Maternal and Paternal Adverse Childhood Experiences (ACEs) and Offspring Health and Wellbeing: A Scoping Review.

BACKGROUND: Adverse childhood experiences (ACEs) are common, often co-occur, and are associated with poor health outcomes across the life course. Emerging research has emphasized the lasting consequences of ACEs across generations, suggesting parental ACEs are associated with poor physical and mental health outcomes in children. However, the individual effects of fathers' ACEs and pathways of transmission remain unclear. A scoping review was conducted to summarize the current knowledgebase of the intergenerational consequences of parental ACEs on offspring health, clarify pathways of transmission, understand how ACEs are operationalized in the intergenerational literature, and identify gaps in knowledge. METHODS: Six electronic databases were searched for articles published in English from 1995 to 2022 relating to the long-term consequences of parental ACEs on offspring physical and mental health. Articles underwent title, abstract, and full-text review by two investigators. Content analysis was performed to integrate findings across the included studies. RESULTS: The search yielded 14,542 unique articles; 49 met the inclusion criteria. Thirty-six articles focused exclusively on mothers, one solely on fathers, and 12 included both mothers and fathers in their analyses. Six studies used an expanded definition of ACEs. Both direct and indirect associations between parental ACEs and poor offspring outcomes were identified, primarily through biological and psychosocial pathways. CONCLUSIONS: Findings underscore the importance and oversight of fathers and the need to solidify a unified definition and measure of ACEs. This review identified modifiable protective factors (social support, father involvement) and pathways of transmission (parental mental health, parenting); both having important implications for intervention development.

What is known on this subject? Recently, research has highlighted the intergenerational consequences of parental ACEs on offspring physical and mental health outcomes with a primary focus on mothers. Maternal exposure to ACEs is associated with poor offspring behavioral, mental and physical health, and developmental outcomes.What the study adds? This review extends prior literature by summarizing the nascent research on paternal ACEs, pathways of transmission, and suggesting the transmission of maternal ACEs to offspring outcomes is observed across a wide range of health outcomes and ACEs.

Parent Experiences of Empowerment: Understanding the Role of Parent Empowerment in Child Health Promotion.

BACKGROUND: Establishing healthy behaviors during a child's first 5 years is essential for healthy growth. Parents are targeted as agents of change because they serve as primary models of behavior during this period. Although parent-focused interventions often target empowerment as a driver of change, our understanding of how parents experience the process of empowerment in the context of child health promotion remains limited. OBJECTIVE: This qualitative study explored the process by which parents gain empowerment through participation in a health promotion intervention. METHODS: Semi-structured interviews were conducted with 37 low-income parents who participated in Parents Connect for Healthy Living (PConnect), a 10-week empowerment-centered obesity prevention intervention. Data were analyzed using inductive-deductive thematic analysis and guided by empowerment theories. RESULTS: Most parents were Hispanic/Latino (41%) and female (97%). Five themes emerged that correspond to the process by which parents gained empowerment: (1) friendships formed and relationships strengthened during PConnect, (2) parents strengthened relationships with their children and believed in their ability to parent successfully, (3) the experience of knowledge led to behavior change, (4) parents used new resources to improve family health, and (5) parents took action. CONCLUSION: Empowerment theory should be a component of health promotion programs.

Latinx individuals' knowledge of, preferences for, and experiences with prenatal genetic testing: a scoping review.

BACKGROUND: The American College of Obstetricians and Gynecologists recommends prenatal genetic testing (PGT) be offered to all pregnant persons regardless of known risk factors. However, significant racial/ethnic differences exist regarding acceptance of PGT contributing to disparities. Latinas (Latinx), one of the fastest growing ethnic groups in the United States, have low PGT acceptance rates. This systematic scoping review aimed to provide a landscape of existing literature on Latinx individuals' knowledge of, preferences for, and experiences with prenatal and preconception genetic testing. Synthesizing the current state of the science may inform development of culturally tailored interventions to support high-quality PGT decisions (e.g., informed, aligned with a pregnant persons' values). METHODS: We conducted a structured, systematic literature search of published articles and gray literature in electronic databases (PubMed, PsycINFO, CINAHL, Medline, Embase, Eric, Social Services Abstracts, and PsycArticles). Articles in English published prior to March 2021 were retrieved relating to genetics, pregnancy, and Latina women. Articles underwent title, abstract and full-text review by independent investigators to assess inclusion and exclusion criteria. Risk of bias was evaluated by two investigators. Iterative thematic analysis was employed to group study findings into themes to identify possible targets for interventions. RESULTS: The search generated 5511 unique articles. After title screening, 335 underwent abstract review and subsequently 61 full-text review. Twenty-eight studies met inclusion criteria and 7 additional studies were included after reviewing reference lists. Three overarching themes emerged: genetic knowledge/literacy (26/35, 74%), provider (mis)communication/patient satisfaction (21/35, 60%), and cross-cultural beliefs (12/35, 34%). Studies indicate discordant patient-provider language (n = 5), miscommunication (n = 4), and lack of concordant decision-making (n = 4) pose barriers to high-quality PGT decisions. Immigration status (n = 1) and religious beliefs (n = 5) are additional factors influencing PGT decisions. CONCLUSIONS: Identified studies suggest that cultural and linguistic factors affect Latinx PGT decision-making. Latinx individual's comprehension and recall of PGT information is enhanced by culturally and linguistically concordant providers-suggesting that culturally-informed interventions may enhance PGT acceptability and support high-quality decisions. Future directions to surmount PGT disparities may include community health workers and cultural brokers to empower Latinx people to make informed decisions aligned with their values and preferences.

Significant racial, ethnic, and language disparities exist in prenatal genetic testing (PGT). Latina (Latinx) people, one of the fastest growing ethnic groups in the United States, have low acceptance rates of PGT. This scoping review provides a systematic search of the literature to better understand Latinx individuals' knowledge of, preferences for, and experiences with PGT. Eight electronic data bases were systematically searched and identified articles underwent title, abstract, full text, and reference review. Iterative thematic analysis was conducted to group article findings into themes. Thirty-five studies met inclusion criteria and three overarching themes were identified: genetic knowledge/literacy, provider (mis)communication/patient satisfaction, and cross-cultural beliefs. Findings indicate that discordant patient-provider decision making and language and patient provider miscommunication pose barriers to high-quality PGT decisions. Latinx individuals' understanding and recall of PGT information is improved when delivered in a culturally and linguistically concordant manner. This suggests culturally-informed interventions, including the use of community health workers or cultural brokers, may enhance PGT acceptability and support high quality pregnancy decisions.

Incongruence in Perceptions of Pain: Associations with Mental Health in Couples Living with Fibromyalgia.

Guided by the theory of dyadic illness management, this study examined the association between the within-couple incongruence regarding perceptions of pain experienced by adults with fibromyalgia (AwFM) and symptoms of depression and anxiety in AwFM and their partners. Participants included 204 couples. Three second-order dyadic variables were created from the couples' perceptions of pain interference experienced by AwFM: (1) absolute magnitude of incongruence in perception of pain, (2) average perception of pain, and (3) direction of incongruence (i.e., who perceives pain to be higher). Structural equational modeling was used to examine the association between the three dyadic variables and AwFM and partner symptoms of depression and anxiety, adjusting for covariates. These steps were repeated for pain severity. Higher average perception of pain interference within the couple was associated with greater symptoms of depression and anxiety in AwFM and partners. AwFM exhibited greater symptoms of depression when their perception of their pain interference was higher than their partner's. Incongruence variables were not significantly associated with AwFM or partners' anxiety symptoms. Near identical results were found for pain severity. A dyadic approach to mental health treatment, which includes enhanced communication skills, should be adopted to optimize the mental health of couples living with fibromyalgia.

Coronavirus disease 2019 vaccination among young children: Associations with fathers' and mothers' influenza vaccination status.

Objectives: To examine the association between parents' influenza vaccination and their children's coronavirus disease 2019 (COVID-19) vaccination status. Methods: Participants included father-mother dyads from Fathers & Families, a cohort of fathers and their co-parents living in the United States. Parents' influenza vaccination status and children's COVID-19 vaccination status were reported from June 2022-July 2023. Logistic regression was used to examine the association between parental influenza vaccination (both parents vs. neither parent vs. mother only vs. father only vaccinated) and child COVID-19 vaccination (received at least 1 vs. 0 doses). Models were adjusted for recruitment site, income, parent education, child race/ethnicity, child age, and childcare enrollment. Inverse probability weighting was used to account for selection bias into the father-mother dyad sample. Results: Children were predominately non-Hispanic White (56 %) and aged 3-5 years (62 %). In most households, both parents (64 %) received the influenza vaccine and half (53 %) of children received the COVID-19 vaccine. One-in-four fathers (23 %) lacked knowledge about their child's COVID-19 vaccination eligibility. Compared to children with two unvaccinated parents, having only their father (adjusted odds ratio [AOR] = 2.84, 95 % confidence interval [CI]: 1.52-5.36), only their mother (AOR = 4.04, 95 % CI: 2.16-7.68), and both parents (AOR = 10.33, 95 % CI: 6.29-17.53) vaccinated against influenza was associated with higher odds of children receiving the COVID-19 vaccine. Conclusions: Father and mother influenza vaccination is associated with child COVID-19 vaccination. Given many fathers were unaware their child was eligible for the COVID-19 vaccine, it is critical to tailor vaccine messaging for fathers.

Sense of mastery and attitude towards illness: Examining longitudinal benefits of a medical specialty camp for youth with sickle cell disease.

Medical specialty camps can play an important role in the positive development of psychosocial outcomes for children and youth with sickle cell disease (SCD). This study examined how sense of mastery and attitude towards illness outcomes changed over 6 months for 100 campers aged 8-16 years with SCD. The outcomes were measured twice before and twice after camp. Latent growth curve modeling was used to analyze data. Results showed no changes in the outcomes for this study population. Implications for future research designs, populations, and outcomes are discussed, as are implications for communications about camp, and policy and practice.

Racial and Ethnic Disparities in Childhood Growth Trajectories.

Childhood overweight and obesity are a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States of America (USA) have drastically increased, particularly among Black and Latino/a populations. However, they tend to be underrepresented in the childhood obesity literature. This study expands previous literature by identifying different BMI growth trajectories for Black, Latino/a, and White children from birth to age nine. This study found a high prevalence rate of overweight and obesity in a predominantly low-income minority group. Using growth-based trajectory modeling, this study also found different growth trajectories by racial/ethnic groups, with Latino/a children having the most concerning growth trajectories from birth to 9 years. These findings demonstrate that ethnic/racial disparities in childhood overweight and obesity start as early as birth, indicating the need to devote more attention from researchers and health policy-makers to address these disparities as early as possible.

Childhood obesity risk factors by race and ethnicity.

OBJECTIVE: Childhood obesity is a public health concern that often worsens with age. Although several risk factors at the child and maternal levels have been identified in cross-sectional studies, less is known about their long-term contribution to racial/ethnic disparities in childhood obesity. This study examines child- and maternal-level factors associated with the growth trajectories of White, Black, and Latino children. METHODS: Group-based trajectory models were used to identify BMI z score trajectories from birth to 9 years of age among White, Black, and Latino children. The associations of child- and maternal-level factors with the trajectory group identified as at risk for obesity were examined using adjusted logistic regression analysis, stratified by race/ethnicity. RESULTS: Among White children, fast-food consumption (odds ratio [OR] = 1.66; 95% CI: 1.09-2.52) was associated with higher odds of following an at-risk trajectory. Among Black and Latino children, prepregnancy BMI was associated with following an at-risk trajectory (OR = 1.05; 95% CI: 1.03-1.08 for Black children, and OR = 1.12; 95% CI: 1.07-1.17 for Latino children). CONCLUSIONS: These findings showed racial/ethnic differences in the risk factors that influence the likelihood of obesity during childhood. Further research is needed to identify modifiable racial/ethnic specific risk factors to guide obesity-prevention interventions.

Adaptation and implementation outcomes of a parenting program for low-income, ethnically diverse families delivered virtually versus in-person.

Driven by the COVID-19 pandemic, many in-person health behavior interventions were compelled to quickly pivot to a virtual format with little time or capacity to reflect on or examine possible equity-related implications of a format that required digital access and remote learning skills. Using a parenting program for low-income families as a case study, this paper (a) outlines the process of adapting the program from an in-person to a virtual format and (b) examines the equity-related implications of this adaptation. Parents Connect for Healthy Living (PConnect) is a 10-session empowerment-focused parenting intervention designed to promote family health for Head Start families. In 2020, PConnect was adapted over a 6-month period from an in-person to a virtual format due to the advent of the COVID-19 pandemic. Three core elements were retained in the adaptation; session content, provision of coaching support for facilitators, and the co-facilitation model. Key modifications include session length, group composition, and language of program delivery. Head Start and PConnect records provided data to compare reach, acceptability, and appropriateness of virtual and in-person PConnect. Seventy-eight parents enrolled in the in-person program and 58 in the virtual program. Participant demographics and satisfaction were similar across formats, and demographics similar to the general Head Start population. Participation was higher in the virtual format. Parents participated in the virtual program primarily via smart phones (68%). This case study supports the acceptability and appropriateness of virtual parenting programs in ethnically diverse, low-resource settings.

The purpose of this study was to examine the process of adapting an in-person health and empowerment parenting program, Parents Connect for Healthy Living (PConnect), to a virtual format, and examine if this adaptation and implementation of the virtual format led to inequities. Modifications to in-person PConnect to accommodate a virtual format included session length, group composition, and language of program delivery. Participant demographics and satisfaction were similar across the in-person and virtual formats. Attendance was slightly higher in the virtual format, and differences in attendance rates by race/ethnicity in the virtual program were less apparent. Findings from this case study indicate future programs for parents in low-resource settings should consider a virtual or hybrid approach.

Prevalence and predictors of parental depressive episodes: Results from a 15-year longitudinal study.

BACKGROUND: Depression affects approximately 7.5 million parents in the United States each year. Parental depression has detrimental consequences for both the parent and the parent-child relationship. The purpose of this study was to: (1) understand the prevalence of parental depressive episodes longitudinally, (2) identify the risk and protective factors for parental depressive episodes, and (3) compare the risk and protective factors for depressive episodes among mothers and fathers. METHODS: We used six waves of the Fragile Families and Child Wellbeing Study to descriptively examine parental depression over a period of 15 years. We used logistic and fixed effects regressions to assess the association between a number of demographic, health and parenting variables and maternal and paternal depression. RESULTS: Our sample was primarily Black (48%) and Hispanic/Latino (27%). Fathers had a slightly lower prevalence of depression compared to mothers at all waves (approximately 13% averaged across waves for fathers, compared to 18% for mothers). Factors negatively correlated with depression among mothers and fathers included: social support, employment, and better-perceived health. Factors positively associated with depression for mothers and fathers were substance misuse and having a parent with a history of depression, anxiety, or drug misuse. LIMITATIONS: Our study was unable to identify causal relationships and the directionality of the relationship between depression and other variables of interest. CONCLUSIONS: We found that parental depression is prevalent in a sample of predominantly racially minoritized parents. Addressing comorbidities and increasing social support access may help manage parental depression and ensure a healthy child development.

The Use of Music by Adolescents and Young Adults With Sickle Cell Disease.

Pain is common and often severe in people with sickle cell disease (SCD), occurring as acute intermittent pain episodes called vaso-occlusive episodes (VOEs), as well as chronic pain conditions including bone infarctions, avascular necrosis of joints, and neuropathic pain. Analgesics such as opioids, nonsteroidal anti-inflammatory medications (NSAIDS), and anticonvulsants for neuropathic pain, although often necessary to manage these types of pain, are associated with side effects. Nonpharmacologic interventions such as to listening to music and music therapy may reduce pain. The objectives of this study were to determine whether the use of music by adolescents and young adults with SCD was helpful, and if so, the types of music that helped, and how music helped them. A convenience sample of nine English-speaking inpatients ages 13 to 21 years, with SCD and at least two prior hospitalizations for VOE, took part in interviews with music therapists. Participants were asked open-ended questions about both pain and music. Participants identified that music was helpful for pain relief as well as for mood regulation, focusing attention during cognitive tasks such as homework, distraction, relaxation, and feeling understood or connected with others. Despite this, while hospitalized, participants reported that they did not tend to use music to help with pain. These findings support the use of both music medicine and music therapy as interventions for pain and distress in adolescents and young adults with SCD.