An Evaluation of Knowledge, Awareness, Attitudes, and Behaviors Regarding COVID-19 Among Parents of Pediatric Dental Patients.

Children infected with COVID-19 have a critical part in community-based viral transmission. This study aimed to evaluate knowledge, awareness, attitudes, and behaviors of parents of pediatric dental patients on COVID-19 and to present required actions to prevent its spreading. A total of 524 parents took part in this cross-sectional study. A self-administered questionnaire was prepared for determining sociodemographic characteristics and socioeconomic status of parents, along with their COVID-19-related knowledge, awareness, attitudes, and behaviors. In total, 90.6% of parents were unaware that disease may show no symptoms; 61.1% and 32.6% did not know roles of "close contact with asymptomatic patients" and "dentistry practices" in transmission, respectively; 30.2% thought it could be transmitted to their children at dental clinics, and only 16.4% stated their children as carriers. Parents need to be informed on COVID-19 transmission through contact with asymptomatic individuals, risks associated with dentistry practices, and role of children in transmission.

Developing a logic model of change for the determinants of parental nurturance in the first 1000 days: A mixed-method study protocol.

BACKGROUND: Parents play a key role in providing nurturance and nurturing care to their child during the first 1000 days which is important for optimal child development. Various factors have been found to influence parenting but the contribution of these factors toward parental nurturance within the first 1000 days is not yet known in the South African context. This paper describes a protocol for a project that aims to develop a logic model of change for the determinants of parental nurturance in the first 1000 days in the South African context. METHOD: This study will apply a mixed methods approach with a sequential design within an intervention mapping framework. The study will occur in two phases. The first phase will identify the problem, which will be done via a scoping review, a policy review and a needs assessment for parents and stakeholders. This phase will recruit approximately 35 participants (20 parents and 15 stakeholders) for the qualitative component and then approximately 398 participants for the quantitative component. Data will be collected via semi-structured interviews and with questionnaires (Home Observation for Measurement of the Environment Inventory, the Depression and Anxiety Scale, and the Multidimensional Perceived Social Support Scale). Data will be thematically analysed, and the Statistical Package for Social Science (SPSS) will be used to determine descriptive statistics, both of which will inform the development of the model in phase 2. The second phase will be the development of a logic model of change for determinants for parental nurturance in the first thousand days. This phase will consist of one stage- a consensus workshop which will be attended by approximately 20 participants (5 parents, 5 pregnant woman/new mothers, and 10 stakeholders). The data collected in this stage will be thematically analysed and will contribute to the refinement of the model. DISCUSSION: The first thousand days (FTD) is a period in which rapid growth occurs in all domains of development. If children do not receive sensitive and responsive care in an environment that is conducive for their optimal development, children may not reach their full developmental potential.

Beyond childcare: Changes in the amount and types of parent-child time over three decades.

Parents' time with children has increased over the past several decades, according to many scholars. Yet, research predominantly focuses on childcare activities, overlooking the majority of time that parents spend with children. Using time diaries from the 1986-2015 Canadian General Social Survey, we examine trends in the quantity and distribution of parents' childcare time and total co-present time in the company of children, as well as the behavioral or compositional drivers of these trends. Co-present time with children increased sharply since the mid-1980s, by 1 hour per day for fathers and 1.5 hours for mothers. This rise was driven not only by childcare activities, but also parents' time in housework and mothers' time in leisure with children present. Decomposition analyses indicate that changes in parenting behavior primarily explain these increases in co-present time. This study expands knowledge on intensive parenting through a more comprehensive understanding of parents' daily lives with children.

Selon de nombreux chercheurs, le temps que les parents passent avec leurs enfants a augmenté au cours des dernières décennies. Pourtant, la recherche se concentre principalement sur les activités de garde d'enfants, négligeant la majorité du temps que les parents passent avec les enfants. À l'aide d'agendas tirés de l'Enquête sociale générale canadienne de 1986 à 2015, nous examinons les tendances relatives à la quantité et à la répartition du temps passé par les parents à s'occuper des enfants et du temps total de coprésence en compagnie des enfants, ainsi que les facteurs comportementaux ou compositionnels de ces tendances. Le temps de coprésence avec les enfants a fortement augmenté depuis le milieu des années 1980, de 1 heure par jour pour les pères et de 1,5 heure pour les mères. Cette augmentation est due non seulement aux activités de garde d'enfants, mais aussi au temps consacré par les parents aux tâches ménagères et par les mères aux loisirs en présence des enfants. Les analyses de décomposition indiquent que les changements de comportement parental expliquent principalement ces augmentations du temps de coprésence. Cette étude élargit les connaissances sur la parentalité intensive par une compréhension plus complète de la vie quotidienne des parents avec les enfants.

Rebuild the Academy: Supporting academic mothers during COVID-19 and beyond.

The issues facing academic mothers have been discussed for decades. Coronavirus Disease 2019 (COVID-19) is further exposing these inequalities as womxn scientists who are parenting while also engaging in a combination of academic related duties are falling behind. These inequities can be solved by investing strategically in solutions. Here we describe strategies that would ensure a more equitable academy for working mothers now and in the future. While the data are clear that mothers are being disproportionately impacted by COVID-19, many groups could benefit from these strategies. Rather than rebuilding what we once knew, let us be the architects of a new world.

Risk and Protective Factors for Frequent Electronic Device Use of Online Technologies.

A sample of 10,460 U.S. elementary schoolchildren was analyzed to identify early predictors of frequent use of online technologies (i.e., messaging, online gaming, and social networking). Children (Mage  = 67.44 months) at greater risk displayed more externalizing problem behaviors in kindergarten (messaging OR = 1.11; online gaming OR = 1.21; social networking OR = 1.12) or were Black (messaging OR = 1.65; online gaming OR = 1.64; social networking OR = 1.68). Children from higher-income families were at lower risk (online gaming OR = 0.89; social networking OR = 0.89). Boys were more frequent users of online gaming (OR = 3.35) but less frequent users of messaging (OR = 0.62) and social networking (OR = 0.80). Protective factors included specific parenting behaviors.

Negative parenting behaviour as a mediator of the effects of telephone-assisted self-help for parents of pharmacologically treated children with attention-deficit/hyperactivity disorder.

A previous randomised controlled trial demonstrated the effects of a telephone-assisted self-help (TASH) intervention for parents of pharmacologically treated children with attention-deficit/hyperactivity disorder (ADHD) on ADHD symptoms, oppositional symptoms, functional impairment, and negative parenting behaviour (per-protocol analyses). In the current study, we examined whether changes in positive and negative parenting behaviour mediated the effects on symptoms and impairment. Parents in an enhancement group (n = 51) participated in a 12-month TASH intervention (eight booklets plus up to 14 telephone consultations) as an adjunct to routine clinical care, whereas parents in a waitlist control group (n = 52) received routine clinical care only. Parents completed measures of child symptoms, child functional impairment, and parenting behaviour at baseline, at 6 months, and at 12 months. The mediating effects of parenting behaviour were examined using regression analyses. Per-protocol analyses (n = 74) revealed a significant indirect intervention effect on functional impairment through negative parenting behaviour at 6 months as well as indirect intervention effects on oppositional symptoms and functional impairment through negative parenting behaviour at 12 months. The indirect effect on ADHD symptoms through negative parenting behaviour at 12 months just failed to reach significance. The analyses yielded no indirect intervention effects through positive parenting behaviour. The study provides some, albeit limited, support for the importance of changes in negative parenting behaviour to achieve changes in symptoms and functional impairment during parent training. In consideration of the inconsistent results of previous studies concerning the mediating role of positive and negative parenting behaviour, further research is required to better understand the mechanisms of change during parent training, also including other possible mediators like parenting stress and parental self-efficacy.

Stress and emotional wellbeing of parents due to change in routine for children with Autism Spectrum Disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia.

BACKGROUND: Parents of children with Autism Spectrum Disorder (ASD) experience considerable amounts of stress and impaired emotional well-being. Consequently, it is likely that these have been adversely impacted by COVID-19 outbreak due to disruptions to the schedules of children with ASD. AIM: This study investigated the stress and emotional well-being of parents of children with ASD in Saudi Arabia during the COVID-19 pandemic. METHOD: The study obtained quantitative data from 150 parents of children with ASD from different regions in Saudi Arabia using an online survey. The data collected included demographic data of the parents, ASD status of the family, ASD support during COVID-19 pandemic, severity of ASD behaviours in comparison to the pre- COVID-19 status eating behaviour of the child with ASD, Parental Stress, and emotional well-being. The PSI-short form (PSI-SF) (Abidin, 1995) scale was utilised to obtain data related to parental stress and the General Health Questionnaire (GHQ-12) (Goldberg, 1992) scale was utilised to obtain data related to parents' emotional well-being. RESULTS: The study found that family ASD status (in particular, age and gender of child with ASD, and severity of his/her symptoms) had a significant impact on parental stress and emotional well-being. Moreover, parental stress and emotional well-being were negatively impacted by the frequency and usefulness of ASD support received during COVID-19 pandemic. These were also adversely impacted by the change in severity of ASD behaviours of the children with ASD. Finally, parental stress was found to have a negative impact on the emotional well-being of parents. Overall, the study found that the parental stress and emotional well-being of parents of children with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic. CONCLUSIONS: Overall, the study found that the parental stress and emotional well-being of parents with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic. This study recommends the involvement of the Saudi Ministry of Health to establish and extend support services to support parents of children with ASD. Moreover, the provision of training programs to help parents deal with the characteristic behaviour of their children with ASD such as, the ability to maintain routines, aggressive or repetitive behaviour, is also recommended.

Racial/ethnic group differences in parenting attitudes among at-risk emerging adults: The roles of adversity, relationship quality, and caregiver involvement and attitudes.

BACKGROUND: Healthy parenting attitudes are foundational for positive parenting and child well-being. However, few studies explore their formation and mediators explaining racial/ethnic group differences. OBJECTIVE: The present study prospectively examines potential mediators for racial/ethnic group differences in parenting attitudes in a diverse sample of emerging adults (EA). PARTICIPANTS & SETTING: Participants are EA and their caregivers (N = 891) who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHODS: Adverse childhood experiences (ACEs), parenting attitudes, and caregiver-child relationship quality and involvement were assessed. Mediators of racial/ethnic group differences were tested using Structural Equation Modeling with bias-corrected confidence intervals based on 1000 bootstrapped samples. RESULTS: Black EA had less appropriate developmental expectations and perceptions of family roles, empathy toward children, and rejection of physical punishment, compared to White EA. Latinx EA also had less empathy toward children compared to White EA. Caregivers' parenting attitudes mediated group differences, beyond ACEs and relationship quality and involvement. Significant mediation effects include: appropriate developmental expectations, R2 = 0.08, p < .05; rejection of physical punishment, R2 = 0.06, p < .05; appropriate family roles, R2 = 0.16, p < .05; and empathy toward children, R2 = 0.15, p < .05, for Black relative to White EA, as well as, empathy toward children, R2 = 0.12, p < .05, for Latinx relative to White EA. CONCLUSION: Findings highlight the mediating role of intergenerational transmission of parenting attitudes for explaining racial-ethnic differences and supporting positive parenting practices in diverse communities.

Outcomes of Equity-Oriented, Web-Based Parenting Information in Mothers of Low Socioeconomic Status Compared to Other Mothers: Participatory Mixed Methods Study.

BACKGROUND: Typically, web-based consumer health information is considered more beneficial for people with high levels of education and income. No evidence shows that equity-oriented information offers equal benefits to all. This is important for parents of low socioeconomic status (SES; low levels of education and income and usually a low level of literacy). OBJECTIVE: This study is based on a conceptual framework of information outcomes. In light of this, it aims to compare the perception of the outcomes of web-based parenting information in low-SES mothers with that of other mothers and explore the perspective of low-SES mothers on contextual factors and information needs and behavior associated with these outcomes. METHODS: A participatory mixed methods research was conducted in partnership with academic researchers and Naître et grandir (N&G) editors. N&G is a magazine, website, and newsletter that offers trustworthy parenting information on child development, education, health, and well-being in a format that is easy to read, listen, or watch. Quantitative component (QUAN) included a 3-year longitudinal observational web survey; participants were mothers of 0- to 8-year-old children. For each N&G newsletter, the participants' perception regarding the outcomes of specific N&G webpages was gathered using a content-validated Information Assessment Method (IAM) questionnaire. Differences between participants of low SES versus others were estimated. Qualitative component (QUAL) was interpretive; participants were low-SES mothers. The thematic analysis of interview transcripts identified participants' characteristics and different sources of information depending on information needs. Findings from the two components were integrated (QUAN+QUAL integration) through the conceptual framework and assimilated into the description of an ideal-typical mother of low SES (Kate). A narrative describes Kate's perception of the outcomes of web-based parenting information and her perspective on contextual factors, information needs, and behavior associated with these outcomes. RESULTS: QUAN-a total of 1889 participants completed 2447 IAM responses (50 from mothers of low SES and 2397 from other mothers). N&G information was more likely to help low-SES participants to better understand something, decrease worries, and increase self-confidence in decision making. QUAL-the 40 participants (21 N&G users and 19 nonusers) used 4 information sources in an iterative manner: websites, forums, relatives, and professionals. The integration of QUAN and QUAL findings provides a short narrative, Kate, which summarizes the main findings. CONCLUSIONS: This is the first study comparing perceptions of information outcomes in low-SES mothers with those of other mothers. Findings suggest that equity-oriented, web-based parenting information can offer equal benefits to all, including low-SES mothers. The short narrative, Kate, can be quickly read by decision policy makers, for example, web editors, and might encourage them to reach the underserved and provide and assess trustworthy web-based consumer health information in a format that is easy to read, listen, or watch.

A comparison of primary care parenting programs for Latinx families.

Introduction: Primary care agencies remain an ideal setting for implementing parenting programs that meet the needs of Latinx parents. However, little to no research has been done on how well adapted primary care parenting programs (PCPPs) are to the beliefs, values, and practices of many Latinx families. Method: Using 5 inclusion criteria, 8 PCPPs were selected and compared across 8 domains: focus, age of child, composition, sequence, duration, training length, estimated start-up costs, and number of cultural adaptations. Results: PCPPs vary widely across all 8 domains, with some PCPPs being relatively brief and low cost and others more all encompassing and expensive. Only 4 of the 8 programs demonstrated cultural adaptations outside Spanish translation. Conclusion: This comparison demonstrates that there is a lack of cultural consideration among researchers who develop PCPPs. Recommendations for providing culturally attuned parenting services for Latinx families within a primary care environment are given. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Women's Experiences of the Effect of Financial Strain on Parenting and Mental Health.

OBJECTIVE: To develop a conceptual theory to describe how financial strain affects women with young children to inform clinical care and research. DESIGN: Qualitative, grounded theory. SETTING: Participants were recruited from the waiting area of a pediatric clinic and an office of the Special Supplemental Nutrition Program for Women, Infants, and Children embedded within the largest safety-net academic medical center in New England. Participants were interviewed privately at the medical center or in the community. PARTICIPANTS: Twenty-six English-speaking women, mostly single and African American/Black, with at least one child 5 years old or younger, were sampled until thematic saturation was met. METHODS: We used grounded theory methodology to conduct in-depth, semistructured interviews with participants who indicated that they experienced financial strain. We analyzed the interview data using constant comparative analysis, revised the interview guide based on emerging themes, and developed a theoretical model. RESULTS: Five interrelated themes emerged and were developed into a theoretical model: Financial Strain Has Specific Characteristics and Common Triggers, Financial Strain Is Exacerbated by Inadequate Assistance and Results in Tradeoffs, Financial Strain Forces Parenting Modifications, Women Experience Self-Blame, and Women Experience Mental Health Effects. CONCLUSION: For women with young children, financial strain results in forced tradeoffs, compromised parenting practices, and self-blame, which contribute to significant mental health problems. These findings can inform woman-centered clinical practice and advocacy interventions. Women's health care providers should identify families experiencing financial strain, provide referrals to financial services, and join advocacy efforts to advance social policies that address the structural causes of poverty, such as increased minimum wage and paid family leave.

Maternal experiences of domestic abuse and their effect on the mother's approach to parenting.

Children's nurses have an important role in identifying and supporting families who experience domestic abuse. Safeguarding guidance is available to direct nurses working with families, children and young people in these situations. However, nurses working with children and families require the knowledge and ability to assess the parenting approach of mothers exposed to domestic abuse to reduce long-term detrimental effects to the child. The aim of this literature review was to explore research about how maternal experiences of domestic abuse affect the mother's approach to parenting. A search of healthcare databases was undertaken to identify relevant research. The articles were coded by grouping similar findings leading to the identification of three themes: modelling behaviours; compensating behaviours; and coping and parenting. Modelling behaviours involved mothers learning aggressive behaviours and becoming increasingly violent towards their child. Mothers displaying compensating behaviours were lenient in their parenting or provided positive discipline if the child was female, and those who were identified as coping and parenting had suboptimal mental health with an increase in depressive symptoms.

Building Community Partnership to Sustain the Minnesota Student Parent Support Initiative.

PURPOSE: Considerable attention has been given to the sustainability of adolescent health programs as federal funds have become limited. This article describes important steps and lessons learned in seeking buy-in from stakeholders to promote sustainability and secure non-federal funds to maintain the Minnesota Student Parent Support Initiative (MSPSI) after federal funding ended. DESCRIPTION: MSPSI was established in 2010 to address the academic and health needs of expectant and parenting postsecondary students. MSPSI provided coordinated case management and referrals to health, education, and social services for expectant and parenting adolescents, as well as for their children, through Student Parent Centers (SPCs). Six important actions sustained the SPCs after the Office of Population Affairs (OPA) grant funds ended in November 2017: (1) preparing and planning for sustainability, (2) creating and engaging a sustainability committee, (3) assessing sustainability needs and creating a sustainability plan, (4) creating a data system to collect relevant data, (5) building capacity to support communication with decision makers, and (6) sharing data and success stories. ASSESSMENT: The implementation of the sustainability plan resulted in ongoing communications and data sharing with key partners that helped secure additional funds for continuing the program after OPA funding ended. CONCLUSION: Implementing the MSPSI sustainability plan developed from OPA's sustainability framework was effective in sustaining the SPCs after federal funding ended. The sustainability planning, the ability to secure funds, the attempt at passing legislation, and the lessons shared in this article provide valuable guidance to organizations seeking strategies to sustain adolescent health programs.

Intimate Partner Violence, Maternal and Paternal Parenting, and Early Child Development.

BACKGROUND AND OBJECTIVES: Previous research has demonstrated associations between maternal experience of intimate partner violence (IPV) and a range of adverse outcomes among women and their young children. However, few studies have examined the associations between maternal experience of IPV and early child development (ECD) outcomes in low- and middle-income countries (LMIC). Our objectives in this study were to examine the association between IPV victimization and ECD and assess whether the association was mediated by maternal and paternal stimulation. METHODS: We combined cross-sectional data from the Demographic and Health Surveys for 15 202 households representing mothers and fathers of children aged 36 to 59 months in 11 LMIC. We used multivariable linear regression models to estimate the association between IPV victimization in the year preceding the survey and ECD, which we measured using the Early Child Development Index. We used path analysis to determine if the association between IPV victimization and ECD was mediated through maternal and paternal stimulation. RESULTS: After adjusting for sociodemographic variables, IPV victimization was negatively associated with ECD (ß = -.11; 95% confidence interval = -.15 to -.07). Path analysis indicated that the direct association between IPV victimization and ECD was partially and independently mediated through maternal and paternal stimulation. CONCLUSIONS: Interventions that include components to prevent IPV may be effective for improving ECD in LMIC.

Meeting the Multifaceted Needs of Expectant and Parenting Young Families Through the Pregnancy Assistance Fund.

INTRODUCTION: The Pregnancy Assistance Fund (PAF) program funds states and tribes to provide a wide range of services to improve health, social, educational, and economic outcomes for expectant and parenting teens and young adults, their children, and their families. This introductory article to the Maternal and Child Health Journal supplement Supporting Expectant and Parenting Teens: The Pregnancy Assistance Fund provides a description of the PAF program, including the program goals and structure, participants and communities served, and services provided; presents data on the reach and success of the program; and describes lessons learned from PAF grantees on how to enhance programs and services to have the best outcomes for expectant and parenting young families. METHODS: Performance measure data are used to describe the reach and success of the PAF program, and implementation experiences and lessons learned from PAF grantees were gathered through a standardized review of grantee applications and from interviews with grant administrators. RESULTS: Since its establishment in 2010, the PAF program has served 109,661 expectant and parenting teens, young adults, and their families across 32 states, including the District of Columbia, and seven tribal organizations; established more than 3400 partnerships; and trained more than 7500 professionals. Expectant and parenting teens and young adults who participated in the PAF program stay in high school, make plans to attend college, and have low rates of repeat pregnancy within a year. CONCLUSIONS: Expectant and parenting teens and young adults in the PAF program demonstrated success in meeting their educational goals and preventing repeat unintended pregnancies. In addition, the staff who implemented the PAF programs learned many lessons for how to enhance programs and services to have the best outcomes for expectant and parenting young families, including creating partnerships to meet the multifaceted needs of teen parents and using evidence-based programs to promote program sustainability.

Survive and Thrive in Brazil: The Boa Vista Early Childhood Program: study protocol of a stepped-wedge, randomized controlled trial.

BACKGROUND: A growing body of evidence suggests that early life health and developmental outcomes can be improved through parental support programs. The objective of this project was to test the feasibility, impact, and relative cost-effectiveness of an adapted "Reach Up and Learn" program delivered through home-visiting programs as well as through center-based parenting groups on child health and development in the municipality of Boa Vista, Brazil. METHODS: A randomized, stepped-wedge design was used to roll out and evaluate the two parenting platforms in Boa Vista municipality. A total of 39 neighborhoods with a high Neighborhood Vulnerability Index were selected for the study. For the first phase of the program, nine neighborhoods were randomly selected for home visits, and two were randomly selected for the center-based parenting groups. In the second phase of the program, 10 neighborhoods were added to the home-visiting program, and eight were added to the center-based program. In the final phase of the program, the remaining 10 control areas will also be assigned to treatment. Study eligibility will be assessed through a baseline survey completed by all pregnant women in the 39 study areas. Pregnant women will be eligible to participate in the study if they are either classified as poor, were under age 20 years when they became pregnant, or if they indicate to have been exposed to domestic or sexual violence. To assess program impact, an endline survey will be conducted when children reach age 2 years. The primary study outcome is child development at age 2 years as measured by the PRIDI instrument. Secondary outcome will be infant mortality, which will be assessed linking municipal vital registration systems to the program rollout. DISCUSSION: This trial will assess the feasibility and impact of parenting programs rolled out at medium scale. The results from the trial should create evidence urgently needed for guiding Brazil's national Criança Feliz program as well as similar efforts in other countries. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03386747. Registered on 13 December 2017. All items of the World Health Organization Trial Registration Data Set are available in this record.