The association between perceived social support and parenting self-efficacy among parents of children aged 0-8 years.

Strengthening social support has been recognized as a potentially effective strategy to enhance parenting self-efficacy, but empirical evidence is limited. This study examined the association between perceived social support and parenting self-efficacy.Data of 647 parents of children aged 0-8 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Data were collected between October 2017 and December 2019. Multivariable linear regression models were used to examine the association between social support and parenting self-efficacy. The mean age of the participants was 33.8 years (SD = 4.9); 94.9% mothers. At the start of the study, 15.1% parents perceived low to moderate social support. Parents who experienced lower levels of social support at the start of the study reported lower parenting self-efficacy at follow-up (ß: 0.13; 95% CI: 0.05, 0.21), independent of potential socio-demographic confounders. Experiencing an increase in perceived social support during the study period was associated with an increase in parenting self-efficacy (ß: 0.15; 95% CI: 0.10, 0.21). Our findings indicate perceived social support is associated with parenting self-efficacy among parents of children aged 0-8 years. Future longitudinal studies need to confirm our findings and may examine which social support interventions are effective in strengthening parenting self-efficacy.

Associations between organised leisure-time activities and mental health problems in children.

Previous studies conducted mainly among adolescents have found associations between participation in sport organised leisure-time activities (OLTAs) and mental health problems (MHP). Fewer research studies have been performed to primary school-aged children and to organised non-sport OLTAs. Therefore, the objective is to examine whether there is an association between participation in sport and non-sport OLTAs and a high risk of MHP in 4- to 12-year-olds. Data were used on 5010 children from a cross-sectional population-based survey conducted between May and July 2018 in Rotterdam, the Netherlands. Associations between sport OLTAs, non-sport OLTAs and breadth of OLTAs and a high risk of MHP were explored using logistic regression models adjusting for sociodemographic characteristics, stressful life events and physical activity. Of all children, 58% participated in sport OLTAs and 22% in non-sport OLTAs. The proportion of children with high risk of MHP among participants in sport OLTAs is smaller than among non-participants (OR 0.66, 95% CI: 0.53, 0.81). The proportion of children with high risk of MHP among participants in non-sport OLTAs is smaller than among non-participants (OR 0.69, 95% CI: 0.53, 0.91). The proportion of children with a high risk of MHP among participants in 1 category of OLTAs (OR 0.61, 95% CI: 0.49, 0.76) and in 2-5 categories of OLTAs (OR 0.48, 95% CI: 0.32, 0.71) is smaller than among non-participants.  Conclusion: The proportion of children with high risk of MHP among participants in OLTAs is smaller than among non-participants. What is Known: • Around 10--20% of children and adolescents experiences mental health problems. • Sport organised leisure-time activities have been found to be associated with a lower risk of mental health problems in adolescents. What is New: • The proportion of children with a high risk of mental health problems in participants in organised leisure-time activities is smaller than among non-participants. • The proportion of children with a high risk of mental health problems in participants with a higher breadth of organised leisure-time activities is smaller compared to non-participants.

Socio-demographic characteristics associated with perceived social support among parents of children aged 0-7 years: the CIKEO study.

BACKGROUND: Social support has been associated with numerous positive outcomes for families' health, wellbeing and empowerment. This study examined which socio-demographic characteristics are associated with perceived social support among parents of children aged 0-7 years. METHOD: Cross-sectional data of 1007 parents of children aged 0-7 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Social support was assessed with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to examine associations between socio-demographic characteristics and perceived social support. RESULTS: The mean age of the participants was 34.1 years (SD = 5.1); 92.9% were mothers. The multivariable regression model showed that fathers (ß: -0.15, 95% CI: - 0.22, - 0.08), parents with a low educational level (ß: -0.12, 95% CI: 0.18, - 0.06), parents with a low income (ß: -0.10, 95% CI: - 0.19, - 0.01), unemployed parents (ß: -0.14, 95% CI: - 0.20, - 0.07), and parents of older children (ß: -0.07; 95% CI: - 0.13, 0.00) perceived lower levels of social support. Interaction analyses showed that parents with a migration background and a low educational level were particularly susceptible to perceiving lower levels of support (ß: -0.34, 95% CI: - 0.52, - 0.15). CONCLUSION: Fathers, parents with a low educational level, parents with a low income, unemployed parents, parents of older children, and parents with both a migration background and a low educational level are at increased risk of perceiving lower levels of social support. IMPLICATIONS: We recommend to develop, implement and evaluate intervention strategies to strengthen perceived social support among the abovementioned subgroups of parents, in order to improve families' health, wellbeing and empowerment. TRIAL REGISTRATION: NTR7607 in the Netherlands trial registry.

Parental, child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0-7 years old: the CIKEO study.

BACKGROUND: A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE. OBJECTIVE: To investigate factors associated with PSE in parents of children aged 0-7 years old, and to explore whether the associations were different between mothers and fathers. METHODS: We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE. RESULTS: Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (- 2.05, 0.87), and 0.23 (- 0.46, 3.29), respectively. CONCLUSIONS: A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care. TRIAL REGISTRATION: Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

Evaluation of the promising neighbourhoods community program to reduce health inequalities in youth: a protocol of a mixed-methods study.

BACKGROUND: Reducing socioeconomic health inequalities among youth is a major challenge for governments around the world and reports on successful attempts are scarce. Socioecological and integral approaches with collaborative partnerships and community engagement are recommended but knowledge about the effectiveness and effective and ineffective elements is limited. The Promising Neighbourhoods program employs such an approach aiming to reduce socioeconomic inequalities in health, safety and talent development in youth. We will evaluate the process-implementation, and effectiveness of the Promising Neighbourhoods program. METHODS/DESIGN: Core elements of Promising Neighbourhoods are a collaborative community programming approach with stakeholders, data-based priority setting, knowledge-, and theory-based policies and evidence-based interventions. Community stakeholders and key-leaders from the neighbourhoods are engaged in the program. For this evaluation study the program will be implemented in three intervention neighbourhoods. These neighbourhoods will be compared to three control neighbourhoods at baseline in 2018/2019 and at follow-up in 2020/2021 after full implementation of the Promising Neighbourhoods program. Intervention neighbourhoods receive a tailored intervention-package including evidence-based interventions and additional measures by community stakeholders. In control neighbourhoods, no special planning will take place thus interventions are offered as usual. A mixed-methods approach following the stages of the logic model from program is applied for this evaluation. Questionnaires, focus groups, and registration data will be collected among community stakeholders, key-leaders, and youth to evaluate the process-implementation of the program. Indicators of intermediate and ultimate outcomes will be studied among N = 818 children and N = 818 youngsters using difference-in-difference regression analysis to evaluate the effectiveness of the Promising Neighbourhoods program. DISCUSSION: Hypotheses are that a collaborative community approach with stakeholders leads to clear priority-setting and better tailored interventions of better quality. We further hypothesise a decline in socioeconomic inequalities in intermediate and ultimate outcomes for health, safety and talent development in the intervention neighbourhoods in comparison to control neighbourhoods. The results add knowledge about effective and ineffective elements of collaborative community programming approaches to reduce health inequalities in youth and thus are relevant for local and national public health authorities. TRIAL REGISTRATION: Netherlands National Trial Register number NL7279 . Date of registration: 26-Sept-2018.

Evaluation of effectiveness of (elements of) parenting support in daily practice of preventive youth health care; design of a naturalistic effect evaluation in 'CIKEO' (consortium integration knowledge promotion effectiveness of parenting interventions).

BACKGROUND: The number of interventions to support parents is growing. The level of evidence regarding these intervention varies. In this paper we describe a study that aims to assess the effectiveness of specific 'elements' within such parenting interventions for families with children up to 7 years. A naturalistic effect evaluation will be applied. Study questions are: 1. What is the exposure of parents to (elements of) parenting interventions in the daily practice of preventive youth health care? 2. What are the associations between the exposure to (elements of) parenting interventions and outcomes in parents/children related to parenting and child development? METHODS/DESIGN: Thousand parents/caregivers are recruited by preventive youth health care providers in the Netherlands. Measurements will be performed after inclusion and after 12-months follow up. Data regarding child/parent/caregiver characteristics, use of (parenting) interventions and care, and outcomes with regard to parenting skills, family functioning and child development will be collected. Outcomes will be compared between parents/children exposed and non-exposed to the (elements of) parenting interventions (adjusting for confounders). DISCUSSION: We hypothesize that parents/caregivers with exposure to (elements of) parenting interventions show (relatively more) improvements in parenting outcomes. Results will support intervention selection/development, and support communities/professionals to select appropriate intervention-elements. TRIAL REGISTRATION: Netherlands National Trial Register number NL7342 . Date of registration: 05-November-2018, retrospectively registered.

Substance Use Patterns Among Adolescents in Europe: A Latent Class Analysis.

BACKGROUND: Several researchers have investigated substance use patterns using a latent class analysis; however, hardly no studies exist on substance use patterns across countries. OBJECTIVES: Adolescent substance use patterns, demographic factors, and international differences in the prevalence of substance use patterns were explored. METHODS: Data from 25 European countries were used to identify patterns of adolescent (12-16 years, 50.6% female) substance use (N = 33,566). RESULTS: Latent class analysis revealed four substance use classes: nonusers (68%), low-alcohol users (recent use of beer, wine, and alcopops; 16.1%), alcohol users (recent use of alcohol and lifetime use of marijuana; 11.2%), and polysubstance users (recent use of alcohol, marijuana, and other illicit drugs; 4.7%). Results support a general pattern of adolescent substance use across all countries; however, the prevalence rates of use patterns vary for each country. CONCLUSIONS/IMPORTANCE: The present research provides insight into substance use patterns across Europe by using a large international adolescent sample, multidimensional indicators and a variety of substances. Substance use patterns are helpful when targeting policy and prevention strategies.

Community variation in adolescent alcohol use in Australia and the Netherlands.

To investigate the cross-national relevance of community health promotion, this paper compared community variation in alcohol use and risk and protective factors for adolescents in Australia (State of Victoria, 2009) and the Netherlands (2007/2008). Multi-level analyses examined community variation in heavy episodic (binge) alcohol use [≥5 drinks in a session ≥once in the prior fortnight (>63 ml of ethanol)] and associations with predictors. Representative community samples of adolescents (12-17 years) were recruited. The participants were 7812 students from 36 Australian communities and 15 082 adolescents from 124 Dutch communities. Predictors included adolescent reports of family, school, peer and neighbourhood environments and community predictors (rural, disadvantage). The overall prevalence of alcohol use prevalence was similar in both nations. Australia had higher use at younger ages and no difference between genders. In the Netherlands older adolescents and males used alcohol at significantly higher rates. Although individual predictors were mostly similar, binge drinking was more strongly associated with poor family management, friends' use of drugs and community disorganization in Australia. Significant community variation in adolescent heavy alcohol use was observed in both countries, but was higher in the Netherlands [inter class correlation 6.1%, (95% CI: 4.5-8.3%)] than Australia (ICC 2.4%, 1.3-4.5%). Youth from rural areas drank at a higher level, especially in the Netherlands. Targeting community level adolescent alcohol use appears feasible in both countries. Although behavioural patterns and risk and protective influences are similar in the Netherlands and Australia, important differences should be taken into account in tailoring community interventions.

Transforming prevention systems in the United States and the Netherlands using Communities That Care Promising prevention in the eyes of Josine Junger-Tas.

Josine Junger-Tas introduced the Communities That Care (CTC) prevention system to the Netherlands as a promising approach to address the growing youth violence and delinquency. Using data from a randomized trial of CTC in the United States and a quasi-experimental study of CTC in the Netherlands, this article describes the results of a comparison of the implementation of CTC in 12 U.S. communities and 5 Dutch neighborhoods. CTC communities in both countries achieved higher stages of a science-based approach to prevention than control communities, but full implementation of CTC in the Netherlands was hampered by the very small list of prevention programs tested and found effective in the Dutch context.

Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study.

BACKGROUND: Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia. METHODS: Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children. RESULTS: The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05). CONCLUSIONS: Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.

A Cross-national Comparison of Risk and Protective Factors for Adolescent Drug Use and Delinquency in the United States and the Netherlands.

The present study compared associations between risk and protective factors and adolescent drug use and delinquency in the Netherlands and the United States. Data were collected from students between the ages of 12 and 17 using the same school-administered survey instrument in both countries. Levels of exposure to risk and protective factors were generally similar in both countries. The same risk and protective factors shown to be associated with U.S. adolescents' drug use and delinquency were related significantly to Dutch youth's drug use and delinquency. One important exception was that Dutch students perceived their parents' attitudes to be more favorable toward alcohol use; these attitudes also were more predictive of adolescents' regular drinking in the Netherlands compared to the United States. The findings indicate that the risk and protective factors measured in this study can be important targets for prevention of health-compromising behaviors among young people in the Netherlands and the United States.

Validation Study of the Child and Youth Resilience Measure (CYRM-28) Among Dutch Youth.

A validation study of a 28-item Child and Youth Resilience Measure (CYRM-28) among a Dutch sample was presented. A sample of 525 adolescents (16-20 years old) from the CYRM-28 in the Netherlands was analyzed. Descriptive statistics, confirmatory factor analysis (CFA), construct validity analysis, and reliability tests were carried out on data collected to identify and present factor structure, construct validity, and reliability. The CFA suggested a three-structure framework with individual, relational, and contextual subscales. Overall, the results were similar to the results found in other international validation studies measuring resilience among teenagers. Integral support of vulnerable youth needs to fit in with the lives and world of these adolescents in their transition to adulthood. Measuring resilience with the CYRM-28 can be used to assist this. Dutch individual and contextual subscales need further research.

Effectiveness of the Promising Neighbourhoods community program in 0-to 12-year-olds: A difference-in-difference analysis.

Objective: The purpose of this study was to evaluate a collaborative community-based program that aims to a) increase the health, safety and talent development of youth, and b) contribute to the reduction of socioeconomic inequalities. Methods: A difference-in difference design with two separate cross-sectional samples in 2018 (n = 984) and 2021 (n = 413) among 0- to 12-year-olds with an intervention and comparator condition was used. The program, called Promising Neighbourhoods, consists of collaboration with community stakeholders, data-based priority setting, knowledge-and theory-based policies, and evidence-based interventions. The program was implemented in three neighbourhoods which were compared with three similar comparator neighbourhoods in which the program was not implemented. Logistic difference-in-difference regression was used to test effectiveness of the intervention on informal parenting support, outdoor-play, sport club membership, general health and risk of emotional and behavioural difficulties and to examine differences in intervention effects between children with a lower or higher socioeconomic status. Results: A significant intervention effect of the Promising Neighbourhoods program after two-years was found for outdoor-play (OR 0.61; 95%CI 0.37, 0.99). No other significant intervention effects were found for other outcomes. No different interventions effects were found for children with a lower or higher socioeconomic status on outcomes. Conclusion: The findings of this study indicate a positive intervention effect for one of the outcomes in 0- to 12-year-olds. Further mixed-methods evaluation research and using longer follow-up periods are needed to examine the value of these type of programs. Further development of Promising Neighbourhoods seems warranted. Trial registration: This study was prospectively registered in the Netherlands National Trial Register (Number: NL7279) on 26 September 2018.

The Association between Stressful Life Events and Emotional and Behavioral Problems in Children 0-7 Years Old: The CIKEO Study.

BACKGROUND: Stressful life events (SLEs) are recognized risk factors for emotional and behavioral problems, but the association is understudied among young children. Our aim was to examine the association between exposure to SLEs and emotional and behavioral problems in young children up to 7 years old. METHODS: We analyzed baseline data from 959 children (mean age = 3.3 years; SD = 1.9; 47.5% girls) in the CIKEO study, a community-based longitudinal study in the Netherlands. Linear regression was used to assess the associations between the total as well as the individual exposure to SLEs experienced in the past 12 months, and emotional and behavioral problems assessed by CBCL 1.5-5. Interactions of SLEs and child age, sex, ethnic background, and socioeconomic status were explored. RESULTS: Higher total exposure to SLEs, as indicated by the number of SLEs, was significantly associated with higher CBCL total, internalizing and externalizing problem scores (p for trend < 0.05). The results did not differ by child age, sex, ethnic background, or family SES. Six out of the 12 SLEs explored were independently associated with greater CBCL total/externalizing/internalizing scores (p < 0.05). CONCLUSIONS: Exposure to SLEs is associated with higher levels of emotional and behavioral problems in young children, and the impact of SLEs may vary depending on the types of events. Stressful life events might be a useful target for interventions to improve emotional and behavioral well-being among young children.