Assessing attitudes towards pediatric research participation across diverse populations: Psychometric properties of a novel tool.

BACKGROUND: Clinical trials play a crucial role in advancing medical knowledge and improving health outcomes. However, there is a recognized need for greater representation of marginalized groups to ensure that research findings can be generalized and effectively applied to all individuals. While the Pediatric Research Participation Questionnaire (PRPQ) was developed to assist pediatric clinical trials research by identifying benefits and barriers to research participation among children with chronic medical conditions, there is still limited insight into the structure of the PRPQ when administered in diverse samples, including the general pediatric population. Therefore, the current study examined the factor structure of the PRPQ in a general pediatric population to investigate whether rural-urban differences exist in the PRPQ factor structure. METHODS: Caregivers (N = 600) of children under age 18 completed the PRPQ in a population-based survey in Mississippi. Sampling was stratified to ensure equal representation in rural (n = 300) and urban areas (n = 300). Exploratory and confirmatory factor analyses were conducted to determine the factor structure of the PRPQ. RESULTS: A five-factor structure was identified, compromising: social pressure, direct benefit, reasons for participation, mistrust in research/researchers, reasons against participation. While results were similar among urban participants, a three-factor structure emerged for rural participants. CONCLUSIONS: This study contributes to the broader understanding of research participation among underrepresented groups. The findings suggest that clinical researchers should consider tailoring recruitment strategies to increase clinical trial participation among children in rural areas. Understanding factors that influence pediatric research participation, particularly among marginalized communities, is crucial for developing effective recruitment and retention strategies.

Parental Discipline During Emerging Adulthood: A Person-Centered Approach.

Although most parental discipline research examines the effects of discipline in children and adolescents, recent research has demonstrated that emerging adults continue to receive parental discipline. Importantly, a newly validated instrument for assessing discipline specifically during emerging adulthood has been created. Scales from this instrument include maternal and paternal approval, disappointment, and abuse, and these scales were associated with other parenting behaviors and psychological outcomes during emerging adulthood. However, a person-centered approach has not been conducted with this instrument. Given that discipline occurs at an idiographic level and that group norms inform such behaviors, a person-centered approach would identify highly informative emerging adult profiles based on patterns of discipline they receive from their parents. Thus, the current study utilized latent profile analysis (LPA) of 1110 participants attending a Southern United States university to identify emerging adult discipline profiles. These groups were then associated with parental and emerging adult psychological problems to gain an understanding of how these factors relate to different patterns of discipline across gender. Results best supported four profiles labeled as approving, distant, disappointed, and abusive. These groups reported increasingly higher parental and personal psychological problems across approving, distant, disappointed, and abusive profiles. Gender moderated some of these effects. Implications and future directions are discussed.

Developmental/behavioral training innovation in a high-need, low-resource state: The child health and development promotion fellowship.

INTRODUCTION: Developmental and behavioral problems are prevalent in early childhood, whereas the workforce available to identify and address early problems is comparatively limited. Beyond workforce shortages, additional barriers to developing and training a highly skilled workforce in this area exist-particularly in rural, high-need, and underserved U.S. states. As the health care landscape emphasizes expertise in interdisciplinary care, training approaches that provide intensive learning opportunities for supporting a skilled early childhood developmental workforce necessitate novel training approaches. This Workforce Catalyst report summarizes the initial conceptualization, development, execution, and evaluation of a Child Health and Development Promotion (CHDP) postgraduate fellowship in a high need, underserved rural area. METHOD: Three cohorts totaling 15 trainees across fields including psychology, pediatric nursing, speech-language pathology, social work, and occupational therapy were recruited and cross-trained in an intensive postgraduate fellowship in early childhood development and behavior. RESULTS: The CHDP fellowship led to experiences across the care continuum and resulted in multiple clinical, educational, and scholarly products. Outcomes revealed a training program aligned with Infant and Early Childhood Mental Health competencies, high in-state retention (71%) and employment (93%) following training, and graduates who report leadership positions and sharing of specialty developmental-behavioral knowledge in organizations focused on early childhood. DISCUSSION: The CHDP Fellowship is a novel, immersive, and interdisciplinary training experience demonstrating positive initial training outcomes in Mississippi. The model and experience may serve as a roadmap for bolstering a skilled early childhood workforce in other underserved and high-need states. Aspects regarding scale of reach, funding, and accreditation are discussed as barriers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood adversity associated with poorer health: Evidence from the U.S. National Survey of Children's Health.

BACKGROUND: The association between adverse childhood experiences (ACEs) and increased risk of health problems is well established. However, many studies have relied on unrepresentative or high-risk samples and have focused on a narrow range of health problems. Prior research assessing potential age differences in the ACE-health connection is also sparse. OBJECTIVE: To comprehensively examine the extent to which ACEs are associated with physical, mental, and neurodevelopmental health outcomes in childhood and assess whether these associations differ between age groups. PARTICIPANTS & SETTING: Pooled cross-sectional data from the 2016-2019 National Survey of Children's Health (N = 98,732). METHODS: We estimated age-stratified binary logistic regression models examining associations between the number of ACEs and physical, mental, and neurodevelopmental health problems net of sociodemographic and socioeconomic controls. Separate models were estimated for the total population (ages 3-17), early childhood (ages 3-5), middle childhood (ages 6-11), and adolescence (ages 12-17). RESULTS: We observed a dose-response relationship between ACE exposure and childhood physical, mental, and neurodevelopmental health problems in all age groups. The largest disparities exist between children with no ACEs and three or more ACEs. Compared to children without ACEs, children with three or more ACEs had significantly higher adjusted odds of externalizing disorders (OR = 4.40), internalizing disorders (OR = 5.13), neurodevelopmental disorders (OR = 2.40), and physical health problems (OR = 2.08). CONCLUSIONS: Our results add to evidence linking ACEs to childhood health disparities. Further, findings indicate that ACEs have persistent negative effects across age groups and that clinicians should monitor ACEs when assessing children's physical, mental, and neurodevelopmental health at any age.

Defining the role of exposure to ACEs in ADHD: Examination in a national sample of US children.

BACKGROUND: Clinical presentations of ADHD vary according to biological and environmental developmental influences. An emerging field of research has demonstrated relationships between exposure to adverse childhood experiences (ACEs) and ADHD prevalence, particularly in high-risk samples. However, research examining the combined role of traditional risk factors of ADHD and ACEs is limited, and reliance on high-risk samples introduces sampling bias. OBJECTIVE: To examine the influence of ACEs on ADHD diagnosis using a large, nationally representative sample of US children. PARTICIPANTS AND SETTING: Nationally representative samples (2017 and 2018) of 40,075 parents from the National Survey of Children's Health (NSCH). METHODS: We conducted logistic regression models to examine the association of ACEs and ADHD diagnosis, controlling for child and parent demographic variables and other risk factors. RESULTS: Exposure to ACEs was significantly associated with parent-reported ADHD diagnosis, controlling for known parental and child-risk factors of ADHD. The association followed a gradient pattern of increased ADHD prevalence with additional exposures. Compared to children with no ACEs, the odds of an ADHD diagnosis were 1.39, 1.92, and 2.72 times higher among children with one, two and three or more ACEs. The ACE most strongly associated with the odds of ADHD was having lived with someone with mental illness closely followed by parent/guardian incarceration. CONCLUSIONS: Results further strengthen the evidence that ACEs exposure is associated with increased ADHD prevalence. Clinicians should assess ACEs in the diagnosis of ADHD. Furthermore, results of the study lend support to the efforts of agencies (both institutional and state-level) promoting routine screening of ACEs in children.

Effect of Parental Corporal Punishment on Endorsement of Its Use: Moderated Mediation by Parent Gender and Attitudes Toward Corporal Punishment.

Previous research has examined the factors that place an individual at a risk of using harsh discipline on children. Chief among these predictors is an individual's own experience of corporal punishment, as well as favorable attitudes toward corporal punishment as a parenting strategy. However, few studies have examined the relationships among these variables in emerging adults. Thus, the current study advanced this area of research by examining how attitudes toward corporal punishment mediated the association between the experience of corporal punishment within the past year and the endorsement of corporal punishment as a future parenting strategy of choice among emerging adults when presented with a vignette. In addition, the current study examined gender differences among study variables, including participants' parental disciplinary practices and whether participants were more accepting of using corporal punishment against a boy or girl in a hypothetical vignette. Participants (N = 393; Mage = 19.21) completed an online survey that included a hypothetical vignette depicting child misbehavior. Results from the current study suggested the experience of corporal punishment from mothers appeared to have more of an influence on the decision to endorse corporal punishment in the vignette for both emerging adult males and females. The findings from the current study highlight the importance of reducing the use of corporal punishment as a discipline strategy, as the experience of corporal punishment appears to shape attitudes which may favor future use of the practice.

Racial differences in college-student drinking.

Racial differences in drinking motives, protective behavioral strategies (PBSs), alcohol consumption, and alcohol-related problems were examined among college student drinkers (N = 443: 296 [66.8%] White, 147 [33.3%] Black). Survey participants were recruited from large undergraduate sociology classes and residence halls at the university. Key differences between Black and White college students in drinking behaviors, reasons for drinking (i.e., motives), and the use of PBSs were observed. These racial differences have implications for the implementation of prevention/intervention programs intending to reduce alcohol consumption and alcohol-related problems among college students.

Mother-Father Dyad Conflict Strategy Clusters: Implications for Emerging Adults.

Research has examined the different parenting styles that are present during emerging adulthood; however, less is known about potential parental conflict strategies that emerging adults may be experiencing during this developmental time period. Conflict strategies are conceptualized in the current study as parents' efforts to regulate, correct, or enforce a consequence in response to their emerging adult child's behavior. Previous research on discipline during childhood and adolescence has suggested the use of harsh discipline (e.g., use of physical force) leads to negative outcomes for children. Despite evidence linking harsh discipline methods to harmful outcomes in various developmental periods and suggested influence of parents in emerging adulthood, very little is known about how parents handle conflict with their emerging adult children. Thus, the present study investigated parental conflict strategies and mental health outcomes of emerging adults. Results revealed a significant parent-child gender interaction for non-violent strategies and psychological aggression. Moreover, results indicated that emerging adult children of parents who utilize similar levels of aggressive methods reported greater psychological problems. The findings from the current study underscore parents' use of conflict strategies when interacting with their emerging adult children, and further emphasize the importance of future research in this area.

Predictors of justice system involvement: Maltreatment and education.

Decades of research have established that experience of abuse and/or neglect in childhood is related to negative outcomes, such as juvenile delinquency. Existing research has shown that involvement in child welfare services is also related to juvenile delinquency, particularly for children who are victims of neglect. Research has also identified educational factors such as chronic absenteeism as significant predictors of involvement in the juvenile justice system. However, little research has investigated the combined influence of educational factors, child abuse, and involvement in child protective services on justice system involvement. The current study examined the influence of educational factors and involvement in child protective services on justice system involvement. The study utilized records from an educational database of children who attended a school within a county of Mississippi in any year from 2003 through 2013. Cases were then matched with records from the county Youth Court, Law Enforcement agencies, and Child Protection Services. A multivariate logistic regression controlling for gender, race, current age, and time at risk was conducted to involvement in the justice system. In general, educational factors were stronger predictors of justice system involvement than allegations of maltreatment.

DUI recidivism by intervention adherence: a multiple risk factor approach.

BACKGROUND: Multi-component impaired driving interventions can reduce driving under the influence (DUI) recidivism rates; however, outcomes are better for those who complete the interventions and are adherent with program expectations. Research is needed to examine the differences between DUI offenders who are adherent vs. non-adherent to intervention efforts. OBJECTIVE: The current study utilized a multi-risk factor model to predict recidivism among first-time DUI offenders enrolled in an intervention program. Differences between offenders who were adherent (including program completion) vs. non-adherent with the intervention were examined. METHOD: Using data from the Mississippi Alcohol Safety Education Program (MASEP) and state administrative records, the current study examined both recidivism rates and rates of intervention completion for all individuals enrolled in the program. The sample was predominantly White (58.8%) and male (80.2%). RESULTS: Individuals who were adherent with the intervention were significantly less likely to recidivate within 3 years. Prior traffic or other criminal violations positively predicted recidivism rates. The likelihood of recidivism varied, with males, African Americans, and younger individuals with less education at greater risk of recidivism. Adherence with the intervention was more common for African American and older participants. CONCLUSION: The MASEP participants who were adherent with the intervention were significantly less likely to recidivate than those who were non-adherent. However, variance in the multi-component intervention completion rates suggests that the program resonates better with specific population subsets. We argue for researchers and policymakers to further explore how specific population subsets react to varying intervention programs to maximize efforts to reduce impaired driving.

Parental and emerging adult psychopathology: Moderated mediation by gender and affect toward parents.

Current research indicates that children tend to view parents with psychopathology more negatively and children who hold negative perceptions of parents are at a greater risk for psychopathology. Yet, less research examines how parental psychopathology influences offspring psychopathology through affect toward parents. The current study tested a model that examined the associations among parental psychopathology, positive affect toward parents, and emerging adult psychopathology. Associations were expected to be partly indirect via positive affect toward parents and emerging adult gender was expected to moderate these associations. Results indicated gender-moderated mediation with significant effects found for males but not females. Results from the current study emphasize the importance of examining affect toward parents as a risk factor for emerging adult psychopathology. Additionally, results of the current study demonstrate the importance of examining the role of emerging adult gender as a potential moderator in these relationships.

Use of evidence-based substance use treatment practices in Mississippi.

Over the past decade, substance abuse treatment professionals have begun to implement evidence-based practices (EBPs) into the treatment of substance use disorders. There is a growing body of research on the diffusion of EBP in addiction treatment; however, less is known about individual state initiatives to implement EBPs among community providers. The current study aimed to evaluate the progress of an initiative of the Mississippi Department of Mental Health (MDMH) to increase the implementation of evidence-based substance abuse treatment practices by certified providers. In addition, the study examines potential barriers to implementing these practices. To accomplish this goal, we reported the findings of two surveys of Mississippi addiction professionals conducted in 2010 and in 2013.