Parental history of positive development and child behavior in next generation offspring: A two-cohort prospective intergenerational study.

This study examined whether positive development (PD) in adolescence and young adulthood predicts offspring behavior in two Australasian intergenerational cohorts. The Australian Temperament Project Generation 3 Study assessed PD at age 19-28 (years 2002-2010) and behavior in 1165 infants (12-18 months; 608 girls) of 694 Australian-born parents (age 29-35; 2012-2019; 399 mothers). The Dunedin Multidisciplinary Health and Development Parenting Study assessed PD at age 15-18 (years 1987-1991) and behavior in 695 preschoolers (3-5 years; 349 girls) and their New Zealand born parents (age 21-46; 1994-2018; 363 mothers; 89% European ethnicity). In both cohorts, PD before parenthood predicted more positive offspring behavior (ßrange  = .11-.16) and fewer behavior problems (ßrange  = -.09 to -.11). Promoting strengths may secure a healthy start to life.

Early-onset and recurrent depression in parents increases risk of intergenerational transmission to adolescent offspring.

BACKGROUND: To assess whether the age-of-onset or the recurrence of parents' major depressive disorder (MDD), measured prospectively in a longitudinal birth cohort study, predicted offspring depression at age 15. METHODS: A two-generation study of New Zealanders, with prospective, longitudinal data in the parents' generation (n = 375) and cross-sectional data from their adolescent offspring (n = 612). Parent and offspring depression was measured with structured clinical interviews. Parent depression was measured at six time points from age 11 to 38 years. Adolescent offspring depression was measured at age 15. RESULTS: Compared to adolescents whose parents were never depressed, those whose parents met criteria for MDD more than once and those whose parents first met criteria before adulthood had more symptoms of depression. The combination of early-onset and recurrent depression in parents made adolescents particularly vulnerable; their odds of meeting criteria for MDD were 4.21 times greater (95% CI = 1.57-11.26) than adolescents whose parents were never depressed. The strength of the intergenerational effect did not vary as a function of parent or offspring sex. The prevalence of adolescent depression was 2.5 times higher in the offspring than at age 15 in the parents' generation. CONCLUSIONS: Recurrent depression in both fathers and mothers increases offspring risk for depression, particularly when it starts in childhood or adolescence, but a single lifetime episode does not. Health practitioners should be aware of age-of-onset and course of depression in both parents when assessing their children's risk for depression.

The experiences of young people with chronic illness in New Zealand: A qualitative study.

BACKGROUND: Around 10% of young people suffer from chronic health conditions, and their health care needs are different from those of children or adults. Most research about young people's chronic illness focuses on specific conditions, on younger children's experience, and on the perspectives of parents. This study explored the experiences of young people with two very different chronic conditions (asthma and cancer) and their perception of the New Zealand health system's response to their needs. METHODS: This was a collaborative research process where eight young co-researchers who had asthma or cancer were employed to work alongside the research team to develop protocols, interview peers, and assist with analysis. The challenges of this process are described in the article. Twenty-one young people between ages 15 and 27 from two urban areas of New Zealand participated in semistructured open-ended interviews about their health care experiences. Sixteen participants were female, and five male. Eleven of the participants had finished cancer treatment (with an average of 3.6 years since diagnosis), and 10 had asthma. Purposeful sampling meant that 80% of the participants with asthma were identified as Maori and the other participants identified with a range of other ethnic groups. Data were thematically coded, and coresearchers were consulted to derive the ultimate findings. RESULTS: Chronic illness disrupted the trajectory of young people's lives and had significant effects on their relationships. The New Zealand health system generally did not respond well to the needs of these young people, but many encountered extraordinary individuals who supported them effectively. The experiences of some indigenous participants indicate that health professionals require effective cultural competence training. CONCLUSIONS: This study provides insights into how young people with very different conditions experience the health system. Young people should be consulted and actively included in decision making about making health systems responsive to their diverse needs.

Midwifery experiences in rural Southern Aotearoa New Zealand: insights into pre-eclampsia management.

AIM: This study investigated the experiences of rural midwives in the Southern region of Aotearoa New Zealand, focussing on practices and challenges in caring for pregnant individuals displaying signs of pre-eclampsia (PE). METHOD: Conducted as part of the University of Otago's Trainee Intern Healthcare Evaluation Project, investigating the efficacy of the soluble FMS-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio test, this exploratory study employed qualitative research methods. Twenty-three midwives from nine locations across the Southern region were interviewed by trainee intern doctors (TIs) using a semi-structured interview protocol. Thematic analysis was applied to the data. RESULTS: The study highlighted the challenging context of rural midwifery, emphasising diverse working conditions, geographic complexities and the impact of the midwifery shortage. Midwives' decision making about PE depended on location, experience, scientific evidence, holistic model of care and the constant concern about PE. A model illustrating midwifery decision making in PE management was developed. CONCLUSION: Rural midwives in Aotearoa New Zealand's Southern region managing PE cases face complex challenges. The model derived from this study illustrates the delicate balance that rural midwives navigate, emphasising the need for strategies to support their practice and preserve Aotearoa New Zealand's distinctive maternity care model.

Impact of New Zealand teenagers' fertility intentions on childbearing.

Objective: To assess the impact of age 15 fertility intentions on childbearing outcomes three decades later. Background: Evidence is mixed about the implications of teenage fertility intentions on later childbearing. Taking a prospective life course approach to assessing intentions and outcomes may help clarify these mixed findings. Method: A general population birth cohort (born 1972/73) was asked about their fertility intentions at age 15 and 775 of this sample (384 women, 391 men) provided data on their childbearing between ages 15 and 45. Results: At age 15, almost all of the sample indicated they would like to have children in the future (93%). Most (79%) reported having had a biological child by they time they were 45; but those who professed to not wanting children as teenagers were significantly less likely to have had a child three decades later. Conclusion: Fertility intentions during adolescence are probably influenced by social, political and economic norms and may influence later childbearing decisions. This may be particularly true for those whose intentions counter established norms around childbearing. Implications: A life course framework is useful for examining the relationship between hypothetical fertility intentions and outcomes.

Adolescent and young adult mental health problems and infant offspring behavior: Findings from a prospective intergenerational cohort study.

BACKGROUND: Parental depression and anxiety have been consistently linked to offspring behavior problems across childhood. However, many of the risks for these common mental health problems are established well before pregnancy. This study takes advantage of rare, prospective data to examine relations between parental mental health histories (from adolescence onwards) and next generation offspring behavior problems. METHODS: Data were drawn from a multi-generational cohort study that has followed Australians from infancy to adulthood since 1983, and 1171 of their offspring assessed prospectively from pregnancy. Generalized estimating equation models were used to estimate associations between parents' depression/anxiety symptoms in adolescence and young adulthood and offspring behavior problems at 1 year. RESULTS: In analyses of 648 mother-infant and 423 father-infant dyads, after adjustment for confounders and concurrent mental health problems, mean behavior problem scores in infants of mothers with a history of mental health problems in both adolescence and young adulthood were over half a standard deviation higher than those of mothers without problems during these periods, B = 2.19, 95% CI 1.21 - 3.17, ß = 0.52. No association was observed for fathers. LIMITATIONS: We only included infants born to participants aged 29-35 years and we assessed behavior problems via parent-report. CONCLUSIONS: A mother's history of persistent depression and anxiety from adolescence to young adulthood can predict higher levels of behavior problems in her infant. Findings support calls for greater policy and prevention focus on preconception and postnatal mental health, particularly a mother's early emotional health history, prior to parenthood.

Intergenerational changes in adolescents' physical fitness and weight in New Zealand.

AIMS: This research examines fitness and body weight in two cohorts of adolescents, to determine continuity and changes in these measures across two generations. METHODS: Height, weight and fitness were measured in a population-based cohort of 15 year-olds in 1986/7 (Dunedin Study, n=968). The same measures were obtained for their 15-16 year-old children between 2007 and 2015 (Next Generation Study, n=343). Fitness was defined as maximal aerobic capacity (V'O2max). Height and weight were measured in all participants and fitness was adjusted for weight (V'O2max/kg). RESULTS: The Next Generation participants were, on average, heavier than the Dunedin Study participants had been, and had higher body mass index values (kg/m2). Unadjusted V'O2max values for boys did not differ between generations, but were lower in Next Generation girls compared to Dunedin Study girls. For both sexes, the Next Generation participants had lower weight-adjusted V'O2max values than the Dunedin Study participants. Compared to their parents, weight-adjusted V'O2max values were approximately 25% lower in girls and 15% lower in boys. CONCLUSIONS: Overall adolescents today appear to be less fit and heavier than their parents were at the same age. The decline in fitness over a generation is particularly evident in adolescent girls, although boys also have lower levels of fitness once body weight has been taken into account.

A literature review for large-scale health information system project planning, implementation and evaluation.

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS.

Does being an older parent attenuate the intergenerational transmission of parenting?

Evidence that the transition to parenthood is occurring at older ages in the Western world, that older parents provide more growth-facilitating care than do younger ones, and that most prospective studies of the intergenerational transmission of parenting have focused on relatively young parents led us to evaluate whether parental age might moderate-and attenuate-the intergenerational transmission of parenting. On the basis of the seemingly commonsensical assumption that as individuals age they often become more psychologically mature and have more opportunity to reflect upon and free themselves from the legacy of childhood experiences, we hypothesized that deferring parenting would weaken links between rearing experiences in the family of origin and parenting in the family of procreation. To test this proposition we repeated analyses reported by Belsky, Jaffee, Sligo, Woodward, and Silva (2005) on 227 parents averaging 23 years of age linking rearing experiences repeatedly measured from 3 to 15 years of age with observed parenting in adulthood; we added 273 participants who became parents at older ages than did those in the original sample. Although previously reported findings showing that rearing history predicted mothering but not fathering reemerged, parental age generally failed to moderate the intergenerational transmission of parenting. Other investigators prospectively following children and adults into adulthood and studying the intergenerational transmission process should determine whether these null results vis-à-vis the attenuation of transmission with age obtain when parents with older children are studied or when other methods are used. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Intergenerational transmission of warm-sensitive-stimulating parenting: a prospective study of mothers and fathers of 3-year-olds.

More than 200 New Zealand men and women studied repeatedly since age 3 were videotaped interacting with their own 3-year-old children to determine (a) whether childrearing and family climate experienced in 3 distinct developmental periods while growing up (i.e., early childhood, middle childhood, early adolescence) predicted parenting and (b) whether romantic relationship quality moderated the effect of childrearing history on observed parenting. Support for the first hypothesis emerged across all 3 developmental periods for mothers (only), with no evidence of moderating effects of romantic relationship quality for mothers or fathers. Results are discussed in terms of supportive versus harsh parenting, mother-father differences, and the characteristics of the sample.