Importance of Family Connection for Healthy Weight Behaviors Amid Adverse Family Experiences and Behavioral Difficulties.

OBJECTIVE: Adverse family experiences (AFEs), including parent divorce and domestic violence, negatively affect obesogenic behaviors and engagement in healthy weight behaviors (HWBs). The current study used a moderated mediation model to investigate the role of family connection in the relationship between AFEs and HWBs for children with behavioral difficulties. METHOD: Youth (6-17 years old; n = 13,921) from the 2016 National Survey of Children's Health data set were included in the study. RESULTS: Family connection mediated the relationship between AFEs and each HWB. The models of physical activity and screen time had significant direct effects. Behavioral difficulties moderated the direct effect of AFEs and screen time and physical activity. CONCLUSION: Family connection mediated the relationships between each HWB and AFEs. The findings suggest that for children without behavioral difficulties, family connection was a stronger protective factor for adequate physical activity and decreased screen time.

Caregiver stress in children with craniosynostosis: a systematic literature review.

OBJECTIVES: We present an overview of the literature on caregiver stress in children with craniosynostosis and report common trends in the literature. INTRODUCTION: Craniosynostosis occurs approximately 1 in 2500 births. As this is a diagnosis most common in infants and often requires surgical treatment, this is a significant and stressful ordeal for caregivers. Caregiver stress impacts various outcomes for the child, and little is understood and known about caregiver stress in the pediatric craniosynostosis population. METHODS: A literature search for all articles pertaining to craniosynostosis and parental/caregiver stress was conducted using PubMed, Embase, PsychINFO, and CINAHL databases. RESULTS: Seven articles on caregiver stress in craniofacial abnormalities patients and three articles on caregiver stress in pediatric craniosynostosis patients specifically were identified. Three articles on parental satisfaction after craniosynostosis repair were also identified and included in the review. Few published studies exist in the literature on caregiver stress in children with craniosynostosis and no clear trends were identified. It is evident that caregiver stress significantly affects the psychosocial outcomes of children with craniosynostosis. However, there are an equal number of studies reporting significant differences in caregiver stress in children with craniosynostosis as those reporting no significant differences. CONCLUSIONS: There is evidence that caregiver stress affects psychosocial outcomes of children with craniosynostosis, but no clear trends of either increased or decreased levels of stress were identified in caregivers of children with craniosynostosis. Additional research is needed to identify risk factors related to caregiver stress.

Sleep in Teens With Type 1 Diabetes: Perspectives From Adolescents and Their Caregivers.

PURPOSE: The purpose of this study is to identify barriers, facilitators, and consequences of obtaining sufficient sleep in adolescents with type 1 diabetes. METHODS: Semistructured interviews were conducted with 25 adolescents (52% female, mean age = 15.6 years) and 25 caregivers. Interviews were transcribed and coded using Atlas.ti. A thematic analytic approach was used to identify and organize significant patterns of meaning (themes) and interpret themes across the data. RESULTS: Several barriers were identified, with the most common being the use of electronics before bed and sleep disturbances related to diabetes management. Caregivers described strategies for helping adolescents achieve sufficient sleep, such as enforcing bedtimes and limiting distractions, but many adolescents could not identify facilitators of sleep. Weekday/weekend discrepancies in sleep timing were commonly disclosed. CONCLUSIONS: This study is the first to examine the perceptions of barriers and facilitators to obtaining sufficient sleep in adolescents with T1D and their caregivers. Results have the potential to inform providers' recommendations regarding sleep, including possible interventions to promote sleep in this high-risk population.