Local Data for Action: Statewide Dissemination of School Wellness Policy Evaluations in Wisconsin.

School settings can influence child health, including physical activity and diet, through the promotion of high-quality wellness policies. Many studies have analyzed the quality of school wellness policies, but evidence is lacking regarding the dissemination of the policy evaluation results to school districts. This study describes the process the Wisconsin Health Atlas followed to disseminate tailored school wellness policy data reports and interactive dashboards to school districts throughout the state and the results of the statewide dissemination efforts. Prioritizing the translation of research to practice, the process included collaborating with key stakeholders and partners to provide formative feedback on the dissemination activities. The electronic and hard copy reports were disseminated to 232 districts through email and U.S. mail. Each district received a tailored report featuring an executive summary, local data for action, personalized policy recommendations, best practices, and a unique code to enter into interactive data dashboards to explore additional local, regional, and state-level data. In the utilization follow-up survey (20.3% response rate), respondents indicated that the report will help their district to improve the quality of their school wellness policy. Additionally, respondents who had used the report specified they used the data to identify areas for policy improvement and to support their triennial assessment, suggesting that districts value the technical support. To support school districts in improving the quality of school wellness policies, we recommend researchers prioritize collaborative dissemination efforts and provide actionable policy data when conducting school wellness policy evaluations.

Getting under the skin: Physiological stress and witnessing paternal arrest in young children with incarcerated fathers.

U.S. jails see nearly 11 million annual admissions, rates that disproportionately affect men of color-more than half of whom are fathers. An estimated 7% of U.S. children experience the incarceration of a parent, increasing their risk for poor developmental and health outcomes. Although stress processes are often suggested as an underlying mechanism linking paternal incarceration to child well-being, few studies have examined such links. To study how witnessing a father's arrest prior to incarceration in jail relates to children's stress processes, we collected data on 123 individuals from 41 families with young children whose father was in jail, including collecting hair from 41 children, and analyzed their cumulative stress hormones, cortisol, and cortisone. Results indicate that children had higher cumulative stress hormone concentrations when they witnessed their father's arrest. Moreover, there was evidence of a blunted stress reaction in children who witnessed the arrest and who also had high levels of ongoing behavioral stress symptoms, similar to findings in Post-Traumatic Stress Disorder studies. Long-term exposure to stress can have deleterious effects on children's brain development, further increasing risk for developmental psychopathology. Findings have implications for criminal justice approaches that safeguard children during parental arrest.

Multisite randomized efficacy trial of educational materials for young children with incarcerated parents.

Although children with incarcerated parents exhibit more behavior problems, health concerns, and academic difficulties than their peers, few interventions or resources are available to support affected children. This randomized, controlled, multisite efficacy trial evaluated Sesame Street's "Little Children, Big Challenges: Incarceration" initiative with children aged 3 to 8 years with a jailed father. Seventy-one diverse children and their caregivers were randomized to an educational outreach group (n = 32) or wait list control group (n = 39). Researchers observed children during jail visits and interviewed caregivers by phone 2 and 4 weeks later. The effects of the intervention on children's behavior and emotions occurring during a jail visit depended on what children had been told about the father's incarceration. Children who were told honest, developmentally appropriate explanations showed less negative affect at entry, an increase in negative affect when the intervention was administered, and a decrease in negative affect during the visit. Intervention group children who were told distortions, nothing, or explanations that were not developmentally appropriate showed more negative affect initially, and their negative affect remained relatively stable during their time in the jail. In addition, children who were told the simple, honest truth about the parent's incarceration (a recommendation in the educational materials) exhibited more positive affect during the visit, with a medium effect size. Caregivers in the educational outreach group reported more positive change in how they talked to children about the incarceration over time compared to the control group.

Wisconsin School Wellness Policies after Federal Legislation Change: Understanding Key Mechanisms of Policy Improvement.

BACKGROUND: The Final Rule of the Healthy Hunger Free Kids Act, published in 2016, required school districts participating in the federal Child Nutrition Programs to update their local wellness policies to reflect the more stringent requirements effective June 30, 2017. OBJECTIVE: Our aim was to investigate whether Wisconsin school wellness policies (SWPs) were updated after the Final Rule, measure policy quality change, and describe mechanisms of successful policy change. DESIGN: From 2016 through 2018, an explanatory sequential mixed-methods study examined change in SWP quality before and after the Final Rule was published. SWPs were collected in 2 waves reflecting policies written before and updated after the July 21, 2016 publication of the Final Rule. Semi-structured key-informant interviews were conducted with districts that demonstrated significant policy improvement. PARTICIPANTS/SETTING: Quantitative analysis examined 442 Wisconsin school districts' SWPs. Semi-structured interviews were conducted with 14 school districts that demonstrated significant change between waves. MAIN OUTCOME MEASURES: WellSAT 2.0 strength and comprehensiveness scores measured SWP quality among districts that updated their policies. Themes from interviews were identified using framework analysis. STATISTICAL ANALYSIS PERFORMED: First, we calculated the proportion of Wisconsin school districts participating in federal Child Nutrition Programs for which SWPs were obtained at both waves of policy collection (n = 192 districts, 43.4%). Among districts that updated SWPs in wave II, repeated-measure analysis of variance tests described policy quality and policy quality change, respectively. RESULTS: Among the 192 districts that updated their SWPs, policy quality increased overall and for 5 of 6 domains. Nutrition education scores did not show significant change. Interviewees commonly cited wellness leadership, support and resources, and buy-in and culture change as key components of policy improvement. CONCLUSIONS: Fewer than half of Wisconsin school districts updated their policies in the 10 months after the Final Rule was published. SWP from these districts showed policy quality improvement in most areas. Interviews with successful districts indicate the common need for empowered leaders and supportive environments to facilitate culture change around student wellness.

Fathers in Jail and their Minor Children: Paternal Characteristics and Associations with Father-Child Contact.

OBJECTIVES: More than five million children have experienced a co-resident parent leaving to spend time behind bars. Most incarceration occurs in jails, yet little is known about contact between parents in jail and their minor children. Such information is essential to inform programming and policy to support families in the context of incarceration. METHODS: In the present study, 315 fathers in jail with minor children (3-17 years old) were recruited from four jails in the Midwest region of the United States. Fathers in jail reported their demographic information, incarceration-related characteristics (e.g., number of prior arrests), children's exposure to incarceration-related events, and frequency of contact with their children. RESULTS: Four main findings emerged: 1) telephone contact was the most common modality for engaging with children during a paternal jail stay, with 22% of fathers reporting daily phone contact with children, 2) types of contact were correlated, so that more phone contact and letter writing were associated with more frequent visits, 3) White, non-Hispanic fathers and those who did not plan to live with their children upon release were less likely to report telephone contact with their children, and 4) children who witnessed their fathers' arrest were less likely to write and children who witnessed their fathers' criminal activity were less likely to visit. CONCLUSIONS: Contact between fathers in jail and children has implications for the parent-child relationship. Future research should explore quality of and barriers to contact, including incarceration-related events.

Cognitively-Based Compassion Training for parents reduces cortisol in infants and young children.

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants' and young children's cumulative physiological stress.

Este estudio puso a prueba una práctica de intervención contemplativa secular con base en un grupo, el Entrenamiento Compasivo con Base Cognitiva (CBCT), con padres de niños pequeños. Nosotros reportamos sobre un estudio de efectividad preliminar controlado al azar. Maestros titulados administraron el CBCT por 20 horas a lo largo de 8-10 semanas en dos grupos de padres con infantes y niños pequeños. El grupo de intervención fue comparado con un grupo de control en lista de espera. Treinta y nueve padres y sus niños, que oscilaban en edad de 4 meses a 5 años, fueron evaluados antes y después de la intervención (n=25 grupo de intervención, n=14 grupo de control en lista de espera) en cuanto a la concentración de cortisol en el cabello. Los padres también completaron cuestionarios auto-administrados en ambos momentos temporales con respecto a información demográfica, síntomas físicos de estrés, estrés de crianza, auto-compasión, así como plena conciencia. Los niños de padres en el grupo CBCT experimentaron una significativa disminución de cortisol al momento de la evaluación posterior a la intervención, tal como se les comparó con el grupo de control. Sin embargo, el cortisol de los padres y las medidas de auto-reporte no cambiaron significativamente. El CBCT pudiera ser una nueva manera positiva de intervenir con padres para reducir el estrés fisiológico cumulativo de infantes y niños pequeños.

Cette étude a testé une intervention de pratique contemplative séculaire et basée sur un groupe, la Formation de Compassion Cognitive (abrégé ici selon l'anglais CBCT), avec des parents de jeunes enfants. Cet article porte sur une étude d'efficacité préliminaire randomisée et contrôlée. Des formateurs certifiés ont procédé à une CBCT de 20 heures réparties sur 8-10 semaines chez deux cohortes de parents avec des nourrissons et des jeunes enfants. Le groupe d'intervention a été comparé à un groupe de contrôle en liste d'attente. Trente-neuf parents et leurs enfants, allant de 4 mois à 5 ans d'âge, ont été évalués avant et après l'intervention (n=25 intervention, n=14 contrôle de liste d'attente) sur la concentration de cortisol capillaire. Les parents ont également rempli des questionnaires auto-administrés aux deux temps d'évaluation, concernant des données démographiques, les symptômes physiques de stress, le stress de parentage, l'auto-compassion et la pleine conscience. Les enfants de parents du groupe CBCT ont fait preuve de baisses de niveau de cortisol importantes à l'évaluation post-intervention en comparaison au groupe de contrôle. Cependant le cortisol parental et les mesures auto-rapportées n'ont pas changé de manière importante. La CBCT peut être une nouvelle manière positive d'intervenir avec les parents afin de faire baisser le stress physiologique cumulatif des nourrissons et des jeunes enfants.

School Wellness in Wisconsin: Evaluating Policies for Practices to Prevent Pediatric Obesity.

BACKGROUND: We examined written language in Wisconsin school wellness policies (SWPs) for federal mandate compliance, quality related to obesity prevention, and school characteristics associated with variations in quality. This is the first near census of Wisconsin SWPs and examines whether adhering to federal mandates results in strong policies aimed at preventing pediatric obesity. METHODS: Policies were coded using the WellSAT 2.0. Policy quality was computed as comprehensiveness and strength based on 6 subscales and 2 overall scores. Variations in policy quality were examined by district size, free/reduced lunch percentage, and year of last revision. RESULTS: We received SWPs from 91% of districts. Six of the 8 federal mandates were addressed by the majority of districts, although less than one fourth addressed all. Most comprehensiveness scores were weak to moderate, and strength scores were weak. All school characteristics were significantly related to overall policy quality; effect sizes were small. CONCLUSIONS: Our results confirm the necessity of statewide focus on SWP improvement and suggest that while districts may be meeting federal mandates related to pediatric obesity, few policies include health promotion practices beyond those required. Policies remain fragmented and lack focus on obesity prevention practices; we identify modifiable areas for improvement.

Jailed Parents and Their Young Children: Residential Instability, Homelessness, and Behavior Problems.

This study examined family disruption in the form of jailed parents' housing instability in the year leading up to their most recent incarceration, including periods of homelessness with and without their children, and links between parental housing instability and children's behavior problems. Using the Family Stress Proximal Process Model to understand the links between stressors related to family disruption and child outcomes, the study analyzed data from interviews and surveys with 165 jailed fathers and mothers with young children (age 2-6 years) regarding jailed parents' reports of housing instability during the 12 months prior to their incarceration and child behavior problems. Analyses showed that housing instability, homelessness, and recidivism in jailed parents were relatively common, with a significant proportion of the disruptions occurring with young children, although many disruptions involved parental absence from children. Results indicated that the more months that parents lived with their children prior to incarceration in jail during the past year, the less housing instability the parents experienced. Additionally, multiple regression analyses revealed that more housing instability experienced by parents in the year leading up to their incarceration in jail were associated with elevations in children's internalizing and externalizing behavior problems. These results have implications for future research that explores family disruption as a mechanism in understanding recidivism and homelessness among adults and risk for child behavior problems in families affected by parental incarceration.

Attachment in young children with incarcerated fathers.

The present study examined young children's attachment behaviors during paternal incarceration and reported on initial validity of a new measure used to rate children's attachment-related behaviors and emotions during visits in a corrections setting. Seventy-seven children, age 2 to 6 years, and their jailed fathers and current caregivers participated in the home visit portion of the study, whereas 28 of these children participated in the jail visit. The results indicated that 27% of children witnessed the father's crime and 22% of children witnessed the father's arrest, with most children who witnessed these events exhibiting extreme distress; children who witnessed these events were more likely to have insecure attachments to their caregivers. Consistent with attachment theory and research, caregivers who exhibited more sensitivity and responsivity during interactions with children and those who provided more stimulating, responsive, learning-oriented home environments had children who were more likely to have secure attachments (measured with the Attachment Q-Sort). We also found preliminary evidence for the validity of our new measure, the Jail Prison Observation Checklist, in that children's attachment-related behaviors and emotions during the jail visit correlated with their attachment security observed in the home. Our observations indicate that, in certain contexts, noncontact visits with incarcerated parents can be stressful for children and that children's caregivers may play a significant role during these visits.

Risk and resilience in preterm children at age 6.

Children born preterm are at risk for experiencing significant deleterious developmental outcomes throughout their childhood and adolescence. However, individual variation and resilience are hallmarks of the preterm population. The present study examined pathways to resilience across multiple domains (e.g., social activities, peer relations, attention-deficit/hyperactivity disorder symptomology, externalizing and internalizing behavior, and sleep quality) as children born preterm reached school age. The study also examined early child and family predictors of resilience. Using a prospective longitudinal design, 173 infants born preterm and without significant neurological complications were assessed at five time points: neonatal intensive care unit discharge, 9 months, 16 months, 24 months, and 6 years. Three pathways of adaptation emerged at 6 years: children who were resilient, those who remained at-risk, and children who exhibited significant difficulties. Resilient children were less likely to have experienced negative parenting at 9 and 16 months, more likely to delay gratification at 24 months, and more likely to experience neonatal health complications than nonresilient children.

Early parenting, represented family relationships, and externalizing behavior problems in children born preterm.

Through assessment of 173 preterm infants and their mothers at hospital discharge and at 9, 16, 24, 36, and 72 months, the study examined early parenting, attachment security, effortful control, and children's representations of family relationships in relation to subsequent externalizing behavior problems. Less intrusive early parenting predicted more secure attachment, better effortful control skills, and fewer early behavior problems, although it did not directly relate to the structural or content characteristics of children's represented family relationships. Children with higher effortful control scores at 24 months had more coherent family representations at 36 months. Moreover, children who exhibited less avoidance in their family representations at 36 months had fewer mother-reported externalizing behavior problems at 72 months. The study suggests that early parenting quality and avoidance in children's represented relationships are important for the development of externalizing behavior problems in children born preterm.