An Equity-Focused Assessment of Evidence-Based Parenting Intervention Research.

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.

Does parents' cognitive ability affect household educational investment? Evidence from Chinese families with left behind children.

The large group of left-behind children with the absence of parental accompanying are likely to have serious physical and psychological problems, which may lead to serious public safety and social economic troubles in adulthood. Such unique phenomenon calls us attention on the impact of parents on household educational investment. Based on the data of China Family Panel Studies in 2014, This paper examines the effects of parents' cognitive ability on household educational investment for their children. The research propositions were tested using multiple regression analysis methods. Results indicate that parents' cognitive ability can significantly improve the level of monetary and non-monetary investment in education. We also find that compared with their counterparts, the cognitive ability of left-behind children's parents fails to affect their household educational investment, due to the "parent-child separation effect". Further analysis shows that improving the regional informatization level of parents of left-behind children can alleviate the "parent-child separation effect", and finally facilitate cognitive ability's role in increasing household educational investment. These findings enlighten education policy makers and households a feasible way to alleviate the imbalance and insufficiency of household educational investment among left-behind children families.

Creating an Alianza: Group Perinatal Education for Newly Immigrated Latinx Pregnant People.

Pregnant people who are recent immigrants often face barriers navigating the health care system and establishing a support network to sustain them through pregnancy and new parenthood. The Cultivando una Nueva Alianza (CUNA) program from the Children's Home Society of New Jersey was created to address these obstacles. For over 20 years, CUNA has collaborated with local midwives to develop a program for newly immigrated, Spanish-speaking Latinx pregnant people. The curriculum, facilitated by trained members of the community, provides education around pregnancy, birth, and early parenting and connects participants with prenatal care and community resources while cultivating a social support network. The program's success is seen in improved clinical outcomes, ongoing involvement by graduates, and strong continued support from community stakeholders. The CUNA program has been replicated in nearby communities and offers a blueprint for a low-tech intervention to improve the health and wellness of this population.

Pregnant and early parenting Indigenous women who use substances in Canada: A scoping review of health and social issues, supports, and strategies.

This study reviews and synthesizes the literature on Indigenous women who are pregnant/early parenting and using substances in Canada to understand the scope and state of knowledge to inform research with the Aboriginal Health and Wellness Centre of Winnipeg in Manitoba and the development of a pilot Indigenous doula program. A scoping review was performed searching ten relevant databases, including one for gray literature. We analyzed 56 articles/documents. Themes include: (1) cyclical repercussions of state removal of Indigenous children from their families; (2) compounding barriers and inequities; (3) prevalence and different types of substance use; and (4) intervention strategies. Recommendations for future research are identified and discussed.

Racial disparities in pregnancy options counseling and referral in the US South.

OBJECTIVE: The objective of this study is to examine racial variation in receipt of counseling and referral for pregnancy options (abortion, adoption, and parenting) following pregnancy confirmation. Equitable offering of such information is a professional and ethical obligation and an opportunity to prevent racial disparities in maternal and child health. DATA SOURCE: Primary data from patients at southern United States publicly funded family planning clinics, October 2018-June 2019. STUDY DESIGN: Patients at 14 clinics completed a survey about their experiences with pregnancy options counseling and referral following a positive pregnancy test. The primary predictor variable was patients' self-reported racial identity. Outcomes included discussion of pregnancy options, referral for those options, and for support services. DATA COLLECTION: Data from eligible patients with non-missing information for key variables (n = 313) were analyzed using descriptive statistics, χ2 tests, and multivariable logistic regression. PRINCIPAL FINDINGS: Patients were largely Black (58%), uninsured (64%), and 18-29 years of age (80%). Intention to continue pregnancy and receipt of prenatal care referral did not differ significantly among Black as compared to non-Black patients. However, Black patients had a higher likelihood of wanting an abortion or adoption referral and not receiving one (abortion: marginal effect [ME] = 7.68%, p = 0.037; adjusted ME [aME] = 9.02%, p = 0.015; adoption: ME = 7.06%, p = 0.031; aME = 8.42%, p = 0.011). Black patients intending to end their pregnancies had a lower probability of receiving an abortion referral than non-Black patients (ME = -22.37%, p = 0.004; aME = -19.69%, p = 0.023). In the fully adjusted model, Black patients also had a higher probability of wanting access to care resources (including transportation, childcare, and financial support) and not receiving them (aME = 5.38%, p = 0.019). CONCLUSIONS: Clinical interactions surrounding pregnancy confirmation provide critical opportunities to discuss options, coordinate care, and mitigate risk, yet are susceptible to systemic bias. These findings add to limited evidence around pregnancy counseling and referral disparities. Ongoing assessment of pregnancy counseling and referral disparities can provide insight into organizational strengths or the potential to increase structural equity.

Determinants of severe physical disciplinary practices against children in Egypt.

BACKGROUND: Although nearly 43 % of Egyptian children aged less than 14 years had ever experienced severe physical violent punishment at home, no previous studies identified the predictors of the practice in Egypt. OBJECTIVE: This research aims at identifying the determinants of the use of any severe violent physical practice to discipline children. PARTICIPANTS AND SETTING: The latest national Egyptian Demographic and Health Survey is the main source of data. The caregivers of 13024 children were interviewed. METHODS: A binary logistic regression model is developed to identify the determinants of the use of severe physical disciplinary practices. RESULTS: Results show that children whose parents believe that physical punishment is necessary to discipline children are more likely to experience severe violence (OR = 3.3). Children in the preprimary stage have a high odds ratio of experiencing a severe violent punishment compared to those in preparatory and secondary stages (OR = 3.5). Children whose mothers have experienced domestic physical violence are more likely to be subject to severe physical violence (OR = 1.6 for husband violence, and 1.4 for parents/siblings violence). Children living in Urban Lower Egypt are approximately twice likely as children living in urban governorates to be subject to severe physical violence. Children living in the poorest households are the most likely to experience severe physical violence. CONCLUSION: Severe violent disciplinary practice inside the home is common in Egypt. The findings urge for activating Egyptian Child Law and implementing continuous training programs for parents on positive parenting.

Adaptive Parenting Among Low-Income Black Mothers and Toddlers' Regulation of Distress.

Parenting differs in purpose and strategy according to cultural background (Brooks-Gunn & Markman, 2005; Iruka, LaForett, & Odom, 2012). The current study tests a unique latent factor score, Adaptive Parenting, that represents culturally-relevant, positive parenting behaviors: maternal coping with stress through reframing, maternal scaffolding of toddlers' learning during a low-stress task, and maternal commands during a high-stress task. Participants were Black mothers (N = 119; Mage  = 27.78) and their 24- to 30-month-old toddlers. Families were part of a broader study examining family resilience among urban, low-income young children and their families. Results demonstrate that the proposed variables align on a single factor and positively predict toddlers' emotion regulation. Findings are discussed in the context of Black culturally-specific parenting processes.

Examining dual method contraceptive use among midwestern parenting Latinx teens: Perspectives from adolescent parents, caretakers, and nurses.

BACKGROUND: Despite dual method (DM) contraception being effective in reducing repeat-births and sexually transmitted infections (STIs), Latinx adolescent parents who live in non-traditional migration areas remain vulnerable for both outcomes. OBJECTIVE: This study applied the Unified Theory of Behavior (UTB) and drew upon Bronfenbrenner's social ecological model to explore multiple stakeholders' (adolescent parents, caregivers, and nurses) perceptions of factors that influence DM intentions and use among Latinx adolescent parents. METHODS: Semi-structured interviews with Latinx adolescent parent-caregiver dyads and nurses were analyzed using thematic analysis. RESULTS: Study findings revealed that while all participant groups considered medical providers as DM influencers, contradicting views related to caregivers' as DM influencers emerged among adolescent parents and caregivers. Findings suggest that DM is deemed both acceptable and effective; and adolescent parents' reported DM self-efficacy. DM obstacles included negative emotions, environmental constraints, and poor knowledge and skills. CONCLUSIONS: Study results suggest that constructs from the UTB framework are useful in identifying individual and social factors that can potentially influence DM intentions and use among Latinx adolescent parents. IMPLICATIONS FOR PUBLIC HEALTH NURSING: This study's findings have potential implications for public health nurses interested in designing community-based interventions to reduce repeat-births and STIs among Latinx adolescent parents.

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth.

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent-child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the "Asian American youth paradox" in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.

Este estudio utilizó datos de una encuesta longitudinal de jóvenes filipinoamericanos y coreanoamericanos para analizar las maneras en las que los factores universales (p. ej.:las conductas antisociales entre pares y el conflicto entre padres e hijos) y las variables de los procesos familiares asiáticoamericanos (p. ej.: las normas de género) predicen independientemente y colectivamente el promedio de calificaciones y los problemas interiorizados y exteriorizados. Nos propusimos explicar la "paradoja de los jóvenes asiáticoamericanos" en la cual un bajo grado de problemas exteriorizados y un alto promedio de calificaciones coexisten con un alto grado de problemas interiorizados. Descubrimos que los factores universales fueron en gran parte predictivos de los problemas de los jóvenes y se mantuvieron firmes cuando se tuvo en cuenta el proceso familiar asiáticoamericano. El proceso familiar asiáticoamericano también explicó independientemente el desarrollo de los jóvenes y, en parte, la paradoja de los jóvenes asiáticoamericanos. Por ejemplo, las normas de género aumentaron el distrés mental. Los controles académicos hicieron lo opuesto a lo deseado, por ejemplo, tuvieron un efecto negativo en el promedio de calificaciones así como en otras áreas del desarrollo. La obligación familiar, evaluada por actividades centradas en la familia y por la colaboración, fue beneficiosa tanto para los resultados exteriorizados como interiorizados de los jóvenes. El afecto implícito de los padres, uno de los rasgos distintivos de la crianza de los asiáticoamericanos, fue beneficioso, particularmente para el promedio de calificaciones. Este estudio ofreció importante conocimiento empírico que puede guiar la crianza intercultural y respaldar de manera significativa programas de intervención para jóvenes asiáticoamericanos.

Tobacco use in school students in Afghanistan, Oman and Kuwait and association with parental monitoring: analysis of data from Global School-based Student Health surveys.

BACKGROUND: Nationally representative data are lacking on cigarette smoking in adolescents in Afghanistan, Oman and Kuwait, which are considered low-income, middle-income and high-income countries respectively of the World Health Organization Eastern Mediterranean Region. AIMS: This study examined the effect of parental monitoring on the tobacco use of adolescent school students in Afghanistan, Oman and Kuwait. METHODS: Using data from the 2014 Afghanistan, 2015 Oman and 2015 Kuwait Global School-based Student Health surveys, factors associated with cigarette smoking and tobacco use among the students in the 30 days before the survey were analysed. These factors included: parental understanding of their problems/worries, parental awareness of how they spent their free time, parents searching their belongings without their approval, and parents checking if homework was done. Logistic regression analysis was used to determine the association between tobacco use and parental monitoring. RESULTS: The prevalence of cigarette smoking and/or use of other tobacco products by the students on one or more days in the 30 days before the survey was 10.6% in Afghanistan, 9.3% in Oman and 28.8% in Kuwait. Adolescents whose parents understood their problems, were aware of how they spent their free time, and checked if their homework was done were less likely to be current tobacco users in all three countries (P < 0.05). Adolescents in Oman and Kuwait whose parents searched their belongings were more likely to use tobacco (P < 0.01). CONCLUSION: The prevalence of tobacco use in the adolescents, especially in Kuwait, suggests the need for better schoolbased health education and promotion programmes in these countries.

Protecting young Black female sexuality.

In the USA, Black girls and women face significant health disparities and disproportionately experience violence, racism, discrimination, stereotype messaging and elevated STI/HIV rates. Research shows the importance of familial systems and effective communication in decreasing risky behaviours among Black girls. This grounded theory study explored the sociocultural conditions that influence the process of becoming a sexual Black woman. Analytic results of interviews with 20 Black women identified protection as a major category associated with Black female sexual development and related risk behaviour. This paper describes the role of Black women as protectors of young Black female sexuality, the sociocultural protective strategies they used across the life course and the consequences of absent protection. Findings can inform future evidence-based, culturally sensitive interventions to promote the sexual health and development of Black girls and women in the USA.

Determinants of Parenting Practices Related to Monitoring Sugar Sweetened Beverages Among Hispanic Mothers.

The purpose of this study was to evaluate Hispanic mothers (n = 238) of 2-5 year old children and determinants of their monitoring practices related to their preschooler's consumption of sugar-sweetened beverages (SSB). Hispanic mothers were recruited from numerous areas (i.e. churches, community agencies, and daycares) in southwest Oklahoma City. Constructs of the Reasoned Action Approach (RAA) were evaluated along with demographic questions. Most mothers (92%) were born outside the US, and a majority had been in the US ≥ 11 years (61%). The RAA constructs autonomy, capacity (or self-efficacy), and descriptive norms predicted a significant amount of the variance of SSB monitoring practices (14.7%). Results show that public health interventions that promote maternal monitoring practices related to SSB for Hispanic mothers should focus on promoting capacity, autonomy, and norms. Such interventions can take place in community centers, clinics, and day cares.

Parenting within residential neighborhoods: A pluralistic approach with African American and Latino families at the center.

The intersection of SES and race-ethnicity impact youth development at the family and neighborhood levels. The confluence of neighborhood structural and social characteristics intersects to impact parenting multiple ways. Within lower-income neighborhoods, there is variability in economic and racial-ethnic demographics and social characteristics and a multitude of different lived experiences. We use a person-centered approach to understand how a plurality of neighborhood social characteristics shape parents' ethnic-racial socialization and monitoring strategies, normative parenting practices for diverse families. With 144 African American and Latino families in a new destination context-areas lacking an enduring historical and economic presence of same-ethnic populations-we examined whether we could replicate neighborhood profiles found in other neighborhood contexts using four neighborhood social process indicators (i.e., connectedness, cohesion and trust, informal social control, and problems), identified family- and neighborhood-level predictors of profiles, and explored differences in ethnic-racial socialization and parental monitoring knowledge by profile. We replicated three neighborhood profiles-integral (high on all positive social dynamics and low problems), anomic (low on all positive social dynamics and high problems), and high problems/positive relationships. Caregivers in these profiles differed in family SES and neighborhood disadvantage such that those in anomic neighborhoods had the lowest income-to-needs ratio whereas those in integral neighborhoods experienced the highest neighborhood disadvantage and lowest proportion of Hispanic residents. Egalitarianism, an ethnic-racial socialization message, and parental monitoring levels differed by neighborhood. Findings suggest African American and Latino families' unique experiences in a new destination context, signaling a complex interplay between race-ethnicity, SES, and place.

Young Latinx children: At the intersections of race and socioeconomic status.

To understand the developmental outcomes of Latinx children growing up poor in the United States, we examine how socioeconomic status (SES) and ethnic minority status jointly condition the development of Latinx children in the United States. To address these gaps, in this chapter we first present a brief demographic profile of Latinx in the United States to contextualize the later theoretical and empirical discussions. We then review theoretical frameworks that explain SES differences in Latinx home environments and examine how they have been used to explain disparities in Latinx children's outcomes. Third, we describe the current research on the early home environments of Latinx children of varying levels of parental SES. Fourth, we review the literature on Latinx children's inequalities noting the scarcity of research that compares Latinx to White children or Latinx to Black children compared to the studies that focus on the White-Black academic gap. Finally, we conclude by summarizing state of knowledge and offering suggestions for future directions. We focus on young children (0-8) due to space limitations but also because the early childhood period is foundational to later development and is where the effects of poverty most likely to have enduring effects.

Viewpoints from families for improving transition from NICU-to-home for infants with medical complexity at a safety net hospital: a qualitative study.

BACKGROUND: We have limited information on families' experiences during transition and after discharge from the neonatal intensive care unit. METHODS: Open-ended semi-structured interviews were conducted with English or Spanish- speaking families enrolled in Medicaid in an urban high-risk infant follow up clinic at a safety-net center, which serves preterm and high-risk term infants. We generated salient themes using inductive-deductive thematic analysis. RESULTS: Twenty-one participants completed the study. The infant's median (IQR) birth weight was 1750 (1305, 2641) grams; 71% were Hispanic and 10% were Black non-Hispanic; 62% reported living in a neighborhood with 3-4th quartile economic hardship. All were classified as having chronic disease per the Pediatric Medical Complexity Algorithm and 67% had medical complexity. A conceptual model was constructed and the analysis revealed major themes describing families' challenges and ideas to support transition centered on the parent-child role and parent self-efficacy. The challenges were: (1) comparison to normal babies, (2) caregiver mental health, (3) need for information. Ideas to support transition included, (1) support systems, (2) interventions using mobile health technology (3) improved communication to the primary care provider and (4) information regarding financial assistance programs. Specific subthemes differed in frequency counts between infants with and without medical complexity. CONCLUSIONS: Families often compare their preterm or high-risk infant to their peers and mothers feel great anxiety and stress. However, families often found hope and resilience in peer support and cited that in addition to information needs, interventions using mobile health technology and transition and financial systems could better support families after discharge.

Exploratory factor analysis of The Comprehensive Feeding Practices Questionnaire (CFPQ) in a low-income hispanic sample of preschool aged children.

The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important measure to assess parent feeding practices as it encompasses a broad range of feeding behaviors, not just behaviors negatively associated with child weight outcomes. However, parent feeding practices have been shown to differ across ethnicities and the CFPQ has not been tested among low-income, Hispanic-American parents with preschool-aged children, a group at elevated risk for developing obesity. A confirmatory factor analysis was performed with the present Hispanic-American sample of Head Start mothers with preschoolers to confirm the original 12-factor, 49-item structure of the CFPQ. Because the original factor structure was not confirmed in the present Hispanic-American sample, an exploratory factor analysis was conducted to examine the psychometric properties of the CFPQ in this sample (n = 187). Among this sample, a five-factor model with 34 items was found to more appropriately assess parent feeding practices than the original 12-factor, 49-item CFPQ. This study provides preliminary validation of the CFPQ for use among low income, Hispanic-American families. Although future research is needed to replicate findings among a larger sample, this study takes an important first step toward more accurately assessing parent feeding practices among this high-risk population to inform tailored interventions that aim to reduce economic and ethnic disparities in child obesity.

Parental values in the UK.

This article investigates the extent to which parental values differ between social groups in the UK at the start of the twenty-first century. The study of parental values is an important area of sociological enquiry that can inform scholarship from across the social sciences concerned with educational inequality and cultural variability in family life. We draw on data from the Millennium Cohort Study to show how parent's social class, religion, religiosity, race and ethnicity, and education are related to the qualities they would like their children to have. Our rank-ordered regression models show that parents in service class occupations place significantly more importance on 'thinking for self' than 'obey parents' compared to those in routine manual occupations. We also show that although class matters, the relationship between education and parental values is particularly strong. Parenting values also differ by parental racial and ethnic background and by levels of religiosity.

Social determinants of health associated with childhood accidents at home: An integrative review.

OBJECTIVE: to analyze the factors associated with childhood accidents at home according to the levels of the social determinants of health. METHOD: integrative review of the literature, with research in databases CINAHL, LILACS and PubMed, with the following main descriptors: child; social determinants of health; accidentes, home. We included 31 studies that related the social determinants of health and childhood accidents, in English, Portuguese and Spanish. RESULTS: the proximal determinants identified were: age and sex of children, and ethnicity. Among the intermediate determinants of health, parental behavior, related to the supervision of an adult, prevailed. Parental employment and socioeconomic status were identified as distal determinants. CONCLUSION: the age and sex of the child, besides direct supervision, were the determinants most associated with accidents. The distal determinants should be better studied because their relation with the occurrence of domestic accidents has not been sufficiently clarified.

Reducing Preschool Behavior Problems in an Urban Mental Health Clinic: A Pragmatic, Non-Inferiority Trial.

OBJECTIVE: This pragmatic, randomized, non-inferiority trial compared the effectiveness and cost of group-based parent management training with mastery-based individual coaching parent management training in a low-income, predominantly African American sample. METHOD: Parents seeking treatment for their 2- to 5-year-old children's behavior problems in an urban fee-for-service child mental health clinic were randomized to the Chicago Parent Program (CPP; n = 81) or Parent-Child Interaction Therapy (PCIT; n = 80). Consent followed clinic intake and diagnostic assessment and parent management training was delivered by clinicians employed at the clinic. Primary outcome measures were externalizing child behavior problems, assessed at baseline and postintervention follow-up, using the Child Behavior Checklist (CBCL) and average per-participant treatment cost. RESULTS: Data from 158 parents were analyzed. Most were mothers (75.9%), African American (70.3%), and economically disadvantaged (98.7% Medicaid insured). Of children, 58.2% were boys, and mean age was 3.6 years (SD 1.03). Based on CBCL scores, behavior problems improved in the 2 conditions (Cohen d = 0.57 for CPP and 0.50 for PCIT). CPP was not inferior to PCIT (90% CI -1.58 to 4.22) at follow-up, even after controlling for differences in treatment length (90% CI -1.63 to 4.87). Average per-participant treatment cost was higher for PCIT (mean $2,151) than for CPP (mean $1,413, 95% CI -1,304 to -170). CONCLUSION: For parents of young children living in urban poverty, CPP is not inferior to PCIT for decreasing child behavior problems. CPP requires less time to complete and costs a third less than PCIT. CLINICAL TRIAL REGISTRATION INFORMATION: Early Parenting Intervention Comparison (EPIC); https://clinicaltrials.gov/; NCT01517867.

African American perspectives on racial disparities in child removals.

BACKGROUND: African American children are overrepresented in foster care at twice to three times the rate of white children. Scholars argue that racism and oppression underlie disproportionality (Kriz & Skivenes, 2011). OBJECTIVE: This study explored disproportionality as seen through the eyes of African American parents in the child welfare system. The aim was to understand why African American families are over-represented in child custody statistics and to improve family and parenting support for African American communities. PARTICIPANTS & SETTING: Participants included twenty-one African Americans--12 women and 9 men, two of whom were foster parents and 19 of whom were parents involved with child welfare services. All participants reside in two impoverished areas in southern United States. Focus groups were used to collect data and were conducted at a community center. METHODS: The method of analysis was constant comparison analysis (Strauss) and thematic analysis of the focus group discussions in the context of institutional policy. FINDINGS: Six themes (profound lack of trust; overwhelming trauma; severe and persistent poverty; health and mental health; socio-economic conditions; and sense of social isolation were identified, along with three participant suggestions to improve child welfare services (family support services, economic revival, and better communication). CONCLUSIONS: In the current study we note the strong link between poverty, child maltreatment, and child removal and conclude with an exploration of practice and policy implications with recommendations for a way forward. The need for culturally competent and trauma informed child welfare services is also discussed.