in the mother-child relationship during the first 36 months of a child's life. While the NCAT has been shown to be a reliable and valid instrument, limited evidence exists of the theoretical congruence between the Barnard Model it is based on and the NCAT scale. The psychometric properties of the NCAT scale and subscales were examined using item response theory in relation to characteristics of interactions in the Barnard Model using data collected during a clinic visit at 12 months of infant age in a sample of mothers and children (N = 1,121 dyads) from a community-based sample in Shelby County, TN. In this secondary analysis, descriptive statistics, reliabilities, and factor loadings for the NCAT were obtained using confirmatory factor analysis and augmented to form multiple indicators, multiple causes models, linking demographic predictors of the mothers and children to the NCAT subscales. Results supported scale abbreviation and theoretical congruence with the Barnard Model, which may provide researchers and practitioners with a more concise, reliable way of measuring maternal-child interaction in community settings.
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Affiliation(s)
| | - J Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee.,Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Andrew J Bush
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Monica Oxford
- Department of Family and Child Nursing, University of Washington, Seattle, Washington
| | - Mona N Wicks
- College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee
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46
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Woods-Jaeger BA, Cho B, Sexton CC, Slagel L, Goggin K. Promoting Resilience: Breaking the Intergenerational Cycle of Adverse Childhood Experiences. HEALTH EDUCATION & BEHAVIOR 2018; 45:772-780. [PMID: 29433342 DOI: 10.1177/1090198117752785] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adverse childhood experiences (ACEs), including trauma exposure, parent mental health problems, and family dysfunction, put children at risk for disrupted brain development and increased risk for later health problems and mortality. These negative effects may be prevented by resilience promoting environments that include protective caregiving relationships. We sought to understand (1) parents' experiences of ACEs, (2) the perceived impact on parenting, (3) protective factors that buffer ACEs potential negative impact, and (4) supports and services that can reduce the number and severity of ACEs and promote resilience among children exposed to early adversity. We conducted in-depth qualitative interviews with 11 low-income, urban parents of young children who had experienced ACEs. Interviews were analyzed for emergent themes and shared with parents from the community to ensure relevance and proper interpretation. Themes from these interviews describe the potential intergenerational cycle of ACEs and key factors that can break that cycle, including parent aspirations to make children's lives better and parent nurturance and support. Parents' suggestions for intervention are also presented. Our findings illuminate protective factors and family strengths that are important to build upon when developing and implementing interventions to promote resilience among parents and children exposed to early adversity. This study benefits from highly ecologically valid data obtained from low-socioeconomic status, racial/ethnic minority parents through one-on-one in-depth interviews and interpreted with the aid of community stakeholders through a community-based participatory research approach.
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Affiliation(s)
- Briana A Woods-Jaeger
- 1 Children's Mercy Hospital, Kansas City, MO, USA.,2 University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Bridget Cho
- 1 Children's Mercy Hospital, Kansas City, MO, USA.,3 University of Kansas, Lawrence, KS, USA
| | | | | | - Kathy Goggin
- 1 Children's Mercy Hospital, Kansas City, MO, USA.,4 University of Missouri Kansas City Schools of Medicine and Pharmacy, Kansas City, MO, USA
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Ordway MR, Sadler LS, Holland ML, Slade A, Close N, Mayes LC. A Home Visiting Parenting Program and Child Obesity: A Randomized Trial. Pediatrics 2018; 141:e20171076. [PMID: 29339565 PMCID: PMC5810599 DOI: 10.1542/peds.2017-1076] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Young children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the "Minding the Baby" (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life. METHODS This study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years. RESULTS More children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher (P < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13-0.78). CONCLUSIONS Using the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.
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Affiliation(s)
| | - Lois S Sadler
- School of Nursing, Yale University, Orange, Connecticut
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | | | - Arietta Slade
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Nancy Close
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Linda C Mayes
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
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Cuartas J. Neighborhood crime undermines parenting: Violence in the vicinity of households as a predictor of aggressive discipline. CHILD ABUSE & NEGLECT 2018; 76:388-399. [PMID: 29223888 DOI: 10.1016/j.chiabu.2017.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/01/2017] [Accepted: 12/04/2017] [Indexed: 05/21/2023]
Abstract
Child discipline is a central component of parent-child interactions. Evidence suggests corporal discipline impairs children's physical, cognitive, and socioemotional development and compromises their future chances, especially since it is more frequently used against at-risk children. Using geocoded data for 1209 children under the age of five and their mothers, this study analyses the relation between the occurrence of crimes in close proximity to households in four major urban municipalities of Colombia and a particularly violent corporal discipline practice: hitting children with objects. Results indicate that exposure to violent crimes, such as homicides and personal injuries, predicts a higher probability of hitting children with objects, even after controlling for a set of individual, family, and neighborhood characteristics. Sensitivity analyses suggest violent crimes are not related to other discipline methods, and less threatening crimes, such as robbery and drug trafficking, are not associated with hitting children with objects. These findings suggest households' walls are permeable, and outside threats may interfere with families' dynamics and well-being. Future directions and implications are discussed.
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Affiliation(s)
- Jorge Cuartas
- School of Government, Universidad de los Andes, Cra. 1, No. 19-27, Block AU, Third Floor, Bogotá, Colombia.
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49
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Abstract
Prior studies suggest that foreign-born individuals have a health advantage, referred to as the Healthy Immigrant Paradox, when compared to native-born persons of the same socio-economic status. This systematic review examined whether the immigrant advantage found in health literature is mirrored by child maltreatment in general and its forms in particular. The author searched Academic Search Premier, CINAHL, CINAHL PLUS, Family and Society Studies Worldwide, MEDLINE, PsychINFO, Social Work Abstracts, and SocINdex for published literature through December 2015. The review followed an evidence-based Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The author identified 822 unique articles, of which 19 met the inclusion criteria. The reviewed data showed strong support for the healthy immigrant paradox for a general form of maltreatment and physical abuse. The evidence for emotional and sexual abuse was also suggestive of immigrant advantage though relatively small sample size and lack of multivariate controls make these findings tentative. The evidence for neglect was mixed: immigrants were less likely to be reported to Child Protective Services; however, they had higher rates of physical neglect and lack of supervision in the community data. The study results warrant confirmation with newer data possessing strong external validity for immigrant samples.
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Affiliation(s)
- Lina S Millett
- College of Nursing, University of Missouri-St. Louis, One University Blvd, St. Louis, MO, 63121, USA.
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50
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Nelson AK, Miller AC, Munoz M, Rumaldo N, Kammerer B, Vibbert M, Lundy S, Soplapuco G, Lecca L, Condeso A, Valdivia Y, Atwood SA, Shin SS. CASITA: a controlled pilot study of community-based family coaching to stimulate early child development in Lima, Peru. BMJ Paediatr Open 2018; 2:e000268. [PMID: 29862331 PMCID: PMC5976100 DOI: 10.1136/bmjpo-2018-000268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine whether the 3-month, community-based early stimulation coaching and social support intervention 'CASITA', delivered by community health workers, could improve early child development and caregiver-child interaction in a resource-limited district in Lima, Peru. DESIGN A controlled two-arm proof-of-concept study. SETTING Six neighbourhood health posts in Carabayllo, a mixed rural/urban district in Lima. Sessions were held in homes and community centres. PARTICIPANTS Children aged 6-24 months who screened positive for risk of neurodevelopmental delay (using validated developmental delay tool) and poverty (using progress out of poverty tool) were enrolled with their caregivers. Dyads with children born >21 days early were excluded. INTERVENTION 12-week parenting/support intervention plus nutritional support (n=41) or nutrition alone (n=19). OUTCOME MEASURES Development and home environment differences and mean changes from baseline to 3 months postintervention were evaluated using age-adjusted z-scores on the Extended Ages and Stages Questionnaire (EASQ) and the Home Observation Measurement of the Environment (HOME) scores, respectively. RESULTS Development in CASITA improved significantly in all EASQ domains, whereas the control group's z-scores did not improve significantly in any domain. The mean adjusted difference (MAD) in change in EASQ age-adjusted z-scores between the two study arms was 1.39 (95% CI 0.55 to 2.22); Cohen's d effect size of 0.87 (95% CI 0.23 to 1.50). Likewise, intervention significantly improved global HOME scores versus control group (MAD change of 6.33 (95% CI 2.12 to 10.55); Cohen's d of 0.85 (95% CI 0.28 to 1.41)). CONCLUSIONS An evidence-based early intervention delivered weekly during 3 months by a community health worker significantly improved children's communication, motor and personal/social development in this proof-of-concept study.
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Affiliation(s)
| | - Ann C Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Betsy Kammerer
- Department of Psychiatry, Children's Hospital Boston, Boston, Massachusetts, USA
| | - Martha Vibbert
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.,SPARK Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Shannon Lundy
- Division of Developmental Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.,UCSF Benioff Children's Hospital, San Francisco, California, USA
| | | | - Leonid Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Socios En Salud Sucursal, Lima, Peru
| | | | | | - Sidney A Atwood
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sonya S Shin
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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