CHILD DISRUPTIVE BEHAVIOR AND PARENTING EFFICACY: A COMPARISON OF THE EFFECTS OF TWO MODELS OF INSIGHTS

In this article, we investigate the effectiveness of INSIGHTS into Children's Temperament (INSIGHTS), a temperament-based preventive intervention, in reducing the disruptive behavior problems of young children from low-income, urban families. Results indicate that children enrolled in INSIGHTS evidenced a decrease in disruptive behavior problems over the course of the intervention, with children with high maintenance temperaments evidencing the most rapid rates of decline. In addition, children in a collaborative version of the program with joint parent and teacher sessions demonstrated more rapid decreases in disruptive behavior than children in a parallel version with separate parent and teacher sessions. Furthermore, high maintenance children in the collaborative intervention evidenced lower levels of disruptive behaviors at the end of the intervention than their peers in the parallel version. Increases in parenting efficacy appeared to be the mechanism through which INSIGHTS reduced child disruptive behavior.

Duality in context: the process of preparedness in communicating with at-risk children

The goal of this study was to explore the cultural meaning of parent-child communication behaviors in inner-city children at risk for common behavioral problems. Following participation in a preventive intervention called Insights Into Children's Temperament, 40 parents of first and second-grade children were interviewed. The data were analyzed using a constant comparative method derived from grounded-theory techniques. Findings indicate that a complex communication process was used by parents with their at-risk inner-city school-age children. The immediacy of safety concerns for the child, the child's temperament, and the current parental state informed the choice of communication behaviors chosen by the parent. The ultimate goal of communication for these participants was to equip their children with tools to assist them to safely navigate their school and community environments. Participants also offered several recommendations that could be useful for practitioners and researchers to incorporate into their work with inner-city families.

Planning a temperament-based parenting program for inner-city families

TOPIC

The design of a temperament-based parenting program for inner-city families.

PROBLEM

Selective intervention parenting programs are needed for children who are at high risk for developing behavioral problems. Planning should incorporate cultural considerations to ensure the program meets needs.

METHODS

A pilot study to assess psychometrics of instruments, obtain preliminary date, test feasibility, and verify appropriateness of the intervention. Reports of child temperament, behavior problems, and maternal distress were obtained from a sample of 244 inner-city mothers of school-age children.

FINDINGS

The three instruments showed adequate reliability with this sample. Attendance rate was 92% for the 18 mothers who participated in the parenting intervention. Focus groups supported the content of the program.

CONCLUSIONS

A pilot study can assist nurses to plan an intervention that responds appropriately to the specific strengths and needs of the community.

Dietary intake and health outcomes among young children attending 2 urban day-care centers

OBJECTIVE

To assess the impact of the Child and Adult Care Food Program (CACFP) on diet and 3 health outcomes--weight-for-height status, dental caries (tooth decay) score, and number of days of illness--among preschool children attending 2 urban day care centers.

DESIGN

Dietary intake and health outcome measures were assessed and compared for children attending 2 day-care centers in an urban community. Data were obtained for 14 days of dietary intake, which were analyzed for energy and 15 nutrients and 6 food groups; anthropometric measures, including weight-for-height; dental caries; and days of illness.

SUBJECTS/SETTING

Forty 3- to 5-year-old black children from 2 day-care centers participated. One center participates in the CACFP. At the other center, children bring all meals and snacks from home.

STATISTICAL ANALYSES PERFORMED

Data from the 2 groups of children were compared using parameteric and nonparametric t tests.

RESULTS

Children receiving CACFP meals at day care had significantly higher mean daily intakes of vitamin A (804 +/- 191 vs 595 +/- 268 retinol equivalents), riboflavin (1.45 +/- 0.32 vs 1.21 +/- 0.22 mg), and calcium (714 +/- 180 vs 503 +/- 143 mg) than the children who brought all of their meals and snacks from home. Children who received CACFP meals also consumed significantly more servings of milk (2.9 +/- 0.9 servings vs 1.5 +/- 0.7) and vegetables (1.8 +/- 0.5 vs 1.2 +/- 0.5 servings) and significantly fewer servings of fats/sweets (4.6 +/- 1.3 vs 5.4 +/- 1.1 servings) than children who brought their meals. Weight-for-height status and dental caries scores did not differ between the 2 groups. Children from the center participating in the CACFP have significantly fewer days of illness (median 6.5 vs 10.5 days) than children from the nonparticipating center.

APPLICATIONS

Nutritious meals provided by the CACFP can improve diets and may promote health among young, urban children. Registered dietitians can contribute to food assistance programs by intervening to enhance the quality of meals served and by examining the impact of participation on measures of diet quality and diet-related health outcomes.