Subjective experience of parent-child relationship in adolescents with congenital heart disease: A qualitative study

PURPOSE

To explore the parent-child relationship through the subjective experience of adolescents with congenital heart disease (CHD).

DESIGN AND METHODS

A descriptive phenomenology approach was adopted. Twelve adolescents aged from 12 to 18 years with CHD were recruited from the pediatric cardiology clinics at two medical centers in Taiwan. Data were collected through in-depth interviews. Data were analyzed using Colaizzi's phenomenological analysis method, and results were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.

RESULTS

The experiences of the adolescents with CHD revealed five themes: 1. the enhancement of self-worth through parents' love; 2. the importance of parental support in desperate situations; 3. the development of a sense of security through mutual understanding; 4. growth under parental expectations; and 5. parental overcontrol disguised as love.

CONCLUSIONS

The parent-child relationship encompasses both positive and negative experiences. Adolescents prioritize their relationship with parents over that with peers.

PRACTICE IMPLICATIONS

Nurses caring for adolescents with CHD can improve care by recognizing the influence of parental love, support in challenges, mutual understanding, parental expectations, and potential negative consequences of overcontrol. This insight guides effective guidance for adolescents, enhancing parent-child interactions and overall well-being.

The motives and experiences of donor-conceived persons requesting the identity of their sperm donors

RESEARCH QUESTION

What are the motives and experiences of donor-conceived persons (DCP) who search for and receive information about their identity-release sperm donor?

DESIGN

A qualitative interview study with 29 individuals (21 women, seven men, one non-binary) who were consecutively recruited after having requested information about their sperm donor at five Swedish University hospitals. All participants were conceived after donor insemination to heterosexual couples within an identity-release donation programme. Individual semi-structured interviews were conducted face-to-face or via telephone between September 2016 and November 2019, and transcribed audio recordings were analysed using reflexive thematic analysis.

RESULTS

The motives and experiences of DCP were described in two themes. The theme 'donor information can fill different needs' describes that varying motives, thoughts and feelings are related to searching for and obtaining donor information. Motives ranged from curiosity and a desire for agency over one's conception to hopes of finding a new father. The theme 'navigating donor information in a relational context' describes the process of obtaining donor information as interpersonal, highlighting that the DCP needs to balance the interests of different stakeholders, and that obtaining donor information can challenge the relationship quality with the father.

CONCLUSIONS

Obtaining the donor's identity has the potential to affect the understanding of DCP of themselves, and to influence relationships within their family in unexpected and challenging ways. Therefore, adequate resources should be allocated to support the growing number of families after identity-release donation.

Associations between nature exposure, screen use, and parent-child relations: a scoping review protocol

BACKGROUND

Today's youth are growing up in an evolving digital world, and concerns about the potential detrimental effects of excessive screen use on biopsychosocial outcomes in childhood are mounting. Parents worry about the impacts of screen-use on their children's wellbeing but at the same time frequently fail to meet their own ideal screen time limits regarding their children's screen use. There is an opportunity to shift research focus away from inflexible and often unrealistic childhood screen time guidelines towards exploration of positive parenting strategies that may have multiple beneficial and significant effects on children's screen-related outcomes. An emerging body of literature suggests that screen time and nature exposure act on psychosocial outcomes in contrasting ways. There is evidence to suggest that exposure to natural environments may counteract some of the potential negative psychosocial effects of excessive screen use; however, this relationship is poorly understood. The overarching aim of this scoping review is to source, categorise, and synthesise existing research exploring the associations between nature exposure, screen use, and parenting across childhood.

METHODS

This mixed-methods systematic scoping review will be conducted following Arksey and O'Malley's framework with methodological enhancements from Levac and associates and recommendations from the Joanna Briggs Institute's methodological guidance for conducting scoping reviews. Five electronic databases will be searched from August 2022 onwards. Two reviewers will independently screen titles, abstracts, and full-text articles. Peer reviewed articles related to the constructs of nature exposure, screen use, and parent/child relations will be considered in the context of early to late childhood. Study characteristics will be collated using a data charting tool collaboratively developed by the research team. Evidence will be presented using tabular and textual form and described using qualitative thematic analysis.

DISCUSSION

This review will gather information about how key definitions are conceptualised, defined, and measured across the literature and map existing trends and areas for future research. It is intended that this review will inform and guide future research direction, recommendations, and programs aimed at supporting parents to navigate the challenges of parenting in a digital age. OSF REGISTRATION: https://doi.org/10.17605/OSF.IO/TFZDV.

Unwanted or Mistimed Pregnancy and Developmental Issues in Ecuadorian Children Aged 3 to 5: A Doubly Robust Estimate Using Data from the National Health and Nutrition Survey 2018

BACKGROUND

Past studies in high-income countries have shown an association between unintended (unwanted or mistimed) pregnancy and child development; no national-level studies in low-and-middle-income countries have been conducted. Moreover, extant studies often adjust for potential mediators, underestimating the average population effect.

METHODS

We aimed to estimate the effect of unintended pregnancy on early childhood development in Ecuadorian children aged 3 to 5, participating in the National Health and Nutrition Survey 2018. We used a design-based doubly robust estimate. First, we used propensity score matching (1:1) to identify a subsample equally likely to come from a desired vs. unintended pregnancy based on geographic area, household income, paternal intendedness, the mother's current marital status, age, ethnicity, and educational level, depressive symptoms, and the child's gender and age. Then, we used a logistic regression model to explore the relation of maternal pregnancy intentions with adequate development, as defined by the Early Childhood Development Index (ECDI). While exempt from review by an Institutional Review Board, this secondary research was conducted in accord with prevailing ethical principles.

RESULTS

Among 1694 observations representing 162,285 Ecuadorian children, unintended pregnancy associated with inadequate development (odds ratio: 1.56; 95% confidence interval: 1.06; 2.29), after adjusting for all relevant confounders. Unintended pregnancy was also negatively associated with all four ECDI domains, socio-emotional development being the most affected.

DISCUSSION

Our doubly robust design found evidence of the relation between the maternal perception of pregnancy and early child development. Addressing this relation to achieve reproductive justice entails considering a wide spectrum of population health and legal interventions to allow adequate access to education, contraception, and safe abortion. Moreover, pre- and post-natal check-ups could screen for unintended pregnancy and provide support accordingly.

Parental stress and dental caries experience in adolescents: analysis of data from a birth cohort study in Pelotas, Southern Brazil

PURPOSE

Analyze the association between parental stress and dental caries experience in adolescents in southern Brazil using data from the Pelotas 2004 Birth Cohort.

METHODS

Interviews and oral health examinations for the determination of the main exposure and outcome of the study were performed in the homes of the adolescents. The outcome was dental caries experience in the permanent dentition analyzed using the Decayed, Missing and Filling Surfaces (DMFS) index. The main exposure was parental stress measured using the Parenting Stress Index-Short Form administered to the parents of the adolescents. Demographic/socioeconomic characteristics, oral health characteristics and oral health-related quality of life were considered potential confounding factors. Negative binomial regressions estimated mean ratios (MR) and 95% confidence intervals (CI).

RESULTS

Nine hundred ninety-six adolescents were evaluated at 12 and 13 years of age. The prevalence of dental caries experience in the adolescents was 36.9% (95% CI: 33.8-40.0) and 15.1% (95% CI: 12.8-17.3) of the parents had parental stress. After adjusting for confounding factors, parental stress was associated with a higher mean number of decayed, missing and filling surfaces in the adolescents (MR = 1.10; 95% CI: 1.01-1.26; p = 0.045).

CONCLUSION

Adolescents of parents with parental stress have more dental caries experience compared to those whose parents do not have parental stress.

Family meals, positive versus negative emotion suppression, and emotional eating: examining adolescent-parent dyadic associations

PURPOSE

The present study aimed to extend existing research by examining adolescent-parent dyadic associations among adaptive and maladaptive family meal characteristics, positive and negative emotion suppression, and emotional eating.

METHOD

Participants included a community-based sample of adolescents and parents (N = 1646 dyads) who participated in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Dyad members both completed measures assessing family meal characteristics (family meal importance beliefs, family mealtime television watching), emotion suppression, and emotional eating via online surveys. Actor-partner interdependence models were used to examine dyadic associations among the assessed family meal characteristics, positive and negative emotion suppression, and emotional eating.

RESULTS

Multiple within-person (e.g., adolescent-adolescent, parent-parent), cross-dyad member (e.g., adolescent-parent, parent-adolescent), and divergent adolescent versus parent dyadic effects were identified that differed based on the extent to which participants suppressed positive versus negative affect. For example, whereas adolescents' stronger beliefs in the importance of frequent family meals were associated with lower levels of their own suppression of positive emotions and, in turn, lower levels of both their own and their parents' emotional eating, these mediational associations were only identified at the within-person (not cross-dyad member) level among parents.

CONCLUSIONS

Collectively, these findings attest to the complexity of associations among the assessed risk and protective family meal characteristics, the suppression of differentially valenced emotions, and emotional eating that manifest at the adolescent-parent dyadic level. Findings also support the continued use of a family-based perspective to further the understanding of factors that are associated with emotional eating.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Consensus-based recommendations for psychosocial support measures for parents and adult children at the end of life: results of a Delphi study in Germany

PURPOSE

The availability of psychosocial support measures has a significant impact on the quality of life of terminally ill and dying patients and the burden experienced by their relatives. To date, no intervention has specifically focused on promoting interaction within the dyads of the following: (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children. A national Delphi study was conducted to provide appropriate recommendations for dyadic psychosocial support measures.

METHODS

Recommendations were formulated from qualitative interview data on the experiences and wishes of patients and family caregivers within these two dyads. Experts from palliative and hospice care providers rated the relevance and feasibility of 21 recommendations on two 4-point Likert-type scales, respectively. Additional suggestions for improvement were captured via free text fields. Individual items were considered consented when ≥ 80% of participants scored 1 (strongly agree) or 2 (somewhat agree) regarding both relevance and feasibility.

RESULTS

A total of 27 experts (35% response rate) completed two Delphi rounds. Following the first round, 13 recommendations were adjusted according to participants' comments. After the second round, consensus was achieved for all 21 of the initially presented recommendations.

CONCLUSION

The Delphi-consented recommendations for parents and adult children at the end of life provide the first guidance for hands-on dyadic psychosocial support measures for parent-adult child relationships, specifically. The next step could involve the structured implementation of the recommendations, accompanied by scientific research. This study was registered on October 27, 2017, with the German Clinical Trials Register (DRKS00013206).

The Impact of Maternal Depression and Parent-Child Interactions on Risk of Parasitic Infections in Early Childhood: A Prospective Cohort in Benin

Objectives

Maternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease. However, few studies have investigated its impact on child risk of infectious disease. We studied the impacts of maternal depressive symptoms and parent–child interactions, independently, on the risk of Plasmodium falciparum malaria and soil-transmitted helminth infection in Beninese children.

Methods

Our population included mothers and children enrolled in a clinical trial during pregnancy (MiPPAD) in Benin. The Edinburgh Postnatal Depression Scale (EPDS) assessed maternal depressive symptoms and the home observation measurement of the environment (HOME) assessed parent–child interactions. Blood and stool sample analyses diagnosed child malaria and helminth infection at 12, 18, and 24 months. Negative binomial and Poisson regression models with robust variance tested associations.

Results

Of the 302 mother–child pairs, 39 (12.9%) mothers had depressive symptoms. Median number of malaria episodes per child was 3 (0–14) and 29.1% children had at least one helminth infection. Higher EPDS scores were associated with lower HOME scores; relative risk (RR) 0.97 (95% confidence interval (CI) 0.95, 0.99), particularly with lower acceptance, involvement, and variety subscales; RR 0.92 (95% CI 0.85, 0.99), RR 0.82 (95% CI 0.77, 0.88), RR 0.93 (95% CI 0.88, 0.99), respectively. However, neither exposure was associated with risk of parasitic infection in children.

Conclusions for Practice

Maternal depressive symptoms are associated with poor parent–child interactions, particularly acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children.

Feasibility and Acceptability of a Novel Primary Care-Based Intervention to Promote Parent-Teen Communication About Teen Strengths

Strength-based approaches to youth development have been tested in community settings and are related to improvements in social, health, and academic realms. However, little is known about similar approaches to enhance parent-teen communication (PTC) in pediatric primary care. The goal of this study was to test the feasibility and acceptability of an intervention to facilitate parent-teen communication about teen strengths. Intervention materials were developed based on a literature review, expert consultation, and feedback from stakeholders. The final intervention was a parent-directed booklet and a parent-teen discussion activity. At the well-adolescent visit (WAV), dyads received an orientation to the materials and were instructed to complete the discussion activity within 2 weeks of the WAV. Health Care Providers verbally endorsed the materials and instructed parents to read the booklet and complete the discussion activity with their teens. Acceptability was assessed at 2-week and 2-month follow-ups. Parent-adolescent dyads from an urban, pediatric primary care practice were enrolled with half assigned to the treatment group. Those in the treatment group (60 dyads) are the focus of this paper. Youth were 13-15 years old, 55% female, and 66% Black. Most participating parents (97%) were female. Fidelity was ≥ 88% for delivery of each of the intervention components. Fifty-four of the 60 parents in the intervention group completed the 2-week call. Of those 54 parents, 96% read the booklet and 62% found the booklet either extremely or very helpful. The majority of parents (67%) and teens (72%) reported that the discussion activity was excellent or very good. Analysis of qualitative data also provided rich insight into the participants' experiences with the intervention materials. Overall results suggest that an intervention to promote PTC about teen strengths is feasible and acceptable to parents and teens within primary care.

Perceptions of Closeness in Adult Parent-Child Dyads: Asymmetry in the Context of Family Complexity

OBJECTIVES

Multi-actor data show that parents' and adult children's evaluations of their relation do not necessarily match. We studied disagreement in parent- and child-reported closeness, comparing parent-child dyads involving separated parents, non-separated parents, and stepparents to shed new light on today's diverse landscape of adult parent-child relations.

METHOD

Using data from the Parents and Children in the Netherlands (OKiN) survey, we analyzed closeness in parent-child dyads (N = 4,602) comparing (step)parents' and their adult children's (aged 25-45) reports. To distinguish directional disagreement (i.e., differences in child- and parent-reported means) from nondirectional disagreement (i.e., the association between child- and parent-reported measures), while accounting for absolute levels of closeness, we estimated log-linear models.

RESULTS

All types of parents tend to report higher levels of closeness than their children. Whereas parental overreport is more prevalent among biological father-child dyads than among biological mother-child dyads, we found no differences between biological dyads and stepdyads. The association between children's and parents' reports is higher among dyads involving stepmothers or married mothers than among those involving separated mothers and (step)fathers.

DISCUSSION

The intergenerational stake (i.e., parental overreport) is not unique to biological parent-child relations. Instead, patterns of disagreement seem most strongly stratified by gender.

Museum program design supports parent-child engineering talk during tinkering and reminiscing

This study focused on tinkering, a playful form of open-ended problem solving that is being widely adopted in science, technology, engineering, and mathematics (STEM) education as a way of encouraging children's engagement in disciplinary practices of engineering. Nevertheless, the design of exhibits and programs and the nature of children's interactions with adults can determine whether and to what extent tinkering engenders participation in engineering practices such as testing and redesign. Researchers and museum practitioners worked together using design-based research methods to develop and test tinkering programs that could best support engineering learning. Two of the programs specified what families' engineering projects should do and provided exhibit spaces for testing and iterating the design (i.e., function-focused programs), and two programs did not. A total of 61 families with 6- to 8-year-old children (M_age = 7.07 years; 25 female) were observed during one of the programs and when reminiscing immediately after tinkering. Parent-child interaction patterns associated with understanding and remembering events-parent-child joint hands-on engagement and joint talk-and engineering design process talk were measured. All four programs were similar in terms of parent-child joint engagement. Compared with families who did not participate in function-focused programs, families who did talked more about the engineering design process during tinkering and when reminiscing. Parent-child engineering talk during tinkering mediated the association between the program design and engineering talk when reminiscing. Implications for research on children's learning and museum practice are discussed.

Acceptability and Feasibility of Hair and Salivary Biomarker Collection Among Multiethnic School-Age Children

OBJECTIVE

As noninvasive biological markers gain increasing popularity in pediatric research, it is critical to understand how study participants perceive these measures, especially among groups underrepresented in biobehavioral research, like children and people of color. The purpose of this study was to examine acceptability and feasibility of hair and salivary biomarker collection in an urban community sample of ethnically diverse children (age 4 to 10 years).

METHODS

Ninety-seven mother-child dyads were recruited for a cross-sectional follow up study of the Minding the Baby® home visiting intervention. Children were Hispanic (63%), Black (34%), and multi-racial (3.1%). A conventional content analysis was conducted using two sources of data: (1) mothers' responses to open-ended interview questions on their views and suggestions regarding biomarker collection, and (2) field notes recorded by investigators.

RESULTS

Forty-four percent of mothers reported biomarker-related questions or concerns, including questions about the purpose of biomarker testing, and concerns about cosmetic issues, child discomfort, and future use of biomarker data. Mothers also offered positive feedback and advice for collection. Issues affecting feasibility included children's hair length and style, refusal to participate, and behavioral or developmental issues.

CONCLUSIONS

Hair and salivary biomarker collection was largely acceptable and feasible in this sample. Strategies for promoting ethical and sensitive biomarker collection include respectful explanations and parental involvement, creating a comfortable and safe environment for the child, flexible collection strategies, and attention to development, cultural preferences and perspectives.

Mother-Child and Father-Child Connectedness in Adolescence and Disordered Eating Symptoms in Young Adulthood

PURPOSE

The aim of the study was to examine mother-child connectedness and father-child connectedness in adolescence as potential protective factors against a range of disordered eating symptoms in young adulthood among males and females.

METHODS

This study used data from the National Longitudinal Study of Adolescent to Adult Health (N = 13,532). Sex-stratified logistic regression models adjusted for demographic covariates were conducted to examine associations of youth-reported mother-child connectedness and father-child connectedness in adolescence (mean age = 15.4 years) with disordered eating symptoms in young adulthood (mean age = 21.8 years).

RESULTS

In this nationally representative sample of U.S. young adults, 7.2% of participants reported binge eating-related concerns, 3.7% reported compensatory behaviors (e.g., self-induced vomiting) to control weight, and 8.6% reported fasting/skipping meals to control weight. Among females, both higher mother-child connectedness and higher father-child connectedness were associated with lower odds of binge eating-related concerns (mother-child: odds ratio [OR] = .83, 95% confidence interval [CI] = .74-.94; father-child: OR = .79, 95% CI = .69-.91), compensatory behaviors (mother-child: OR = .85, 95% CI = .75-.97; father-child: OR = .81, 95% CI = .69-.95), and fasting/skipping meals (mother-child: OR = .79, 95% CI = .72-.87; father-child: OR = .81, 95% CI = .73-.91). No statistically significant associations were observed for mother-child connectedness or father-child connectedness with future disordered eating symptoms among males.

CONCLUSIONS

These findings suggest that improving mother-child connectedness and father-child connectedness in adolescence may be valuable targets for eating disorders intervention, particularly among females.

Psychopathology and impairment of quality of life in offspring of psychiatric inpatients in southern Brazil: a preliminary study

OBJECTIVE

To evaluate the quality of life and risk of psychopathology in the infant and adolescent offspring of psychiatric inpatients from a general hospital unit.

METHODS

Offspring (4-17 years old) of psychiatric inpatients were interviewed face-to-face and assessed with the Strengths and Difficulties Questionnaire (SDQ). Interviews with caregivers and the hospitalized parents were also performed. The quality of life of the offspring, psychopathology of their hospitalized parents, and their current caregivers were investigated in order to evaluate any associations between these aspects and psychopathology in the offspring.

RESULTS

Thirty-four children of 25 patients were evaluated, 38.2% of which presented high risk for some type of psychopathology including hyperactivity or attention deficit disorder (38.2%), behavioral disorders (20.6%), and emotional disorders (17.6%). While only the minority of these children (17.6%) were already receiving mental health treatment, another 41.2% of them exhibited some degree of symptoms and were only referred for specialized assessment. Additionally, 61.8% of the children were reported to be suffering from some impairment in their quality of life.

CONCLUSION

This preliminary study found a high rate of psychopathology in children of psychiatric inpatients. These results corroborate previous evidence that children and adolescents with parents with severe psychopathology are at high risk for developing mental disorders. Public policies and standard protocols of action directed to this population are urgently needed, especially for offspring of parents that are hospitalized in psychiatric in-patient units of general hospitals.

Factors associated with parental underestimation of child's weight status

OBJECTIVE

The aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation.

METHOD

Cross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2-8 years (n=976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance.

RESULTS

Overall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents.

CONCLUSION

Since awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status.

Unemployment, Parental Distress and Youth Emotional Well-Being: The Moderation Roles of Parent-Youth Relationship and Financial Deprivation

We investigated, in a sample of 112 unemployed parents of adolescents aged 10-19 years, the links between parental distress and change in youth emotional problems related to parental unemployment, and the moderation roles of parent-youth relationship and financial deprivation. Data were analyzed using descriptive statistics and correlations. Further, simple moderation, additive moderation, and moderated moderation models of regression were performed to analyze the effects of parental distress, parent-youth relationship and financial deprivation in predicting change in youth emotional problems related to parental unemployment. Results show that parental distress moderated by parent-youth relationship predicted levels of change in youth emotional problems related to parental unemployment. This study provides evidence that during job loss, parental distress is linked to youth emotional well-being and that parent-youth relationships play an important moderation role. This raises the importance of further researching parental distress impacts on youth well-being, especially during periods of high unemployment rates.

The association of parental temperament and character on their children's behavior problems

Purpose. Parents have important roles in child rearing, but the influence of their personality on rearing practices and their impact on the behavior of children has received surprisingly little attention. The aim of the current study was to investigate the relationship between parents' personality and children's problem behaviors. Materials and Methods. Participants consisted of 190 preschool outpatients (104 boys, 86 girls) and their parents who visited traditional Korean pediatric clinics with minor physical symptoms as chief complaints. The personality profiles of the both parents were measured by the Temperament and Character Inventory and children's behavior problems by the Child Behavior Checklist 1.5-5. Correlation and stepwise regression analysis were employed for the statistical analyses. Results. The temperament trait of Harm Avoidance and the character traits of Self-Directedness and Self-Transcendence of the parents were significantly correlated with children's problem behaviors. Character as well as temperament, played an important role in explaining children's problem behaviors after age and gender of children were taken into account. Conclusion. The maturity of parents' character appears to have a key role in reducing the risk of behavior problems in their children. Suggestions are made for parental education and future research.

Intergenerational cohesiveness and later geographic distance to parents in the Netherlands

Although spatial proximity no doubt facilitates interaction and assistance, no research to date has addressed the extent to which children who are emotionally closer to parents choose to live nearby. Using the Netherlands Kinship Panel Study (N = 1055), this research evaluates the relationship between parent-child cohesion at age 15 (measured retrospectively among individuals 18-35 in 2002-2004) and later geographic distance between young adults and their parents in 2006-2007. Importantly, this research is the first to consider the relationship between intergenerational solidarity and young adult's later geographic proximity to parents, proximity known to contribute to exchanges of support between the generations. For both mothers and fathers, each model yielded qualified evidence of the cohesion-proximity relationship. These findings highlight a potential selection issue related to intergenerational support and contact as it is facilitated by geographic proximity.

Sibling structure, distributive norms, and negotiation for mothers-in-law's assistance in rural South China

CONTEXT

Recent studies of parent-adult child relations using a network family approach have paid increasing attention to within-family differences and the role of in-laws in parent-adult child exchanges. However, the effect of sibling structure on the allocation of childcare and household help provided by older women, the negotiation process among in-laws and the underlying principle(s) have been under-examined.

PURPOSE AND METHODS

Based on ethnographic and interview data collected from 28 women in rural South China, this article examines the effect of sibling structure on mothers-in-law's assistance in the context of economic reform, and the role of cultural norms and daughters-in-law in the negotiation process using a family network perspective.

FINDINGS

Since the late 1970s, the sibling order of husbands and the presence of their unmarried brothers have negatively affected the bargaining power of young married women and their access to childcare assistance from their mothers-in-law. In terms of household help, sibling size and the equity principle have prevented mothers-in-law in larger extended families from providing assistance during both the pre-reform and reform periods. Although the equity norm is a pivotal moral resource for daughters-in-law in negotiating parental support, other competing norms, particularly parents' obligations to their unmarried adult sons, may set limits on their claims and bargaining power.

IMPLICATIONS

FINDINGS demonstrate that the distribution of childcare and household help provided by mothers-in-law are results of intra- and intergenerational negotiation among daughters- and mothers-in-law, rather than simply a dyadic parent-child relationship. Competing norms and daughters-in-law also play important roles in the negotiation for parental help.

Children's exposure to second hand smoke at home: a cross-sectional study in Portugal

Second-hand tobacco smoke (SHS) is a major indoor pollutant that causes serious health problems for all exposed, especially children. Children are often exposed to SHS at home, due to parental or other households' or guests' smoking. This study describes Portuguese children's exposure to SHS at home (total and by Portuguese main regions). In 2010/2011, a questionnaire was applied to a sample of Portuguese children in the 4th grade (N=3187, mean age 9.05±0.7 years, 51.1% male). Descriptive analysis, chi-square tests and crude odds ratios were performed. Of the participants, 62.9% of those with smoking parents and 19.2% of those with non-smoking parents were exposed to SHS at their home. Parental smoking varied significantly among regions and was significantly associated with children's exposure to SHS at home. Children's exposure to SHS at home was high, especially if their parents smoke. Children living in Lisbon Region presented the highest SHS exposure rate. The association of SHS exposure with geographic regions suggests the influence of social and contextual factors on smoking behaviour and on tobacco control effectiveness. Our findings highlight the need to effectively prevent children's SHS exposure at their home and to develop tailored tobacco control measures by region.

Lasting effects of an interdisciplinary home visiting program on child behavior: preliminary follow-up results of a randomized trial

Child mental health is of great concern requiring effective and appropriate parenting interventions. This pilot study was the first attempt to examine the intermediate effects of an ongoing parenting home visiting program, Minding the Baby (MTB), on parental reflective functioning (RF) and child behavior. Results indicated that the women who participated in the MTB intervention described their children-when assessed post-intervention-as having significantly fewer externalizing child behaviors. However, there was no significant difference between the two groups on parental RF from the end of the intervention to follow-up. The central finding that children who participated with the MTB program were reported to have significantly fewer externalizing behaviors following the intervention has important clinical and public health implications. Recommendations for the design of future follow-up studies and for further exploration of parental RF as it relates to the MTB outcomes are discussed.

Dating after late-life spousal loss: Does it compromise relationships with adult children?

In Widowhood in an American City (1973), Helena Lopata observed that widows struggle with new romantic relationships because their children often are resentful toward these new partners. Since the publication of Lopata's classic work, however, few studies have explored empirically the ways that widow(er)'s dating affects their relationships with children. We use prospective data from the Changing Lives of Older Couples study (CLOC) to explore: (1) the impact of bereaved spouses' dating on positive and negative aspects of parent-child relationships six and 18 months postloss; (2) the extent to which these associations are explained by preloss characteristics; and (3) the factors that moderate the association between widow(er) dating and parent-child relations. Multivariate analyses show that widowers who are interested in dating six months postloss report low levels of support and high levels of conflict with their children, yet widows report enhanced relationship quality. This pattern reflects the fact that men who are interested in dating do form new relationships, whereas women's interests are not translated into actual dating. Widowers' dating six months postloss compromises parent-child closeness among those with a history of strained parent-child relations, yet enhances closeness among those with historically good relationships. Dating takes a harsher toll on parent-daughter compared to parent-son relationships. Overall, dating threatens parent-child relationships in specific cases, yet it may also strengthen widow(er) s' parent-child bonds. We discuss the implications for the well-being of older widow(er)s and adult children.

Cost of talking parents, healthy teens: a worksite-based intervention to promote parent-adolescent sexual health communication

PURPOSE

To examine the cost and cost-effectiveness of implementing Talking Parents, Healthy Teens, a worksite-based parenting program designed to help parents address sexual health with their adolescent children.

METHODS

We enrolled 535 parents with adolescent children at 13 worksites in southern California in a randomized trial. We used time and wage data from employees involved in implementing the program to estimate fixed and variable costs. We determined cost-effectiveness with nonparametric bootstrap analysis. For the intervention, parents participated in eight weekly 1-hour teaching sessions at lunchtime. The program included games, discussions, role plays, and videotaped role plays to help parents learn to communicate with their children about sex-related topics, teach their children assertiveness and decision-making skills, and supervise and interact with their children more effectively.

RESULTS

Implementing the program cost $543.03 (standard deviation, $289.98) per worksite in fixed costs, and $28.05 per parent (standard deviation, $4.08) in variable costs. At 9 months, this $28.05 investment per parent yielded improvements in number of sexual health topics discussed, condom teaching, and communication quality and openness. The cost-effectiveness was $7.42 per new topic discussed using parental responses and $9.18 using adolescent responses. Other efficacy outcomes also yielded favorable cost-effectiveness ratios.

CONCLUSIONS

Talking Parents, Healthy Teens demonstrated the feasibility and cost-effectiveness of a worksite-based parenting program to promote parent-adolescent communication about sexual health. Its cost is reasonable and is unlikely to be a significant barrier to adoption and diffusion for most worksites considering its implementation.

Rural parents' messages to their adolescent sons and daughters to leave their home communities

The perceptions of 354 seventh and eleventh graders regarding the frequency and nature of their rural parents' messages to them and their closest-in-age sibling to leave their home communities after high school were explored. Survey data showed that almost half (54%) perceived that their parents encouraged them and/or their closest-in-age sibling to leave the area and about 19% of that group reported that their parents' messages to leave were inconsistent between them and their closest sibling. Parents' messages did not differ by youths' sex or age. Consistency of parents' messages between siblings was associated with youths' well-being, family relationship experiences, and future residential preferences. Semi-structured interviews with a subsample of seventh graders and their mothers highlighted parents' and youths' perspectives on parents' messages. This work highlights the familial processes associated with youth future planning and extends the current work on parents' differential treatment of siblings.

Emotional relationship quality of adult children with ageing parents: on solidarity, conflict and ambivalence

Emotions towards a relationship partner provide relevant and specific information about relationship quality. Based on this assumption the present study was performed to identify different types of emotional relationship quality of middle-aged adult children with their ageing parents. This was done by cluster analytic procedures in a sample of 1,208 middle-aged adult children (482 men, 726 women). Using ratings of positive and negative emotions towards their mother and father as grouping variables, the same four-cluster solution emerged for both the child-mother relationship and the child-father relationship. Clusters were labelled as amicable, disharmonious, detached and ambivalent relationships. Results showed that especially amicable relationships clearly prevailed followed by ambivalent, detached and disharmonious relationships. Clusters differed significantly with respect to gender of adult child, willingness to support, expected parental support and overt conflicts. In a cross-classification of cluster membership regarding the child-mother relationship (four clusters) and the child-father relationship (four clusters), all possible 16 combinations were observed, with a considerable degree of divergence regarding the type of relationship quality within the same family. Results are discussed with respect to types of emotional relationship quality, within family differences and the intrafamilial regulation of relationship quality.

Predicting Children's Depressive Symptoms from Community and Individual Risk Factors

Community, demographic, familial, and personal risk factors of childhood depressive symptoms were examined from an ecological theoretical approach using hierarchical linear modeling. Individual-level data were collected from an ethnically diverse (73% African-American) community sample of 197 children and their parents; community-level data were obtained from the U.S. Census regarding rates of community poverty and unemployment in participants' neighborhoods. Results indicated that high rates of community poverty and unemployment, children's depressive attributional style, and low levels of self-perceived competence predict children's depressive symptoms, even after accounting for demographic and familial risk factors, such as parental education and negative parenting behaviors. The effect of negative parenting behaviors on depressive symptoms was partially mediated by personal variables like children's self-perceived competence. Recommendations for future research, intervention and prevention programs are discussed.