Child-friendly family reduces parenting stress in Chinese families: the mediating role of family resilience.

The increasing prevalence of parenting stress has significant implications for the psychological well-being of both parents and children. In view of this, our study sought to examine the mediating and moderating role of family resilience in the association between child-friendly family and parenting stress. Our analysis involved a sample of 316 parents who dedicated a minimum of 14 h per week to caring for their children. The parents were invited to complete three validated instruments-the parenting stress index short form (PSI), the family resilience assessment scale (FRAS), and inventory of the child-friendly family (ICF)-to evaluate their level of parenting stress, family resilience, and child-friendly family, respectively. We tested the mediation model by applying structural equation model analysis. It was found that child-friendly family negatively correlated with parenting stress (path coefficient = -0.56, p < 0.001). This relationship is mediated by family resilience. That is "child-friendly family" leads to increased "family resilience" (path coefficient = 0.68, p < 0.01), which in turn leads to lower "parenting stress" (path coefficient = -0.30, p < 0.05). The mediation effect ratio was 26.70%. We used multiple regression analysis to test the moderation model and found that family resilience did not play a moderating role between child-friendly family and parenting stress. This study holds particular significance for two key reasons: Firstly, it elucidates the relationship between child-friendly family, family resilience, and parenting stress, highlighting the potential of creating a child-friendly family to reduce parenting stress through the enhancement of family resilience. Secondly, our findings provide valuable evidence for the development of innovative approaches that effectively and sustainably alleviate parenting stress.

An automatic speech analytics program for digital assessment of stress burden and psychosocial health.

The stress burden generated from family caregiving makes caregivers particularly prone to developing psychosocial health issues; however, with early diagnosis and intervention, disease progression and long-term disability can be prevented. We developed an automatic speech analytics program (ASAP) for the detection of psychosocial health issues based on clients' speech. One hundred Cantonese-speaking family caregivers were recruited with the results suggesting that the ASAP can identify family caregivers with low or high stress burden levels with an accuracy rate of 72%. The findings indicate that digital health technology can be used to assist in the psychosocial health assessment. While the conventional method requires rigorous assessments by specialists with multiple rounds of questioning, the ASAP can provide a cost-effective and immediate initial assessment to identify high levels of stress among family caregivers so they can be referred to social workers and healthcare professionals for further assessments and treatments.

Predicting the burden of family caregivers from their individual characteristics.

This study examined the association between caregivers' burdens and their individual characteristics and identified characteristics that are useful for predicting the level of caregiver burden. We successfully surveyed 387 family caregivers, having them complete the caregiver burden inventory scale (CBI) and an individual characteristic questionnaire. When we compared the average CBI scores between groups with a particular individual characteristic (including caring for older adult(s), educational level, employment status, place of birth, marital status, financial status, need for family support, need for friend support, and need for nonprofit organizational support), we found a significant difference in the average scores. From a logistic regression model, with burden level as the outcome, we found that caring for older adult(s), educational level, employment status, place of birth, financial situation, and need for nonprofit organizational support were significant predictors of the burden level of caregivers. The research findings suggest that certain individual characteristics can be adopted for identifying and quantifying caregivers who may have a higher level of burden. The findings are useful to uncover caregivers who may need prompt support and social care.

Safety-promoting behaviors of community-dwelling abused Chinese women after an advocacy intervention: a randomized controlled trial.

OBJECTIVE: To examine the effect of an advocacy intervention on the use of safety-promoting behaviors in community-dwelling abused Chinese women as compared to a control condition of usual care. DESIGN: This efficacy trial used a randomized controlled, parallel group design. PARTICIPANTS AND METHODS: A total of 200 Chinese women in a community setting who screened positive for intimate partner violence using the Chinese version of the Abuse Assessment Screen were randomized to receive either an advocacy intervention (intervention group, n=100) or usual community care (control group, n=100). The outcome measured was the change in the self-reported safety-promoting behaviors as measured by the Safety-promoting Behavior Checklist over three time-points (baseline, 3-month follow-up and 9-month follow-up). Participants and assessors were blinded to the study hypothesis. Assessors were further blinded to the group membership of the participants. RESULTS: The Safety-promoting Behavior Checklist scores in the intervention group increased from the baseline on average by 5.65 (95% confidence interval [CI], 4.92-6.39) at 3-month and 6.65 (95% CI, 5.90-7.39) at 9-month follow-ups, while the scores in the control group also increased by 1.71 (95% CI, 1.06-2.37) at 3-month and 1.79 (95% CI, 1.15-2.43) at 9-month follow-ups. After adjusting for baseline differences, the between-group differences in scores were significant at 3-month and 9-month follow-ups (p=0.04). The intervention group increased the scores by 3.61 (95% CI, 2.61-4.61, p<0.001) more than the control group at 3-month and by 4.53 (95% CI, 3.53-5.53, p<0.001) at 9-month follow-ups. CONCLUSION: An advocacy intervention is efficacious in increasing the use of safety-promoting behaviors as compared to usual community care in community-dwelling abused Chinese women.

Effect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: a randomized controlled trial.

CONTEXT: Intimate partner violence (IPV) against women can have negative mental health consequences for survivors; however, the effect of interventions designed to improve survivors' depressive symptoms is unclear. OBJECTIVE: To determine whether an advocacy intervention would improve the depressive symptoms of Chinese women survivors of IPV. DESIGN, SETTING, AND PARTICIPANTS: Assessor-blinded randomized controlled trial of 200 Chinese women 18 years or older with a history of IPV, conducted from February 2007 to June 2009 in a community center in Hong Kong, China. INTERVENTION: The intervention group (n = 100) received a 12-week advocacy intervention comprising empowerment and telephone social support. The control group (n = 100) received usual community services including child care, health care and promotion, and recreational programs. MAIN OUTCOME MEASURES: Primary outcome was change in depressive symptoms (Chinese version of the Beck Depression Inventory II) between baseline and 9 months. Secondary outcomes were changes in IPV (Chinese Revised Conflict Tactics Scales), health-related quality of life (12-Item Short Form Health Survey), and perceived social support (Interpersonal Support Evaluation List) between baseline and 9 months. Usefulness of the intervention and usual community services was evaluated at 9 months. RESULTS: At 3 months, the mean change in depressive symptom score was 11.6 (95% CI, 9.5 to 13.7) in the control group and 14.9 (95% CI, 12.4 to 17.5) in the intervention group; respective changes at 9 months were 19.6 (95% CI, 16.6 to 22.7) and 23.2 (95% CI, 20.4 to 26.0). Intervention effects at 3 and 9 months were not significantly different (P = .86). The intervention significantly reduced depressive symptoms by 2.66 (95% CI, 0.26 to 5.06; P = .03) vs the control, less than the 5-unit minimal clinically important difference. Statistically significant improvement was found in partner psychological aggression (-1.87 [95% CI, -3.34 to -0.40]; mean change at 3 months, 1.5 [95% CI, -1.0 to 3.9] in the control group and 0.3 [95% CI, -0.7 to 1.4] in the intervention group; mean change at 9 months, -6.4 [95% CI, -7.8 to -5.0] and -8.9 [95% CI, -10.6 to -7.2]) and perceived social support (2.18 [95% CI, 0.48 to 3.89]; mean change at 3 months, 6.4 [95% CI, 4.9 to 7.8] and 9.2 [95% CI, 7.7 to 10.8]; mean change at 9 months, 12.4 [95% CI, 10.5 to 14.3] and 14.4 [95% CI, 12.7 to 16.1]) but not in physical assault, sexual coercion, or health-related quality of life. By end of study, more women in the intervention group found the advocacy intervention useful or extremely useful in improving intimate relationships vs those in the control group receiving usual community services (93.8% vs 81.7%; difference, 12.1% [95% CI, 2.1% to 22.0%]; P = .02) and in helping them to resolve conflicts with their intimate partners (97.5% vs 84.1%; difference, 13.4% [95% CI, 4.7% to 22.0%]; P = .001). CONCLUSION: Among community-dwelling abused Chinese women, an advocacy intervention did not result in a clinically meaningful improvement in depressive symptoms. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01054898.