Mindfulness-Enhanced Behavioral Parent Training for Clinic-Referred Families of Children With ADHD: A Randomized Controlled Trial.

Objective: This study evaluated the efficacy of a mindfulness-enhanced behavioral parent training (BPT) group program compared to standard BPT in families of children with ADHD. Method: Parents (N = 63) of children (aged 6-11) diagnosed with ADHD were randomly assigned to either mindful or standard BPT, and participated in 12 weekly 2-hr group sessions. Parents completed a series of questionnaires assessing mindful parenting, parenting stress, harsh discipline practices, behavioral dysregulation, and child ADHD symptoms, before and after completing the group intervention. Results: Parents in the mindful group had decreased harsh discipline practices and improved self-regulation compared to parents in the standard group. Both groups improved in parenting sense of competence and child ADHD symptoms. No significant group differences were found in mindful parenting or parenting stress. Conclusion: There are some important parental benefits to enhancing BPT with mindfulness.

Codevelopment of Healthy and Unhealthy Dietary Behaviors: A Dyadic Examination of Parenting Practices and Adolescent Characteristics.

OBJECTIVE: To identify the pathways through which external, parental, and adolescent factors influence adolescents' motivation to adopt healthy dietary behaviors. METHODS: A total of 28 ethnically and socioeconomically diverse (25% White) families were interviewed in which adolescents (mean age = 12.7 years; 50% girls) and parents (mean age = 43.3 years; 68% mothers) were interviewed separately. Data were first analyzed thematically, and family summaries, supplemented with diagrams, were then used to identify the processes through which factors influenced adolescents' dietary behaviors. RESULTS: The analyses identified 3 main motivational pathways (intrinsic motivation, extrinsic motivation, and amotivation), wherein variability and inconsistencies were observed across and within pathways. The unique combination of external factors, parenting profiles, as well as adolescents' willingness to be socialized by family members, differentiated these pathways from each other. CONCLUSIONS AND IMPLICATIONS: Health interventions need to target the overall approaches that parents use to socialize their adolescent to make healthy food choices instead of targeting specific parenting practices.

The physical activity parenting practices (PAPP) item Bank: a psychometrically validated tool for improving the measurement of physical activity parenting practices of parents of 5-12-year-old children.

BACKGROUND: Many tools have been developed to measure physical activity parenting practices (PAPP). Currently, there is little standardization on how PAPP constructs are operationalized for 5-12 year-old children. Given this lack of consistency our team have started the process of standardizing the measurement of PAPP by developing an item bank which was conceptually informed by 24 experts from 6 countries. PURPOSE: The purpose of this paper is to present the psychometric properties of the PAPP item bank using the expert-informed PAPP conceptual framework. METHODS: A sample (N = 626) of Canadian parents completed the PAPP item bank (100 items measuring 12 constructs). Confirmatory Factor Analyses (CFA), confirmatory bi-factor item analyses, and Item Response Modeling (IRM) were used to assess the structural validity of scores derived from the PAPP item bank. Differential Item Functioning (DIF) and Differential Response Functioning (DRF) were used to determine whether the PAPP items are invariant by parent sex, ethnicity of parent, and household income. Finally, Computerized Adaptive Testing (CAT) simulations were used to determine the efficiency of the item bank - this involved ascertaining whether each construct can be assessed with fewer items. RESULTS: The PAPP expert-informed conceptual framework was mainly supported by the CFA analyses. Notable changes included: a) collapsing smaller constructs into one general construct (modeling, co-participation, and monitoring constructs were collapsed into a construct assessing nondirective support); or b) splitting a construct into two smaller constructs (restrict for safety reason construct was split into indoor physical activity restriction and allowance for unsupervised outside physical activity). While the CFA analyses supported the structural validity of 11 constructs, the bi-factor item analyses and IRM analyses supported collapsing correlated constructs into more general constructs. These analyses further reduced the number of constructs measured by the PAPP item bank to nine constructs (65 items - reliability ranging from .79 to .94). As seven of the PAPP constructs had reliability greater than .80, CAT simulations further reduced the number of items to 31 items. CONCLUSION: Overall, the PAPP item bank has excellent psychometric properties and provides an efficient way to assess PAPP.

The form of a 'half-baked' creative idea: Empirical explorations into the structure of ill-defined mental representations.

Creative thought is conventionally believed to involve searching memory and generating multiple independent candidate ideas followed by selection and refinement of the most promising. Honing theory, which grew out of the quantum approach to describing how concepts interact, posits that what appears to be discrete, separate ideas are actually different projections of the same underlying mental representation, which can be described as a superposition state, and which may take different outward forms when reflected upon from different perspectives. As creative thought proceeds, this representation loses potentiality to be viewed from different perspectives and manifest as different outcomes. Honing theory yields different predictions from conventional theories about the mental representation of an idea midway through the creative process. These predictions were pitted against one another in two studies: one closed-ended and one open-ended. In the first study, participants were interrupted midway through solving an analogy problem and wrote down what they were thinking in terms of a solution. In the second, participants were instructed to create a painting that expressed their true essence and describe how they conceived of the painting. For both studies, naïve judges categorized these responses as supportive of either the conventional view or the honing theory view. The results of both studies were significantly more consistent with the predictions of honing theory. Some implications for creative cognition, and cognition in general, are discussed.

The Ubiquity of Cross-Domain Thinking in the Early Phase of the Creative Process.

To what extent are creative processes in one domain (e.g., technology) affected by information from other domains (e.g., music)? While some studies of professional creators suggest that creative abilities are domain-specific, other studies suggest that creative avocations stimulate creativity. The latter is consistent with the predictions of the honing theory of creativity, according to which the iterative process culminating in a creative work is made possible by the self-organizing nature of a conceptual network, or worldview, and its innate holistic tendency to minimize inconsistency. As such, the creative process is not restricted to the creative domain; influences from domains other than that of the final product are predicted to impact the creative process and its outcome. To assess the prevalence of cross-domain influences on creativity we conducted two studies: one with creative experts, and one with undergraduate students from diverse academic backgrounds. Participants listed both their creative outputs, and the influences (sources of inspiration) associated with each of these outputs. In both studies, cross-domain influences on creativity were found to be widespread, and indeed more frequent than within-domain sources of inspiration. Thus, examination of the inputs to, rather than the outputs of, creative tasks supported the prediction of honing theory that cross-domain influences are a ubiquitous component of the creative process.

Familial Environment and Overweight/Obese Adolescents' Physical Activity.

(1) Background: Family environments can impact obesity risk among adolescents. Little is known about the mechanisms by which parents can influence obesity-related adolescent health behaviours and specifically how parenting practices (e.g., rules or routines) and/or their own health behaviours relate to their adolescent's behaviours. The primary aim of the study explored, in a sample of overweight/obese adolescents, how parenting practices and/or parental modeling of physical activity (PA) behaviours relate to adolescents' PA while examining the moderating role of parenting styles and family functioning. (2) Methods: A total of 172 parent-adolescent dyads completed surveys about their PA and wore an accelerometer for eight days to objectively measure PA. Parents completed questionnaires about their family functioning, parenting practices, and styles (authoritative and permissive). Path analysis was used for the analyses. (3) Results: More healthful PA parenting practices and parental modeling of PA were both associated with higher levels of adolescents' self-reported moderate-vigorous physical activity (MVPA). For accelerometer PA, more healthful PA parenting practices were associated with adolescents' increased MVPA when parents used a more permissive parenting style. (4) Conclusions: This study suggests that parenting practices and parental modeling play a role in adolescent's PA. The family's emotional/relational context also warrants consideration since parenting style moderated these effects. This study emphasizes the importance of incorporating parenting styles into current familial interventions to improve their efficacy.

Moderating effects of family environment on overweight/obese adolescents' dietary behaviours.

BACKGROUND: The familial environment can influence adolescents' risk for obesity. However, we do not fully understand the mechanisms through which parents can influence overweight/obese adolescents' dietary behaviours, specifically whether parenting practices (e.g., rules or routines) and/or their own dietary behaviours are associated with their overweight/obese adolescent's dietary quality. OBJECTIVES: This study examined whether parenting practices and/or parental modeling of dietary quality are associated with overweight/obese adolescents' dietary quality while considering the moderating effects of parenting styles and family functioning. METHODS: Baseline data from 172 overweight/obese adolescents and one of their parents who enrolled in a lifestyle modification intervention were analyzed [mean age = 13.1 (1.8); mean BMI z-score = 2.70 (0.83)]. Parent-adolescent dyads completed three 24-hr dietary recalls online. An index of dietary quality was computed by summing the scores for different food categories assessed in the dietary recall over 3 days. Parents completed questionnaires about their family functioning, dietary parenting practices (i.e., whether child eats breakfast everyday), and styles (authoritative and permissive). Path analysis was used to model interrelationships among the variables using the Stata software version 13. RESULTS: Parental modeling of dietary quality was significantly associated with adolescent dietary quality. Additionally, parenting styles significantly moderated parental modeling, such that an authoritative parenting style in conjunction with modeling healthy eating habits was associated with better adolescent dietary quality. CONCLUSIONS: This work suggests that parental modeling of health behaviours is important; however, it is necessary to consider the broader emotional/relational context into which modeling is expressed since parenting styles moderated these effects. This study provides insight into how parenting styles may alter the effectiveness of parental modeling and highlights the need to account for parenting styles to improve the efficacy of current family-based interventions.

An apple a day: Protective associations between nutrition and the mental health of immigrants in Canada.

PURPOSE: Mental illness represents a major public health burden among Canada's large immigrant population. A burgeoning cross-sectional, longitudinal, and experimental evidence base implicates nutrition in mental health. Healthier diets (e.g., those rich in certain micro-nutrients) may benefit cognitive, social, and emotional functioning through attenuated inflammation and other bio-psychological pathways. The present study examined associations between nutrition and three markers of mental health among immigrants to Canada. METHODS: Employing cross-sectional data from immigrant respondents (n = 37,071) to a nationally representative population-based survey (the Canadian Community Health Survey: CCHS 2011-2014), we modelled associations of daily fruit and vegetable consumption with three mental health outcomes: anxiety and/or mood disorder diagnosis, being distressed (assessed via the 6-item Kessler Psychological Distress Scale), and having good self-rated overall mental health. Multivariable logistic regression analyses were employed, adjusting for various socio-demographic and lifestyle-related variables. RESULTS: Higher consumption of fruit and vegetables demonstrated significant, protective associations with odds of having a mood and/or anxiety disorder, being distressed, and self-rated good mental health. Such patterns of association were similar regardless of ethno-cultural minority status and recency of immigration. Moreover, the protective associations of nutrition and mental health were independent of socio-demographic, health, and lifestyle factors. CONCLUSIONS: Results suggested evidence of protective associations between healthy nutritional intake and mental illness among a large-scale sample of immigrants in Canada. Importantly, the protective associations of healthier diets with immigrants' mental health were independent of various markers of healthy lifestyles (e.g., general health status, physical activity, alcohol use). Healthy dietary intake may, therefore, be worth consideration in efforts to prevent mental illness among immigrants.

Constraints to implementing guidelines for the identification, assessment, and management of childhood obesity in the clinical care setting: Prevention and treatment framework.

The "Pathway for the Identification, Assessment and Management of Overweight and Obese Children & Youth" was developed to support healthcare providers in identifying and treating childhood obesity in British Columbia (Canada). PURPOSE: The study aimed to determine the feasibility and effectiveness of using the Pathway in clinical settings. METHODS: 13 healthcare providers (7 family physicians, 2 pediatricians, 2 registered dietitians, and 2 nurse practitioners) assessed the Pathway and participated in semi-structured interviews in 2015. A direct constant comparative analysis guided the coding of the interviews in the NVivo 9 software. RESULTS: The interviews uncovered the complexity of factors that influenced practices of healthcare providers. Three broad issues were identified as required if the "Pathway" were to be used and fully implemented in practices. First, the "Pathway" needs to be modified in terms of how it is presented and explained and be supplemented with appropriate documentation and resources for its implementation, Second, the constraints that limit implementation need to be addressed and should include a focus on both individual (i.e., the healthcare providers themselves) and environmental (i.e., factors within and outside of providers' organizations) factors. Lastly, there is a need to establish processes and/or infrastructure for adapting the "Pathway" to the local context as resources and supports vary by organizations and regions. CONCLUSION: Healthcare providers should be involved in screening and managing childhood obesity. Addressing the challenges found in this study will enable healthcare providers to take a more active role in addressing childhood obesity in their day to day practices.

Obesity and Regional Immigrant Density.

Canada has an increasingly large immigrant population. Areas of higher immigrant density, may relate to immigrants' health through reduced acculturation to Western foods, greater access to cultural foods, and/or promotion of salubrious values/practices. It is unclear, however, whether an association exists between Canada-wide regional immigrant density and obesity among immigrants. Thus, we examined whether regional immigrant density was related to obesity, among immigrants. Adult immigrant respondents (n = 15,595) to a national population-level health survey were merged with region-level immigrant density data. Multi-level logistic regression was used to model the odds of obesity associated with increased immigrant density. The prevalence of obesity among the analytic sample was 16%. Increasing regional immigrant density was associated with lower odds of obesity among minority immigrants and long-term white immigrants. Immigrant density at the region-level in Canada may be an important contextual factor to consider when examining obesity among immigrants.