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Gender diverse patients (including gender diverse, transgender, and non-binary people) deserve quality health care, which has been referred to as gender affirming care. Given that practitioners' attitudes and competence can influence their provision of gender affirming care, this study used a lens of transnormativity (Bradford & Syed, 2019; Johnson, 2016) to develop a measure of practitioners' transnormative beliefs. The aim of the study was to determine if these beliefs were related to practitioners' gender affirming attitudes and perceptions of competence in gender affirming practice. Survey data were collected from Australian medical and allied health practitioners (N = 95). Exploratory factor analysis was applied to items measuring transnormative beliefs, with the results supporting three higher order factors; conditional approval, narrative, and gender role beliefs. Conditional approval reflected belief in gender diverse identity as authentic and worthy of intervention. Narrative beliefs reflected understanding of common developmental experiences among gender diverse populations, specifically experiences of victimisation and nascence. Gender role beliefs reflected belief in the existence of gender roles. In models that regressed gender affirming attitudes and self-perceived competency on all transnormative beliefs, controlling for demographics and work history, practitioners higher in conditional approval were lower in gender affirming attitudes and practitioners higher in narrative beliefs were higher in gender affirming attitudes and competency. Conditional approval was not significantly associated with competency, and gender role beliefs were not significantly associated with attitudes or competency. Results indicate that practitioners' transnormative beliefs are related to their gender affirming attitudes and suggest that targeting these beliefs through training opportunities could bridge the gap between gender diverse people's healthcare needs and the ability of healthcare practitioners to provide high quality care.
Subject(s)
Allied Health Personnel , Attitude of Health Personnel , Transgender Persons , Humans , Male , Female , Australia , Adult , Transgender Persons/psychology , Transgender Persons/statistics & numerical data , Surveys and Questionnaires , Middle Aged , Allied Health Personnel/psychology , Allied Health Personnel/statistics & numerical data , Gender Identity , Health Personnel/psychology , Health Personnel/statistics & numerical data , Gender-Affirming CareABSTRACT
Embedding mental health and wellbeing programs within youth sports development programs can help provide more young people with mental health support. However, delivering such programs in multiple locations across metropolitan, regional, and rural areas requires novel solutions to overcome geographic and logistical barriers. We examined the delivery of an integrated system delivered within an Australian junior rugby league program. The program included online assessment and feedback about youth mental health, as well as connection with evidence-informed resources and referral sources via parent telephone and email support. There were four methods of delivering player workshops during training sessions: (a) In-person Delivery Only, (b) In-person + Remote Real-time (video-conferenced), (c) In-person + Remote Prerecorded (video-recorded), and (d) Remote Delivery Only (video-conferenced and/or video-recorded). In-person delivered player workshops were facilitated by local rugby league personnel. Remote delivered workshops were facilitated by psychologists from the mental health research team. Participants were 671 boys (12-15 years; M age = 13.35; SD = 0.35) in 21 metropolitan, regional and rural locations. Regardless of delivery condition, players with elevated anxiety, depression and behavioural problems reported significant declines in symptoms from pre- to post-program, and those within healthy ranges did not change from pre- to post-program. Player workshop enjoyment ratings were higher in the In-person + Remote Real-time condition and the Remote Delivery Only condition than the In-person Delivery Only condition. However, non-completion of the post-program assessment across all conditions was higher than in prior studies and a comparison group of players who did not complete the program was not included. Mental health benefits may be observed across in-person and remote modes of delivering mental health workshops within youth sports programs. However, the involvement of mental health personnel, whether in-person or remotely, and mixed delivery modes, may be important for young people's retention and satisfaction.
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INTRODUCTION: Adolescents report using digital technologies for emotion regulation (digital ER), with the aim of feeling better (i.e., improving emotions and reducing loneliness). In this 7-day diary study, we investigated associations of digital ER, emotions, and loneliness, and tested whether prior emotional problems moderated these associations. METHOD: Participants were 312 Australian adolescents (Mage = 13.91, SD = 1.52; 44% boys). Daily surveys measured digital ER; end-of-day happiness, sadness, worry, anger, and loneliness; and peak sadness, worry, and anger. End-of day emotions were subtracted from peak emotions to calculate emotion recovery for sadness, worry, and anger. Participants were randomly selected from two symptom strata (high/low) defined by depression and social anxiety measures collected before the diary. Data were analyzed using multilevel path modeling. Cross-level interactions tested whether symptom strata moderated associations. RESULTS: Digital ER was associated with more recovery from peak to end-of-day sadness and worry, but also with increased sadness, worry, anger, and loneliness by the next end-of-day. Higher end-of-day loneliness was associated with increased next-day digital ER. Prior emotional symptoms were not a significant moderator of daily digital ER and emotion associations. CONCLUSION: Adolescents who report more digital ER in a day show more recovery from the peak of negative emotion that day, but this recovery dissipates, with digital ER also associated with increased negative emotion and loneliness by the next day for all adolescents, regardless of prior symptom status. Lonelier adolescents use more digital ER by the next day, suggesting they need support to make social connections-online or offline.
Subject(s)
Emotional Regulation , Loneliness , Male , Adolescent , Humans , Female , Digital Technology , Australia , Emotions , AngerABSTRACT
This systematic review is the first to synthesize knowledge of parental involvement in child sexual abuse (CSA) prevention programs. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, 24 intervention evaluations met the inclusion criteria of aiming to change parental knowledge, attitudes, behaviors, behavioral intentions, self-efficacy, response-efficacy, or capabilities for prevention of CSA. Included papers were identified via a combination of electronic database searches (PsycINFO, Web of Science, Scopus, Google Scholar, Cochrane Library, World Health Organization's International Clinical Trials Registry Platform, google.com.au, open.grey.eu, Global ETD, Open Access Theses & Dissertations, EThOS, and Trove) and direct communication with researchers. Improvement post intervention was found most commonly for parental behavioral intentions and response-efficacy, closely followed by parental behaviors, then capabilities, self-efficacy, knowledge, and lastly, parental attitudes. Improvements in behaviors, intentions, and response-efficacy occurred in 88 to 100% of the studies in which they were addressed, improvements in self-efficacy and capabilities occurred in 67 to 75%, and improvements in knowledge and attitudes occurred in only 50 to 56%. Many of the included evaluation studies suffered from methodological and reporting flaws, such as high participant attrition, lack of control group, lack of statistical tests, missed testing time points, and a lack of (or short) follow-up. Future parent-focused CSA prevention evaluations must address these concerns by conducting rigorous empirical research with sound methodologies and comprehensive reporting. Furthermore, study designs should consider measuring the real-world impact of increases in assessed parent variables, including their ability to prevent sexual victimization of children.
Subject(s)
Child Abuse, Sexual , Child , Humans , Child Abuse, Sexual/prevention & control , ParentsABSTRACT
Adolescents face many academic pressures that require good coping skills, but coping skills can also depend on social resources, such as parental support and fewer negative interactions. The aim of this study was to determine if parental support and parental negative interactions concurrently and longitudinally relate to adolescents' ways of academic coping, above and beyond the impact of three types of academic stress, students' achievement at school (i.e., grades in school), and age. Survey data were collected from 839 Australian students in grades 5 to 10 (Mage = 12.2, SD = 1.72; 50% girls). Students completed measures of support and negative interactions with parents; academic stress from workload, external pressure (teachers/parents) to achieve, and intrapsychic pressure for high achievement; and ways of academic coping that were grouped into two positive and two negative types. Hypothesized associations were tested concurrently and from one year to the next using path modeling. Beyond the numerous significant influences of academic stress and achievement on coping, and control for age and COVID-19 timing, adolescents with more parental support reported more use of engagement coping (e.g., strategizing) and comfort-seeking, whereas those who reported more negative interactions with parents reported more use of disengagement coping (e.g., concealment) and escape. In the longitudinal model, parental support predicted an increase in engagement and comfort-seeking and a decrease in disengagement coping, whereas negative interaction with parents predicted an increase in disengagement coping. Overall, the findings support the view that coping with academic stressors will continue to depend on parent-adolescent relationships even into the teen years.
Subject(s)
COVID-19 , Female , Adolescent , Humans , Child , Male , Longitudinal Studies , Australia , Adaptation, Psychological , ParentsABSTRACT
INTRODUCTION: Australian practices for diagnosing fetal alcohol spectrum disorder (FASD) are lengthy and require specialist expertise. Specialist teams are based in urban locations; they are expensive and have prolonged waitlists. Innovative, flexible solutions are needed to ensure First Nations children living in rural/remote communities have culturally appropriate and equitable access to timely diagnosis and support. This study compares the accuracy of rapid assessments (index tests) that can be administered by a range of primary healthcare practitioners to specialist standardised FASD assessments (reference tests). The cost-efficiency of index tests will be compared with reference tests. METHODS AND ANALYSIS: At least 200 children aged 6-16 years at-risk of FASD will be recruited across at least seven study sites. Following standards for reporting diagnostic accuracy study (STARD) guidelines, all children will complete index and reference tests. Diagnostic accuracy statistics (including receiver operating curves, sensitivity, specificity, positive and negative predictive values and likelihood ratios) will identify whether rapid assessments can accurately identify: (1) the presence of an FASD diagnosis and (2) impairment in each neurodevelopmental domain, compared to comprehensive assessments. Direct and indirect healthcare costs for index tests compared to reference tests will be collected in primary healthcare and specialist settings. ETHICS AND DISSEMINATION OF RESULTS: Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/20/QCHQ/63173); Griffith University Human Research Ethics Committee (2020/743). Results will assist in validating the use of index tests as part of a tiered neurodevelopmental assessment process that was co-designed with First Nations community and primary healthcare practitioners. Outcomes will be summarised and provided to participating practitioners and sites, and disseminated to community health services and consumers. Findings will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12622000498796.
Subject(s)
Fetal Alcohol Spectrum Disorders , Child , Female , Pregnancy , Humans , Fetal Alcohol Spectrum Disorders/diagnosis , Australia , Health Care Costs , Child Health , Hospitals, PediatricABSTRACT
Parent-Child Interaction Therapy (PCIT) is an intensive parent support program for caregivers and their children who exhibit difficult-to-manage disruptive behaviors. After more than four decades of research supporting its efficacy for reducing children's disruptive behaviors and improving parent-child relationships, PCIT has become one of the most popular and widely disseminated parenting support programs in the world. The evidence for the efficacy of PCIT can be found in many reviews of randomized clinical trials and other rigorous studies. To add to those reviews, our aim was to provide practical guidance on how PCIT can be part of an evidence-based program for families that depends on practitioner expertise, as well as attention to families' diverse needs. To do this, we describe the evolution of PCIT as practiced in a university-community partnership that has continued for over 20 years, alongside a narrative description of selected and recent findings on PCIT and its use in specific client presentations across four themes. These themes include studies of 1) whether the standard manualized form of PCIT is efficacious across a selection of diverse family situations and child diagnoses, 2) the mechanisms of change that explain why some parents and some children might benefit more or less from PCIT, 3) whether treatment content modifications make PCIT more feasible to implement or acceptable to some families, at the same time as achieving the same or better outcomes, and 4) whether PCIT with structural modifications to the delivery, such as online or intensive delivery, yields similar outcomes as standard PCIT. Finally, we discuss how these directions in research have influenced research and practice, and end with a summary of how the growing attention on parent and child emotion regulation and parents' responses to (and coaching of) their children's emotions has become important to PCIT theory and our practice.
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Developmentalists have increasingly concluded that systems approaches to resilience provide a useful higher-order home for the study of the development of coping. Building on previous work on the complementarity of resilience and coping, this paper had two goals: (1) to propose a set of strategies for examining the role of coping in processes of resilience, and (2) to test their utility in the academic domain, using poor relationships with the teacher as a risk factor, and classroom engagement as an outcome. This study examined whether coping serves as a: (1) promotive factor, supporting positive development at any level of risk; (2) pathway through which risk contributes to development; (3) protective factor that mitigates the effects of risk; (4) reciprocal process generating risk; (5) mechanism through which other promotive factors operate; (6) mechanism through which other protective factors operate; and (7) participant with other supports that shows cumulative or compensatory effects. Analyses showed that academic coping at this age was primarily a mediator of risk and support, and a promotive factor that added to engagement for students with multiple combinations of risk and support. Implications are discussed, along with next steps in exploring the role of coping in processes of resilience.
Subject(s)
Resilience, Psychological , Humans , Adolescent , Child , Adaptation, Psychological , Coping Skills , Students , Protective FactorsABSTRACT
Considering the emphasis on parent-led sexual abuse education (PLSAE) in child sexual abuse (CSA) prevention, and the imperative of prevention in families living with demonstrated risk factors, it is important to understand the extent to which this group delivers PLSAE to their children, whether this is associated with any barriers or facilitators, whether parents are engaging in other protective behaviors (such as monitoring and involvement) and the relationship between these variables and other risk factors such as parent and child symptomology. We surveyed 117 parents, with children ranging in age from 25-89 months (67% boys), attending a parenting program for assistance with a range of parenting difficulties and child behavior problems from 2020-22. A large majority of parents reported not giving their children comprehensive prevention messages, discussing body integrity and abduction dangers to a greater extent. PLSAE was significantly positively associated with child internalizing and externalizing symptoms; parent and child age; and discussion of body integrity and abduction. However, PLSAE was not associated with any other measured variables (protective parenting; CSA knowledge; parenting self-efficacy; general and own-child risk appraisal; parent burnout, stress, depression or anxiety; child diagnosis; parental education level; employment or marital status; or income). The current findings suggest that investing resources into increasing parental knowledge, risk perception and confidence may be misguided. Future endeavors should consider helping parents be protective in other ways, for example, through the creation of safe environments and reducing the risks of CSA.
Subject(s)
Child Abuse, Sexual , Child Abuse , Male , Humans , Child, Preschool , Child , Female , Parenting , Child Abuse, Sexual/prevention & control , Parent-Child Relations , Parents , Educational StatusABSTRACT
INTRODUCTION: Many adolescents are concerned about global and future crises, such as the health of the planet or terrorism/safety. Yet, adolescents can also express hope about the future. Thus, asking adolescents about their concern and hope could yield subgroups with different ways of coping and personal adjustment. METHOD: Australian adolescents (N = 863; age 10-16) completed surveys to report their concern (worry and anger) and hope about the planet, safety, jobs, income, housing, and technology, as well as their active and avoidant coping, depression, and life satisfaction. RESULTS: Four distinct subgroups were identified using cluster analysis: Hopeful (low on concern and high on hope across all issues, 32%), Uninvolved (low in concern and hope; 26%), Concerned about the Planet (CP, 27%), and Concerned about Future Life (CFL, 15%). When compared (adjusting for age, sex, and COVID timing), the CP subgroup was highest in active coping (e.g., taking action) but moderate in personal adjustment. Hopeful had the most positive adjustment, whereas CFL had the poorest adjustment. Uninvolved were lowest in coping but moderate in adjustment. CONCLUSIONS: Findings suggest ways of coping and adjustment may not always align, in that CP is connected with more active coping but also some cost to personal adjustment, whereas Hopeful is associated with optimal adjustment but perhaps at the cost of active coping. In addition, although CFL adolescents emerged as the at-risk group, the low levels of hope and coping in Uninvolved adolescents raise the possibility that they are at risk of future problems.
Subject(s)
COVID-19 , Adolescent , Child , Humans , Adaptation, Psychological , Anxiety , Australia , Risk Factors , Male , FemaleABSTRACT
Background and aims: Social network use is widespread, and the study of Instagram seems to have captured more attention in recent years. However, scale development and validation in the field has fallen short of providing sound scales of Instagram motives and usage patterns that consider the uniqueness of Instagram-related behavior. This paper describes the development, psychometric and cross-cultural validation of two new measurement instruments: the "Instagram Motives Questionnaire" (IMQ) and the "Instagram Uses and Patterns Questionnaire" (IUPQ). Methods and results: A preliminary set of items was developed for each questionnaire based on a previous qualitative interview study on Instagram motives, uses, and consequences. In the first study, the questionnaires were distributed to a sample of 312 participants aged 18-35 years (M = 23.81; SD = 4.49), and an exploratory factor analysis was performed. A parsimonious and interpretable 6-factor solution that displayed adequate factor loadings and adequate Omega coefficients for both instruments were found. In a second study, the two instruments and other measures of known social network usage correlates and mental health consequences were administered online to 1,418 English-speaking participants aged 18-34 years (M = 21.35; SD = 3.89). Both scales showed good psychometric properties and the factor structure identified in study 1 was reproduced through confirmatory factor analysis. Omega reliability coefficients were adequate. Finally, when performing multi-group CFA along with a French (n = 1,826) and a Spanish (n = 3,040) sample, language and gender invariance were supported. Correlations with other relevant measures indicate good convergent validity of both scales. Conclusions: The present research provides psychometrically sound instruments for further investigations on Instagram use behaviors.
Subject(s)
Cross-Cultural Comparison , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires , Qualitative ResearchABSTRACT
This study's aim was to examine whether there are negative increasing cycles of peer victimization and rejection sensitivity over time. Drawing from Social Information Processing Theory, we hypothesized that victimization leads to higher levels of rejection sensitivity, which would put adolescents at risk for higher future victimization. Data were collected in a four-wave study with 233 Dutch adolescents starting secondary education (Mage = 12.7 years), and a three-wave study with 711 Australian adolescents in the last years of primary school (Mage = 10.8 years). Random-intercept cross-lagged panel models were used to disentangle between-person from within-person effects. In each sample, a significant between-person association was found: adolescents with higher levels of victimization as compared to their peers also reported higher levels of rejection sensitivity. At the within-person level, all concurrent associations between individual fluctuations of victimization and rejection sensitivity were significant, but there were no significant cross-lagged effects (except in some sensitivity analyses). These findings demonstrate that victimization and rejection sensitivity are interrelated, but there may not be negative victimization-rejection sensitivity cycles during the early-middle adolescent years. Possibly, cycles establish earlier in life or results are due to shared underlying factors. Further research is needed examining different time lags between assessments, age groups, and contexts.
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A Classroom-Based Pilot of a Self-Compassion Intervention to Increase Wellbeing in Early adolescents Abstract Objective: Our first aim was to examine the effect of a 4-week self-compassion-based intervention on emotional well-being in a school classroom of early adolescents. The second aim was to evaluate feasibility and acceptability of the program within a classroom setting. Design: This study was a pre-post pilot design utilizing paired sample t -tests to examine within-person changes in the outcome measures prior to, and following, the intervention. Bivariate correlations were also used to assess covariation between the pre-to-post change scores in self-compassion and the pre-to-post change scores in the outcome measures. SETTING: The intervention was conducted during a wellbeing class at a culturally diverse secondary school. PARTICIPANTS: The sample comprised 18 students aged 12- to 14-years old ( M age = 12.44, SD = 0.61). Intervention: A brief self-compassion-based program, Be Kind to Yourself, Inspire Others, was developed specifically for early adolescents and delivered across four 70- minute lessons. MAIN OUTCOME MEASURES: The outcome measures were self-compassion, resilience, perceived stress, social and general anxiety, and peer and school connectedness. RESULTS: Findings revealed significant increases in self-compassion, resilience, and peer connectedness, and significant decreases in social and general anxiety at posttest, with small to medium effect sizes (Hedges' g = 0.30-0.67). No significant differences were found for perceived stress and school connectedness. Pre-to-post changes in self-compassion covaried with pre-to-post changes in resilience and peer connectedness. Feasibility and acceptability were high. Findings suggest that a brief, classroom-based self-compassion intervention may be feasible and effective in improving indicators of emotional well-being among early adolescents.
Subject(s)
Empathy , Self-Compassion , Humans , Adolescent , Child , Emotions , Anxiety/psychology , Stress, Psychological/psychologyABSTRACT
Appearance rejection sensitivity (ARS) refers to anxiously over-expecting rejection because of perceived appearance flaws. ARS has been associated with poorer mental health, which suggests coping with stress may be negatively affected by ARS. In this study, we investigated if ARS was related to adolescents' emotions and ways of coping with negative appearance evaluation two years later (T2). Other potential correlates of emotions and ways of coping were also tested, including peer appearance teasing, social anxiety, and gender, as well as reports of victimization, social status, and attractiveness gathered from peers. At Time 1 (T1), 329 adolescents (M = 13.9 years, 54% girls) self-reported their ARS, experience of appearance teasing, and social anxiety. T1 appearance victimization, popularity, and attractiveness were measured using peer nominations, and peer likeability was measured with peer ratings. At T2, participants' emotions and coping were measured using vignettes portraying appearance evaluation by peers. In regression models, T1 ARS, appearance teasing, social anxiety and female gender were associated with more T2 negative emotions, social withdrawal, rumination, and (except for social anxiety) thoughts about appearance change. ARS was not significantly associated with T2 positive thinking or support seeking. No peer-report measure was significantly associated with T2 outcomes.
Subject(s)
Bullying , Crime Victims , Adolescent , Female , Humans , Male , Body Image/psychology , Peer Group , Crime Victims/psychology , Adaptation, PsychologicalABSTRACT
One productive avenue for building adolescents' personal strengths and reducing mental health problems is integrating assessment and intervention into organised sports programs. We investigated the efficacy of the RISE program, a rugby league development program for 12- to 15-year-old boys, which integrated a mental health and wellbeing system called Life-Fit-Learning. The Life-Fit System is designed to measure youth's strengths and mental health symptoms and sends mental health feedback to parents, provides group-based workshops, connects youth and parents to online psychoeducation resources, and provides individual telephone follow-up and referral with parents of youth at high-risk for mental health problems. In this study, mental health and wellbeing outcomes were compared in participants who did (RISE, N = 94) and did not (Comparison, N = 82) receive the RISE/Life-Fit-Learning program. RISE players reported their self-satisfaction, grit, gratitude, prosocial behaviour, anxiety, depression, and behavioural problems using the Life-Fit System pre- and post-program. Comparison participants completed measures twice, 6-months apart. Self-satisfaction did not change in RISE participants but declined among comparison participants. In both groups, 26% of players scored in the high-risk range on at least one mental health measure. On mental health measures, high-risk RISE players' depression and behavioural problems improved from pre-to post-program relative to no change among Comparison players. Among participants who were not high-risk, RISE players' anxiety, depression, and behavioural problems did not change whereas Comparison players' behavioural problems increased significantly. Results underscore the value of integrating strengths-based interventions and targeting youth mental health problems within the context of junior sports development programs.
Subject(s)
Anxiety , Mental Health , Adolescent , Anxiety/psychology , Anxiety Disorders , Child , Humans , Male , Parents/psychology , Personal SatisfactionABSTRACT
BACKGROUND: Child sexual abuse (CSA) prevention is dominated by a focus on child education. However, evidence that this education reduces CSA risk is limited and mixed. OBJECTIVE: We investigated whether participants' history of receiving school-based child sexual abuse prevention (CSAPP) was associated with experiencing CSA. Uniquely, we also investigated whether parent-led CSA education (PLSAE) and received protective parenting were associated with CSA. CSA knowledge was also considered. METHODS: Australian university students (N = 1265, Mage = 22.8, SD = 7.7, Moage = 18, Mdage = 20, 75% female) reported their history of CSAPP and PLSAE, experience of CSA, disclosure of CSA, parenting, and CSA knowledge. RESULTS: CSAPP attendance was reported by 29% of respondents, 72% reported PLSAE, and 24% reported CSA. PLSAE was significantly associated with lower risk of CSA, but was CSAPP attendance was not. PLSAE was significantly associated with higher levels of parental involvement/care and monitoring/supervision. In a multivariate logistic regression model, involvement/care and monitoring/supervision were associated with lower risk of CSA, but PLSAE was not. Neither CSAPP attendance nor PLSAE was associated with CSA disclosure or CSA knowledge. CONCLUSIONS: These findings add to the small body of literature using reports of real-life experiences. Results call into question the over-reliance of child-education in CSA prevention and highlight the role of protective parenting. Building parenting capacity to include parenting practices is most likely to be effective for CSA prevention, such as monitoring and involvement, and should be included in CSA prevention efforts.
Subject(s)
Child Abuse, Sexual , Parenting , Adolescent , Adult , Australia/epidemiology , Child , Child Abuse, Sexual/prevention & control , Disclosure , Female , Humans , Male , Parents , Young AdultABSTRACT
OBJECTIVES: Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD: We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS: Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS: There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH: Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.
Subject(s)
Parenting , Parents , Australia , Child , Government , Humans , Parenting/psychology , Parents/psychologyABSTRACT
The Circle of Security-Parenting Intervention (COS-P; Cooper et al., 2009) is a psychoeducational program for caregivers of young children that has been widely disseminated. The program is founded in attachment theory and relies on computer-delivered content and parent reflection and discussion to teach concepts of safety and security to promote better caregiver-child relationships and child wellbeing. The present study is a randomized controlled trial of COS-P, individually delivered to 85 Australian caregivers (51 COS-P, 34 waitlist control) who reported parenting distress and child disruptive behaviors. Caregivers completed a baseline assessment and repeated the assessment after completion of COS-P or 8 weeks on the waitlist. Caregivers completed surveys to report child symptoms, and parenting stress, anxious and avoidant attachment, reflective functioning, parenting practices, and depressive symptoms. No differences in COS-P vs. waitlist participants were found at baseline. Analyses of complete data (35 COS-P, 25-26 waitlist) revealed a greater decline in caregivers' attachment anxiety and negative parenting relative to waitlist, but only attachment anxiety in intent-to-treat analyses. Other improvements were found, but these extended to both the COS-P and waitlist conditions and did not differ between conditions. Overall, effects of COS-P were small and rarely significant, suggesting the need to consider alternative programs that have evidence of effectiveness when providing services to at-risk families.
Subject(s)
Caregivers , Parenting , Australia , Child, Preschool , Humans , Parent-Child Relations , Parents/educationABSTRACT
Understanding parental practices and attitudes regarding child sexual abuse (CSA) prevention could be used to improve CSA prevention, but little information is available. In this study, we summarise survey data collected from 248 Australian and UK parents (87% female) with at least one child aged 6-11 years (M = 8.6, SD = 1.8). This is the first study to quantify parental use of protective practices, other than prevention education, which may guard against CSA. Parental media mediation, which may safeguard against online dangers, was another unique focus of this study. Participants reported their discussion of sensitive topics with their children including CSA; behaviors that may reduce the incidence of CSA (e.g., monitoring, supervision, delegation of care and checking-in with the child); mediation of their child's media use; and attitudes towards CSA prevention education. Parents reported discussing sexual abuse less than other sensitive topics such as abduction dangers, drugs, and death but more than issues surrounding puberty, sex and pornography. Parents reported using high levels of protective behaviours, however some areas of concern were revealed. Of concern was the low-moderate level of parental media mediation, with substantial numbers of children potentially exposed to online risks such as using devices unsupervised in bedrooms or chatting to individuals unknown to their parents and not having their devices checked for concerning content. Almost all parents were supportive of CSA prevention education and felt they should provide this education. However, two-thirds of parents thought CSA education may be associated with harms for the child and two-thirds of parents believed children could prevent their own abuse. Reported results will aid in our understanding of which areas of parenting could be strengthened to create safer environments for children. This research has particularly highlighted the need for parents to be more protective around their children's access to online devices.
Subject(s)
Child Abuse, Sexual , Child Abuse , Child , Female , Humans , Male , Child Abuse, Sexual/prevention & control , Australia , Parents , ParentingABSTRACT
OBJECTIVE: To examine the efficacy of weight-adjusted D-cycloserine (DCS) (35 or 70 mg) relative to placebo augmentation of intensive exposure therapy for youth with obsessive-compulsive disorder (OCD) in a double-blind, randomised controlled trial, and examine whether antidepressant medication or patient age moderated outcomes. METHODS: Youth (n = 100, 7-17 years) with OCD were randomised in a 1:1 ratio to either DCS + exposure (n = 49) or placebo + exposure (n = 51). Assessments occurred posttreatment, 1 month later, and at 3 and 6 months. Pills were ingested immediately before sessions. RESULTS: Significant improvements on all outcomes were observed at posttreatment, and to 6-month follow-up. Treatment arms did not differ across time, with no significant time-by-medication interactions on symptom severity (T1 to T2 estimate: 9.3, 95% confidence interval [CI]: -11.2 to -7.4, and estimate -10.7, 95% CI: -12.6 to -8.7), diagnostic severity (T1 to T2 estimate: -2.0, 95% CI: -2.4 to -1.5 and estimate -2.5, 95% CI: -3.0 to -2.0) or global functioning (T1 to T2 estimate: 13.8, 95% CI: 10.6 to 17.0, and estimate 16.6, 95% CI: 13.2 to 19.9). Neither antidepressants at baseline nor age moderated primary outcomes. There were significantly fewer responders/remitters at 1- and 6-month follow-up among youth in the DCS condition stabilised on SSRIs, relative to youth not taking SSRIs. CONCLUSIONS: DCS augmented intensive exposure therapy did not result in overall additional benefits relative to placebo. Intensive exposure proved effective in reducing symptoms for the overall sample.