Universal Digital Programs for Promoting Mental and Relational Health for Parents of Young Children: A Systematic Review and Meta-Analysis.

Digital parenting programs aim to increase program access, improve psychosocial outcomes for parents and children, and support triage to targeted interventions where required. This meta-analysis assessed the efficacy of online parenting programs in improving parenting skills and capabilities, and by consequence, the mental health and well-being of parents and children, and the quality of the parent-child relationship. Studies were included if they were: (1) online, (2) self-delivered, (3) designed for universal general population prevention, (4) evaluated experimental or quasi-experimental designs, and (5) assessed parent and child emotional and/or relational health, from pregnancy to 5 years of age. A systematic search of electronic databases and grey literature identified 22 studies that met inclusion criteria, including 24 independent samples, with 5671 unique parents. Meta-analyses were conducted using random effects models and Cohen's d effects. Small-to-moderate improvements in parent depression, anxiety, self-efficacy, and social support were observed. No effects on parent stress, satisfaction, or parent-child relationship quality were observed. Meta-regression and sub-group analysis were conducted to identify sensitivity or moderation effects. Collectively, findings suggest any benefits of online parenting programs mostly occur at the time of the intervention, for parent mental health and well-being outcomes, and that enduring effects are unlikely. However, given the cost effectiveness and accessibility of online programs, further research into ways of sustaining effects on parenting outcomes is warranted. Furthermore, given the centrality of the parent-child bond to child development across the lifecourse, additional investment in new digitally facilitated approaches focusing on this bond are likewise warranted.PROSPERO registration CRD42021275647.

Sexting Among Australian Adolescents: Risk and Protective Factors.

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (Mage = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention.

The Role of Consent and Motivations in Sext Dissemination.

Sext dissemination (i.e., the online sharing of sexually explicit images) has the potential to result in legal, social, and psychological harms. Recent research has shown that this behavior can be consensual or non-consensual in nature; yet little is known about how motivations or attitudes may differ between these forms, or with gender. This study is based on a cross-sectional online survey investigating consensual and non-consensual sext dissemination and associated demographic, behavioral, attitudinal, and psychological factors. Participants were 2,126 cisgendered adults aged 18 to 30 years (M = 22.97, SD = 3.21, 55% women, 45% men), resident in Western, English-speaking nations, particularly Australia. Around 10% of respondents reported disseminating texts, and of these, only 19.8% indicated they had permission for this, with no differences across gender. When sexts were disseminated "to gossip," this was significantly more likely to be non-consensual. There were no significant differences between consensual and non-consensual dissemination in subjective attitudes or norms toward dissemination, nor levels of psychological distress. Women were more likely to non-consensually disseminate sexts that had been received as unwanted or unwelcome. Consensual dissemination was weakly associated with being sexually active and having given consent to having one's own images disseminated. We discuss implications for future research regarding consent, and relationship and sexuality education.

School Influences on Adolescent Depression: A 6-Year Longitudinal Study Amongst Catholic, Government and Independent Schools, in Victoria, Australia.

This study examined associations between school sector (Government, Catholic or Independent) and depressive symptomology over the secondary school years. Six waves of data collected annually from a representative Australian sample were examined. Multilevel piecewise linear and logistic regression controlling for a variety of demographic variables and protective factors was undertaken. In all sectors, depressive symptomology decreased between 10 and 13 years of age, but significantly increased for girls at age 13. Adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools. Adolescents in Catholic schools were less likely to report clinical levels of depressed mood compared to adolescents in Government schools.

Telehealth service delivery in an Australian regional mental health service during COVID-19: a mixed methods analysis.

BACKGROUND: COVID-19 required mental health services to quickly switch from face-to-face service delivery to telehealth (telephone and videoconferencing). This evaluation explored implementation of a telehealth mental health response in a regional public mental health provider. METHODS: A mixed methods approach, combining service use data, brief satisfaction surveys, and qualitative interviews/focus groups was undertaken. Number and types of contacts from de-identified mental health service data were compared between April-May 2020 and April-May 2019. Mental health consumers and providers completed brief online satisfaction surveys after videoconferencing sessions. Attitudes and perspectives on the implementation of telehealth were further explored by applying a descriptive qualitative framework to the analysis of interview and focus group data supplied by consumers and providers. Template thematic analysis was used to elucidate key themes relating to the barriers and enablers of telehealth uptake and future implementation recommendations. RESULTS: Total contacts decreased by 13% from 2019 to 2020. Face-to-face contacts decreased from 55% of total in 2019 to 24% in 2020. In 2019, 45% of contacts were by telephone, increasing to 70% in 2020. Only four videoconferencing contacts were made in 2019; increasing to 886 in 2020. Consumer surveys (n = 26) rated videoconferencing as good or excellent for technical quality (92%), overall experience (86%), and satisfaction with personal comfort (82%). Provider surveys (n = 88) rated technical quality as good or excellent (68%) and 86% could achieve assessment/treatment goals with videoconferencing. Provider focus groups/interviews (n = 32) identified that videoconferencing was well-suited to some clinical tasks. Consumers interviewed (n = 6) endorsed the ongoing availability of telehealth within a blended approach to service delivery. Both groups reflected on videoconferencing limitations due to infrastructure (laptops, phones, internet access), cumbersome platform and privacy concerns, with many reverting to telephone use. CONCLUSIONS: While videoconferencing increased, technical and other issues led to telephone being the preferred contact method. Satisfaction surveys indicated improvement opportunities in videoconferencing. Investment in user-friendly platforms, telehealth infrastructure and organisational guidelines are needed for successful integration of videoconferencing in public mental health systems.

A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse.

Cyberbullying can present a serious risk for adolescents and young adults, with severe effects on victims including adverse mental health outcomes and increased risk of suicide. Transgender and gender diverse (TGD) individuals are significantly more likely to experience cyberbullying. However, little is presently known about the lived cyberbullying experiences of TGD adults despite the prevalence of cyberbullying experienced by the TGD community. TGD participants (n = 66, M = 24 years) were recruited through snowball sampling and completed an online questionnaire as part of a larger study, which included qualitative questions regarding cyberbullying. Participants reported that cyberbullying was experienced predominantly on social media sites and was largely anonymous. The content was often physically and sexually threatening and heavily transphobic. Additionally, some cyberbullying experienced by TGD individuals was perpetrated by other TGD individuals and focused on the identity policing and gatekeeping of TGD spaces. Participants reported cyberbullying evoked negative emotions, and they often responded by either arguing with or blocking the perpetrators, thereby demonstrating resilience. Some participants sought social support in response to cyberbullying, which acted as a protective factor. Findings reveal specific harms associated with cyberbullying as experienced by TGD individuals and highlight the need for further research and targeted support.

"Did You Bring It Home with You?" A Qualitative Investigation of the Impacts of the COVID-19 Pandemic on Victorian Frontline Healthcare Workers and Their Families.

Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to "get through it". While efforts have been made by many healthcare organisations to support their workers during this challenging time, the changes in family functioning observed by participants suggest that more could be done for this vulnerable cohort, particularly with respect to family support.

Just Checking It Out? Motivations for and Behavioral Associations With Visiting "Slutpages" in the United States and Australia.

"Slutpages" are a pernicious form of online image-based evaluative voyeurism (OIBEV), whereby (sexualized) images of women are posted on webpages for (predominantly) male groups to rate and comment. Despite media and public concern, OIBEV sites have garnered limited empirical study. This paper presents the first analysis of OIBEV site visitation motivations across United States and Australian samples. Participants comprised a convenience sample of 1148 young adults aged 18 to 29 years (M = 22.54, SD = 2.50); 53.0% women, 47.0% men; 54% residing in the U.S. and 46% in Australia. Respondents completed an online questionnaire. Overall, 23% of United States and 16% of Australian respondents had visited OIBEV sites. OIBEV site visitation was uniquely associated with gender and country (with men and United States being more likely to visit OIBEV sites), requesting and disseminating sexts and having one's own image shared. Cyberbullying perpetration was associated with reduced odds of OIBEV site visitation. Motivations differed by gender, with men (80%) being most likely to visit sites to "check them out" while women were equally likely to check it out (41%) or to see if they were depicted (36%). For men, unique predictors of OIBEV site visitation were having requested, disseminated and received disseminated sexts, lower levels of anxiety and reduced likelihood of cyberbullying perpetration. For women, OIBEV site visitation was uniquely associated with being a United States resident, sext dissemination victimization, receipt of disseminated sexts, higher levels of anxiety but reduced stress. Our findings confirm that OIBEV sites represent a highly gendered form of online image-based sexual abuse, and may have important mental health implications, given the associations with increased anxiety. Our results support the need for "slutpage" education for adolescents and young adults to address social and peer norms that encourage and support non-consensual use of intimate images.

Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

Parent education programs, offered via family-school partnerships, offer an effective means for promoting the mental health and educational functioning of children and adolescents at a whole-school level. However, these programs often have a low uptake. This study aimed to identify strategies for increasing the uptake of parent education programs within preschool and school settings. A three-round Delphi procedure was employed to obtain expert consensus on strategies that are important and feasible in educational settings. First, thirty experts rated statements identified from the literature and a stakeholder forum. Next, experts re-appraised statements, including new statements generated from the first round. Ninety statements were endorsed by ≥80% of the experts. Primary themes include strategies for program selection; strategies for increasing the accessibility of programs and the understanding of educational staff on parent engagement and child mental health; strategies for program development, promotion and delivery; as well as strategies for increasing parent and community engagement. This study offers a set of consensus strategies for improving the uptake of parent education programs within family-school partnership.

Sext Dissemination: Differences across Nations in Motivations and Associations.

Sext dissemination presents policy and legislative challenges given its potential psychological, social, and legal harms. We report on a cross-national comparison of sext-image dissemination in a large sample of 1148 young adults aged 18-29 years (M = 22.54, SD = 2.50, 53.0% women, 47.0% men), either U.S. (53.8%) or Australian (46.2%) residents. The results indicate that 14% of young adults disseminated sexts, with no difference by gender or country. Over 50% of respondents indicated that the last time they received a disseminated sext, it was unexpected or unwelcome, with women twice as likely as men to receive unwelcome sexts. The most frequent motivations for sext dissemination were similar cross-nationally, relating to the attractiveness of the person depicted, as a joke, to gossip, because it was not a big deal, bragging, roasting or teasing, and to increase social status. Motivations of attractiveness, bragging, or social status were more commonly endorsed by men, while women endorsed reasons around gossip or roasting/teasing. Unique predictors of sext dissemination included U.S. residence, requesting sexts, receiving disseminated sexts, having one's own images disseminated, and more positive subjective norms to dissemination, and there was a country-gender interaction, where Australian women and U.S. men were more likely to disseminate sexts than then U.S. women or Australian men. The findings have implications for prevention programs seeking to address harmful online sexual interactions, including addressing respect, consent, and subjective norms supporting non-consensual dissemination.

Motor-response execution versus inhibition alters social-emotional evaluations of specific individuals.

Social-emotional evaluations of unfamiliar people are negatively impacted by ignoring or withholding motor-responses from images that depict them; an effect attributed to the propensity of inhibition to affectively devalue associated stimuli. Prior findings suggest that the social-emotional consequences of inhibition may operate on category-level representations that impact all members of a corresponding group. Here we assess whether such social-emotional consequences of motor-response action versus inaction also operate on item-level representations of specific individuals. Participants memorized individual identities of a group of fellow students before completing a Go/No-go response-inhibition task designed to associate item-level representations of each previously-memorized person with action (Go trials) or inaction (No-go trials). Social identities associated with action were consistently rated as more trustworthy in subsequent evaluations than those associated with inaction. This suggests that the social-emotional consequences of motor-response execution versus inhibition can operate on item-level stimulus representations in memory.

Slutpage Use Among U.S. College Students: The Secret and Social Platforms of Image-Based Sexual Abuse.

The phenomenon of "slutpages," tied to high schools, fraternities, and the military, used to post, share, and comment on nude and semi-nude images of women, has emerged in mass media. To our knowledge, this is the first study to empirically investigate slutpage use behaviors including: visiting slutpages, posting nude images/videos online without consent, and using a vault app to store/share nude images. We conducted a survey of undergraduate college students attending a large Midwestern university in the U.S., with 1867 respondents (36.4% cis/transgender men, 63.6% cisgender women; 18-24 years old M = 20.39) to determine who is engaging in slutpage use behaviors. Our results showed that younger participants and men were more likely to engage in slutpage use behaviors than older participants and women, especially if they participated in Greek Life or played a team sport for their university. Men in a fraternity or on a team sport visited slutpages and posted nude images/video online without consent more frequently than men outside these groups, or women in general. Drinking alcohol and using pornography more frequently were also associated with slutpage use behaviors. This study provides a new understanding of slutpages as a social form of image-based sexual abuse and informs researchers, educators, and policy makers to expand their inquiry into online sexual experiences and exploitation to include this phenomenon.

Training maternal and child health nurses in early relational trauma: An evaluation of the MERTIL workforce training.

BACKGROUND: Parents who experience relational trauma may inadvertently create contexts of care that undermine secure beginnings to life for their young children. Universal health services such as Maternal and Child Health (MCH) services offer a unique whole-of-population platform for prevention through early detection and intervention. To date however, relevant workforce training has been minimal. OBJECTIVES: We report on an evaluation of state-wide workforce training to support MCH nurses to identify and respond to early relational trauma within parent-child dyads. DESIGN: Process and learning evaluation data were obtained at baseline (N = 1450), exit (n = 734) and follow-up (n = 651). SETTINGS AND PARTICIPANTS: Specialist training was developed and delivered to 1513 MCH staff in Victoria, Australia, via a 20-hour program of online learning and clinical skills workshops. RESULTS: At baseline, across eight measures of confidence in recognizing and responding to relational trauma, 30-49% of nurses rated their confidence as low. Significant increases in all areas of self-rated learning were found post-training. Three months post-training, gains in confidence and capability were sustained, with no significant variations by participant role or setting. Overall program satisfaction was >90%. Continuing concerns at follow-up focused on pragmatic concerns about inadequacy of referral networks and appropriate intervention pathways. CONCLUSIONS: In this evaluation of a state-wide training program for nurses working with early relational trauma, we found excellent uptake and program satisfaction, and results support learning impact and retention. Findings are discussed with regard to translation potential across early childhood settings.

Response inhibition immediately elicits negative affect and devalues associated stimuli: Evidence from facial electromyography.

Response inhibition negatively impacts the emotional and motivational significance of associated stimuli. Current accounts question whether this stimulus devaluation effect occurs immediately via negative affect elicited by inhibition, or only occurs later via a misattribution of decreased fluency as unpleasantness in the context of an explicit affective-evaluation task. Using facial electromyography, we recorded indirect physiological markers of affective response during a response-inhibition (Go/No-go) task to test opposing predictions arising from the immediate-affect and delayed-misattribution hypotheses. Engagement of the corrugator supercilli-a muscle closely associated with negative affect-was greater during periods when response inhibition was applied (No-go trials) than when not applied (Go trials). Moreover, corrugator engagement during response-inhibition predicted the magnitude of stimulus devaluation measured behaviorally in subsequent subjective ratings (How cheerful?), with greater engagement during No-go trials that contained abstract-art stimuli later rated negatively than during trials that contained items later rated positively. These results support the immediate-affect hypothesis and converge with prior neuroimaging evidence to suggest that the negative impact of inhibition promptly alters the coding of stimulus value. In contrast, none of the delayed-misattribution based predictions were confirmed.