Intimate partner violence exposure during infancy and social functioning in middle childhood: An Australian mother and child cohort study.

Social functioning of children with experiences of intimate partner violence (IPV) between caregivers in early childhood has received less attention than emotional-behavioral outcomes. Drawing on data from 1507 ten-year-old Australian-born children and their mothers participating in a community-based longitudinal study, this study examined the associations between IPV exposure during infancy and social development during middle childhood. IPV during the first 12 months of life was associated with lower social skills, higher peer problems, and peer victimization at age 10 years, while accounting for concurrent IPV. This study provides evidence for the long-term impacts of early-life IPV exposure on children's social functioning, and the importance of prevention and early intervention programs focused on social development following experiences of IPV.

Parental Mental Health and Parenting Behaviors Following Very Preterm Birth: Associations in Mothers and Fathers and Implications for Child Cognitive Outcome.

OBJECTIVES: To investigate the longitudinal associations between parental mental health symptoms within 4 weeks of birth, parenting behaviors at 1 year, and child general cognitive ability at 4.5-5 years in a sample of children born very preterm (VP). This study also examined whether these associations differed based on level of family social risk. METHODS: Participants were 143 children born <30 weeks' gestation and their parents. Within 4 weeks of birth, mothers' and fathers' depressive and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and Hospital Anxiety Depression Scale-Anxiety Subscale. Parents' sensitive and structuring parenting behaviors were assessed at 1 year using the Emotional Availability Scales. Child general cognitive ability was assessed at 4.5-5 years using the Wechsler Preschool & Primary Scale of Intelligence-Fourth Edition. RESULTS: Higher maternal depressive symptoms were associated with lower levels of sensitive and structuring parenting behavior, while higher maternal anxiety symptoms were associated with higher levels of structuring parenting behavior. There was weak evidence for positive associations between mothers' sensitive parenting behavior and fathers' structuring parenting behavior and child general cognitive ability. There was also weak evidence for stronger associations between mothers' mental health symptoms, parenting behaviors, and child general cognitive ability, in families of higher compared with lower social risk. CONCLUSIONS: Depressive and anxiety symptoms experienced by mothers in the initial weeks following VP birth can have long-term effects on their parenting behaviors. Enquiring about parents' mental health during their child's hospitalization in the neonatal intensive care unit is crucial.

Preconception factors associated with postnatal mental health and suicidality among first-time fathers: results from an Australian Longitudinal Study of Men's Health.

PURPOSE: Prospective evidence about men at risk of postnatal difficulties is rare-particularly for postpartum suicidal ideation. This study aimed to determine the extent to which first-time fathers reported depressive symptoms and suicidal ideation and behaviours in the first postnatal year, and to identify preconception risk factors for postnatal mental health difficulties. METHODS: Secondary analysis of data from The Ten to Men Study-Australia's population-based prospective study of men's health was conducted. Participants were 205 men who became first-time fathers in the 12 months prior to wave 2 (2015/16). Regression analyses were used to ascertain preconception (mental and physical health, lifestyle) and demographic factors associated with postnatal depressive symptoms. RESULTS: Postnatally, 8.3% of fathers reported moderate to severe depressive symptoms, 5% had suicidal thoughts, 3% had plans, and less than 1% had attempted suicide. Preconception depressive symptoms was the only factor significantly associated with postnatal depressive symptoms. CONCLUSION: The transition into fatherhood is marked with significant psychological distress for some men. These results suggest that mental health screening and support in the preconception period is crucial to supporting the mental health of new fathers.

Working out dads (WOD): a study protocol for a randomised controlled trial of a group-based peer support intervention for men experiencing mental health difficulties in early fatherhood.

BACKGROUND: Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers' mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) - a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms. METHODS: This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation. DISCUSSION: This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated. TRIAL REGISTRATION: The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042 ). Date of Registration: March 22nd, 2021.

Intimate partner violence during infancy and cognitive outcomes in middle childhood: Results from an Australian community-based mother and child cohort study.

The cognitive functioning of children who experience intimate partner violence (IPV) has received less attention than their emotional-behavioral outcomes. Drawing upon data from 615 (48.4% female) 10-year-old Australian-born children and their mothers (9.6% of mothers born in non-English speaking countries) participating in a community-based longitudinal study between 2004 and 2016, this study examined the associations between IPV in infancy and cognition in middle childhood (at age 10). Results showed that IPV in the first 12 months of life was associated with lower general cognitive ability and poorer executive attention but not working memory skills. IPV in middle childhood (in the 10th year postpartum) was not associated with cognition. This study provides evidence for the long-term impact of early life exposure to IPV on children's cognition, and points to the importance of early intervention to optimize development.

Trajectories of interparental conflict and children's emotional-behavioural functioning at 10-11 years: an Australian population-based study.

Interparental conflict (IPC) has the potential to adversely affect children's social, emotional, and behavioural functioning. The overall objective of this study was to investigate the relationship between both the severity and chronicity of IPC across early and middle childhood and children's emotional-behavioural functioning at 10-11 years. Specifically, we aimed to: (1) identify distinct trajectories of IPC spanning 10-11 years since birth of the study child as reported by mothers, and (2) examine the emotional-behavioural functioning of children exposed to the identified IPC trajectories. Drawing from a nationally representative longitudinal study of Australian families (N = 4875), four distinct trajectories of IPC were identified: (1) consistently low exposure to IPC over time, (2) persistently elevated exposure to IPC, (3) increasing IPC exposure over time, and (4) decreasing IPC exposure over time. Children exposed to trajectories with high IPC at any point during the study period were reported by their mothers to be experiencing more emotional-behavioural difficulties than children exposed to low IPC over time. Based on teacher report, there were no differences in emotional-behavioural functioning of children exposed to the different patterns of IPC. Our findings reinforce that high parental conflict at any point in a child's life is a form of adversity that can have adverse consequences for their mental health, and that early interventions for parents and caregivers experiencing high IPC are critical.

Inequalities in the distribution of COVID-19-related financial difficulties for Australian families with young children.

BACKGROUND: We examine (1) the frequency of financial difficulties in Australian families with young children (0-8 years) in the early and later phases of the pandemic; (2) the extent to which parents' pre-pandemic socio-economic disadvantage (SED) predicted financial difficulties; and (3) whether grandparent intergenerational SED further amplified this risk. METHOD: Data: Australian Temperament Project (ATP; established 1983, N = 2443) and ATP Generation 3 study (ATPG3; established 2012; N = 702), of which 74% (N = 553) completed a COVID-specific module in the early (May-September 2020) and/or later (October-December 2021) phases of the pandemic. OUTCOMES: Parent-reported loss of employment/reduced income, difficulty paying for essentials, and financial strain. EXPOSURES: Pre-pandemic parent and grandparent education and occupation. ANALYSIS: Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre-pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders. RESULTS: At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30-38; later: 32%, 95% CI = 28-36). Each standard deviation increase in the parents' pre-pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04-1.78). There was little evidence of an interaction between the SED of parents and grandparents. CONCLUSIONS: Financial impacts related to the COVID-19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre-pandemic SED. Given the well-established relationship between disadvantage and child health and development, sustained and well-targeted government supports will be critical to minimizing adverse impacts in years to come.

The COVID-19 pandemic and Australian parents with young children at risk of interparental conflict.

BACKGROUND: The COVID-19 pandemic has created many challenges for families across the world, with those who have recently had a baby particularly vulnerable to increased stress Study Aim: The current study aimed to explore the experiences of the COVID-19 pandemic of families who have recently had a baby in Melbourne, Australia. METHODS: Interviews were conducted with sixteen parents participating in a family-based intervention during early parenthood and seven clinicians who delivered the program. RESULTS: Parents and clinicians described impacts of the pandemic on parent and family functioning included mental health concerns, stress and irritability, feelings of isolation, and increased relationship tension. Parents discussed coping strategies used during the crisis, including activities with their family, connecting with others, trying to stay positive, and self-care activities such as spending time outdoors. Both parents and clinicians acknowledged the importance of mental health and parenting support during and following the pandemic, and for these services to be promoted and easily accessible. DISCUSSION: The study highlights the mental health and parenting support needs of families during times of crisis and emphasises the importance of early intervention for families exhibiting poor communication and relationship tension.

Preservation and reunification for families of young children: case file review of a home-visiting program.

OBJECTIVE: The Home Parenting Education and Support (HoPES) programme is a new intensive 8-week home-visiting intervention supporting the preservation and reunification of families with young children (aged 0-4 years) receiving child protection services following child abuse and/or neglect in Australia. The aims of the study were to (a) describe families who had participated in HoPES, (b) describe the key education content and support activities of the programme, and (c) identify the enablers and challenges in implementing HoPES. BACKGROUND: Intensive home-based family preservation programs are designed to improve parenting skills, reduce specific abusive behaviours, and address child, parent and contextual risk factors for child maltreatment and its recurrence. METHODS: A casefile review and document analysis of 34 families who enrolled in HoPES was conducted. RESULTS: Families enrolled in HoPES were experiencing significant parent and child risk factors for child maltreatment and recurrence. Despite challenges in supporting families experiencing many complex social health issues and stressful life circumstances, there was evidence of intervention tailoring and use of strengths-based approaches to meet the needs of families. CONCLUSION: This casefile review gathered rich evidence to inform further development of a trauma informed and culturally sensitive intervention to support family preservation and reunification, and to guide the next stage of evaluation research to generate a more robust level of evidence.

Examining a rural Victorian community's knowledge and help seeking behaviour for family violence and the role of the local public health service.

OBJECTIVE: The rates of family violence within some rural communities are higher than that of metropolitan areas. The extent to which these rural communities know about and access family violence support services is not well understood. Local health services often play a role in providing information and support for community members at risk of, or experiencing family violence. For a rural community in Victoria, the study aimed to: (a) determine community members' knowledge of family violence services, (b) explore community members' help seeking behaviour for family violence, (c) identify perceived barriers and enabling factors to accessing family violence services and (d) explore community members' expectations of, and preferences for, family violence support provided by local health services. DESIGN: A cross-sectional, anonymous, mixed-methods online survey. SETTING: A rural community in Victoria's Western District, Australia. PARTICIPANTS: Ninety-nine residents, over 18 years of age. RESULTS: The majority of respondents had been exposed to family violence. There were varying knowledge levels of family violence support services as well as a number of barriers identified that directly impacted community members seeking help. There were clear expectations about the role of the local health service in family violence identification and response. CONCLUSION: There are particular challenges for rural communities in providing support for family violence. Valuable insights can be gained from local communities about their knowledge of services and help seeking behaviours. Evidence generated by this study will inform future strategic planning for family violence services and the local health service.

Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort.

OBJECTIVE: To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants. STUDY DESIGN: Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years. RESULTS: Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63). CONCLUSIONS: Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.

The maternal health study: Study design update for a prospective cohort of first-time mothers and their firstborn children from birth to age ten.

BACKGROUND: Maternal health is critical to the health and well-being of children and families, but is rarely the primary focus of pregnancy and birth cohort studies. Globally, poor maternal health and the exposure of women and children to family violence contribute to the perpetuation and persistence of intergenerational health inequalities. OBJECTIVES: The Maternal Health Study was designed to investigate the contribution of social and obstetric risk factors to common maternal physical and psychological morbidities. Over time, our focus has expanded to include mother-child pairs and investigation of intergenerational trauma and family violence. POPULATION: A total of 1507 first-time mothers were recruited in early pregnancy from six public hospitals in Melbourne, Australia, in 2003-2005. METHODS: Women completed questionnaires or telephone interviews in early pregnancy (≤24 weeks); at 32 weeks' gestation; at three, six, nine, 12 and 18 months postpartum; and at four and ten years. At ten years, women and children were invited to participate in face-to-face interviews, which included direct assessment of children's cognitive and language development. A wide range of obstetric, social and contextual factors have been measured, including exposure to intimate partner violence (IPV) (1-year, 4-year and 10-year follow-up). RESULTS: 1507 eligible women were recruited at a mean gestation of 15 weeks. At one year, four years and ten years postpartum, 90.0%, 73.1% and 63.2% of the original cohort took part in follow-up. One in three women in the study (34.5%) reported exposure to IPV in the first ten years of motherhood: 19% in the first 12 months postpartum, 20% in the year prior to four-year follow-up and 18.3% in the year prior to ten-year follow-up. CONCLUSION: The study affords a unique opportunity to examine patterns of maternal and child health and health service use associated with exposure to IPV.

Hair cortisol in mother-child dyads: examining the roles of maternal parenting and stress in the context of early childhood adversity.

Physiological stress is thought to be one way that early adversity may impact children's health. How this occurs may be related to parental factors such as mothers' own stress and parenting behaviour. Hair cortisol offers a novel method for examining long-term physiological stress in mother-child dyads. The current study used hair cortisol to examine the role that maternal physiological stress and parenting behaviours play in explaining any effects of adversity on young children's physiological stress. This cross-sectional study comprised 603 mother-child dyads at child age 2 years, recruited during pregnancy for their experience of adversity through an Australian nurse home visiting trial. Hair cortisol data were available for 438 participating mothers (73%) and 319 (53%) children. Confirmatory factor analysis was used to define composite exposures of economic (e.g. unemployment, financial hardship) and psychosocial (e.g. poor mental health, family violence) adversity, and positive maternal parenting behaviour (e.g. warm, responsive). Structural equation modelling examined maternal mediating pathways through which adversity was associated with children's physiological stress. Results of the structural model showed that higher maternal and child physiological stress (hair cortisol) were positively associated with one another. Parenting behaviour was not associated with children's physiological stress. There was no evidence of any mediating pathways by which economic or psychosocial adversity were associated with children's physiological stress. The independent association identified between maternal and child hair cortisol suggests that young children's physiological stress may not be determined by exogenous environmental exposures; endogenous genetic factors may play a greater role.

"We're in the background": Facilitators and barriers to fathers' engagement and participation in a health intervention during the early parenting period.

ISSUES ADDRESSED: Little is known about the barriers and facilitators associated with engaging fathers in interventions targeting their physical and mental health. The current research therefore aimed to explore fathers' perceived barriers and facilitators to engagement and participation in a health intervention delivered during the early parenting period. METHODS: Eleven fathers of young children (0-4 years) were interviewed about their perceptions and experiences of facilitators and barriers to engaging and participating in an intervention (Working Out Dads) to target their mental and physical health. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis. RESULTS: Fathers identified a number of program-related and father-related facilitators and barriers which impacted their engagement and participation. Program-related facilitators included: accessibility of the program; father advocacy of the program; group fitness/exercise component; and having a father-specific program. Facilitating factors related to fathers included: making social connections; learning how to be a better dad/partner; and partner support and encouragement to attend. Program-related barriers included: travel; lack of awareness; and gender roles. While father-related barriers included: being time poor; sacrifices to family; and apprehension. CONCLUSIONS: The current findings identified many areas that facilitate, encourage and motivate men to participate in interventions which support their mental and physical health during the early parenting period. RELEVANCE: Generating evidence on barriers and facilitators to health interventions is important to improving the current intervention along with informing the development of engaging and targeted health interventions for fathers in early parenthood.

Mental Health Trajectories of Fathers Following Very Preterm Birth: Associations With Parenting.

OBJECTIVE: Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers' depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors. METHODS: In total, 100 fathers of 125 infants born VPT (<30 weeks' gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant's birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months' corrected age. At 12 months' corrected age, fathers' parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers' depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers' parenting behaviors. RESULTS: For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories. CONCLUSIONS: Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.

Predictors of child resilience in a community-based cohort facing flood as natural disaster.

BACKGROUND: Natural disasters are unpredictable and uncontrollable events that usually induce significant level of stress and social disruption in afflicted individuals. The consequences are formidable, affecting lifetime health and economic prosperity. Among natural disasters, floods are the most common causes and tend to have the highest economic burden. The aim of this study was to examine factors associated with child resilience in the face of the natural disaster experienced by the city of Calgary, Alberta, Canada during its unprecedented flood of 2013. METHODS: The current study was conducted in a community-based cohort situated in the city of Calgary. The participants were recruited out of the All Our Families longitudinal cohort within the Cummings School of Medicine at the University of Calgary. Of the total 1711 people contacted, 469 people consented and completed questionnaire. Of those 469 who consented to be part of the study, 467 were eligible to be included for analysis. A flood impact questionnaire was delivered 6 months after the 2013 flood in families whose children were an average of 3 years old. Mother reported questionnaires were used to assess child resilience. The study included maternal data on a range of factors including socio-demographic, history of mental health, relationship with the partner and social support. Child related data were also incorporated into the study, and variables included delivery mode, child sex, and child age at the time of disaster. RESULTS: Child resilience was best predicted by mother's age and social support, and by child gender, the child's externalizing and internalizing behaviors and the Rothbart temperament scale: effortful control. Furthermore, this study revealed that children who were more exposed to the flood events, showed higher resilience compared to the children who were less or not exposed. CONCLUSIONS: These findings highlight the risk and protective factors that predict child resilience and suggest that mother reported questionnaire are useful tools to assess child resilience amidst early life adversity.

Maternal postnatal mental health and offspring symptoms of ADHD at 8-9 years: pathways via parenting behavior.

Exposure to maternal mental health problems during pregnancy and the first year of life has been associated with the development of ADHD. One pathway through which maternal mental health may influence children's outcomes is via its effects on parenting. This study aimed to investigate the mediating role of parenting behavior in the pathway between maternal postnatal distress and later symptoms of ADHD in the child. Biological mothers living with their children participating in the Longitudinal Study of Australian Children with data available from waves 1 (child age 3-12 months) and 5 (child age 8-9 years) were included in the current study (n = 3456). Postnatal distress was assessed by parent report at wave 1. Parenting warmth, hostility and consistency were assessed by parent report at wave 5. ADHD status at wave 5 was ascertained by parent report of the child having a diagnosis of ADHD/ADD or by elevated ADHD symptoms by both parent and teacher report. There was evidence of an indirect pathway from maternal postnatal distress to child ADHD at age 8-9 years via parenting hostility, but not through parenting warmth or consistency, even after accounting for concurrent maternal mental health. Our findings highlight the importance of early identification and intervention for maternal postnatal distress, as treatment may prevent mothers from developing hostile parenting practices and also disrupt the pathway to ADHD in their offspring.

Recruiting fathers for parenting research using online advertising campaigns: Evidence from an Australian study.

BACKGROUND: Fathers are underrepresented in parenting and child health research. Given there is a strong link between fathers' parenting behaviour and children's well-being, there is a need to find ways to engage fathers more consistently. The current short report provides information and learnings about recruiting fathers online using social media. Results are drawn from an Australian study that aimed to recruit roughly equal numbers of mothers and fathers to participate in a survey about employment, parenting, and health, using online advertising. METHODS: First, a series of five Facebook advertising campaigns were run, aimed at "parents" generally (i.e., gender-neutral). A lack of recruited fathers prompted a second series of six Facebook campaigns aimed solely at fathers. All campaigns targeted employed adult parents of children (≤18 years) in Australia using Facebook's "Adverts Manager." RESULTS: The 11 campaigns recruited a total of 1,468 fathers. The vast majority of these fathers were recruited using the advertisements specifically aimed at fathers (n = 1,441). Gender-neutral campaigns inviting and selecting "parents" to participate in the study overwhelmingly yielded samples of mothers. Similarly, advertisements inviting both "mums and dads" resulted in very low recruitment of fathers. CONCLUSIONS: The extremely low numbers of fathers recruited using the gender-neutral "parent-focused" campaigns was unexpected. Potential reasons for this include low engagement with gender-neutral parenting terms, and/or that mothers were disproportionally exposed to the Facebook advertisements. These learnings suggest that father-focused recruitment is required to target and engage fathers in parenting research and services.

Predictors of learning outcomes for children with and without chronic illness: An Australian longitudinal study.

BACKGROUND: Chronically ill children are at increased risk of poor learning outcomes. Knowledge of the predictors of learning outcomes for this group of people is important to inform the development of education supports that stand the best chance of being effective. This study explored the child, family, and school risk and protective factors during the child's transition to elementary school (aged 6-7 years) that were associated with learning outcomes when children were aged 10-11 years for both children with and without a chronic illness. METHODS: Data from the Longitudinal Study of Australian Children were used. Predictor variables were entered into separate multivariate regression models for children with and without a chronic illness. RESULTS: The strongest predictors of learning outcomes were the child's approach to learning, a consistent parenting style, and family socioeconomic position and were common for both children with and without a chronic illness but strongest for children with a chronic illness. CONCLUSION: A child's approach to learning and a consistent parenting style during the period of the child's transition to elementary school are important and potentially modifiable factors that are predictive of academic performance in later childhood. These factors are particularly relevant for children with a chronic illness, their parents/caregivers, teachers both hospital and school based, and pediatricians and can be used to inform interventions.

A pilot evaluation of 'Working Out Dads': promoting father mental health and parental self-efficacy.

AIM: Approximately one in 10 fathers experience mental health difficulties in the early years of parenting, yet there is a dearth of evidence-based interventions to promote fathers' mental health at this time. Therefore, the aims of this study were: (1) to obtain preliminary data on the short-term changes in mental health symptoms and parenting self-efficacy for fathers of young children (aged 0-4 years) participating in Working Out Dads (WOD) and (2) to explore fathers' experiences of participation in WOD. METHOD: The sample consisted of 57 fathers who had at least one child aged between 0 and 4 years. Participants completed pre- and post- measures to assess the severity of depressive, anxiety and stress symptoms and parenting self-efficacy. A brief survey of fathers' experiences in WOD was also completed. RESULTS: There was a significant reduction in fathers' reports of depressive and stress symptoms from pre- to post-intervention, and no significant change in anxiety symptoms. Parenting self-efficacy significantly increased from pre- to post-intervention. All changes were associated with moderate to large effect sizes. Fathers indicated that they were satisfied with the programme and that they were more confident in managing the stress of parenting and in their overall role as a father. CONCLUSIONS: This is the first study to evaluate WOD and provides promising preliminary evidence for its short-term effects on fathers' mental health and parenting self-efficacy. Pilot results are positive and are a critical first step, informing the design of a more robust evaluation in the future.