Creating Connections: A Feasibility Study of a Technology-Based Intervention to Support Mothers of Newborns during Pediatric Well-Visits.

Objective: Intervention in the earliest period of parenthood can make a strong, positive impact on parenting, yet engaging parents of newborns in parenting interventions can be difficult. Technological adaptation of important interventions can improve early engagement. This study reports the initial feasibility of the Creating Connections intervention, a technology-based intervention developed to support mothers of newborns, and feasibility of evaluating the intervention through a randomized clinical trial in pediatric primary care. The intervention includes: 1) a brief tablet-based intervention delivered during a newborn well-child pediatric check-up, and 2) tailored text messages delivered thereafter to boost intervention content. Intervention content includes empirically-supported aspects of parenting behaviors known to positively influence children's social-emotional development. Methods: Project recruitment took place in an ambulatory care pediatric clinic in a large Midwestern city. Mothers received information about infant soothing, book sharing, or both. Results: One hundred and three parents learned about the program and 72 participated. Mothers were primarily Black/African American with incomes at or below $30,000. Only 50% of mothers that received text messages through the program completed follow-up, but these mothers gave overall positive ratings of text messages. Conclusions: Program engagement and ratings of parents support feasibility, but retention rates need improvement. Based on barriers and successes of this investigation, lessons learned about feasibility and acceptability are discussed.

Call to action: Centering blackness and disrupting systemic racism in infant mental health research and academic publishing.

The Infant Mental Health Journal is committed to ending systemic racism and promoting diversity, equity, and inclusion in academic publishing. IMHJ unequivocally denounces all forms of racism and white supremacy, including systemic racism in academic publishing. We commit to investigating and working to terminate the ways in which systemic racism has become normalized in academic publishing, including examining our practices and processes at IMHJ. We invite you to join us in intentional, anti-racist work through your scholarship. As part of this effort, IMHJ has updated the author guidelines to include new information regarding how authors can express the ways in which they are engaging with intention in diverse, anti-racist research. These guidelines are available under the author guidelines section on the IMHJ website (https://onlinelibrary.wiley.com/journal/10970355). As a second immediate response relative to promoting diverse, equitable, and inclusive research, IMHJ is releasing the following Call to Action, focusing on centering Blackness in infant and early childhood mental health research. This call is designed as a first step in our efforts, and IMHJ looks forward to coming initiatives aimed at disrupting systemic racism in infant and early childhood mental health research for the many scholars studying and working with diverse populations marginalized by racism and systemic inequities.

La Revista de Salud Mental Infantil está comprometida a terminar el racismo sistémico y promover la diversidad, la equidad y la inclusividad en las publicaciones académicas. La Revista IMHJ censura categóricamente toda forma de racismo y supremacía de la raza blanca, incluyendo el racismo sistémico en publicaciones académicas. Estamos comprometidos a investigar y trabajar para erradicar los medios por los cuales el racismo sistémico se ha convertido en la norma en las publicaciones académicas, incluyendo el examinar nuestras prácticas y procesos dentro de la Revista IMHJ. Les invitamos a que se nos unan en nuestro esfuerzo intencional, antirracista, por medio de sus investigaciones profesionales. Como parte de este esfuerzo, la Revista IMHJ ha actualizado los parámetros para los autores para incluir nueva información acerca de cómo los autores pueden expresar de qué maneras están trabajando con intención en investigaciones diversas, antirracistas. Estos parámetros se encuentran disponibles bajo la sección de parámetros de autor en la página electrónica de la Revista IMHJ (https://onlinelibrary.wiley.com/journal/10970355). Como una segunda respuesta inmediata en relación con el fomento de la investigación diversa, igualitaria e incluyente, la Revista IMHJ presenta esta Llamada a la Acción, la cual se enfoca en centralizar la Negritud en la investigación de salud mental en infantes y la temprana niñez. Esta llamada está diseñada como un primer paso en nuestros esfuerzos y la Revista IMHJ anticipa próximas iniciativas dedicadas a poner fin al racismo sistémico en la investigación sobre salud mental en infantes y la temprana niñez para los muchos investigadores profesionales que estudian y trabajan con grupos diversos de población marginalizados por el racismo y las desigualdades sistémicas.

Le Infant Mental Health Journal s'engage à mettre fin au racisme endémique et à promouvoir la diversité, l'équité, et l'inclusion dans les publications académiques. L'IMHJ dénonce sans équivoque toutes les formes de racisme et de suprématie de la race blanche, y compris le racisme systémique dans les publications académiques. Nous nous engageons à déterminer comment le racisme systémique s'est normalisé dans les publications académiques et nous nous engageons à travailler à éradiquer cette normalisation ainsi qu'à examiner et à disséquer les pratiques et les processus de l'IMHJ. Nous vous invitons à nous rejoindre dans ce travail intentionnel, délibéré et anti-raciste à travers vos recherches. Dans cette optique l'IMHJ a mis à jour les directives pour les auteurs afin d'inclure plus d'informations sur la manière dont les auteurs peuvent exprimer les façons dont ils s'engagent délibérément dans des recherches diverses et anti-racistes. Ces directives sont disponibles dans la section « directives pour auteurs ¼ dans le site de IMHJ (https://onlinelibrary.wiley.com/journal/10970355). De plus, en tant que deuxième réaction immédiate liée à la promotion de recherches diverses, équitables et inclusives, l'IMHJ rend publique l'Appel à l'Action suivant, mettant l'accent sur la nécessité de centrer la condition noire dans les recherches sur la santé mentale du nourrisson et de la petite enfance. Cet appel est le premier pas de nos efforts et l'IMHJ attend avec intérêt les initiatives à venir se donnant pour but de contrecarrer le racisme systémique dans les recherches sur la santé mentale du nourrisson et de la petite enfance pour les nombreux chercheurs étudiant et travaillant avec des populations diverses marginalisées par le racisme et les inéquités systémiques.

Adaptive Parenting Among Low-Income Black Mothers and Toddlers' Regulation of Distress.

Parenting differs in purpose and strategy according to cultural background (Brooks-Gunn & Markman, 2005; Iruka, LaForett, & Odom, 2012). The current study tests a unique latent factor score, Adaptive Parenting, that represents culturally-relevant, positive parenting behaviors: maternal coping with stress through reframing, maternal scaffolding of toddlers' learning during a low-stress task, and maternal commands during a high-stress task. Participants were Black mothers (N = 119; Mage  = 27.78) and their 24- to 30-month-old toddlers. Families were part of a broader study examining family resilience among urban, low-income young children and their families. Results demonstrate that the proposed variables align on a single factor and positively predict toddlers' emotion regulation. Findings are discussed in the context of Black culturally-specific parenting processes.

Collective trauma and community support: Lessons from Detroit.

The COVID-19 crisis can be defined as a collective trauma, which contributes to an upheaval of community connection and functioning. The current pandemic has also illuminated disparities in mental health supports. In this commentary, we highlight one community organization, located in metro Detroit, that has responded to the trauma by bolstering resources and supports for residents, many of whom are ethnoracial minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Associations between oxytocin receptor gene (OXTR) polymorphisms, childhood trauma, and parenting behavior.

Maternal oxytocin is connected to aspects of parenting including sensitivity, warmth, positive affect, and affectionate touch. Oxytocin receptor gene (OXTR) polymorphisms are associated with circulating oxytocin levels, altered brain activity, and parenting behaviors. This study aimed to replicate prior work on OXTR single-nucleotide polymorphisms (SNPs) rs1042778 and rs53576 in relation to maternal sensitivity, explore associations with other aspects of parenting (i.e., negative parenting), evaluate observational and self-report measures of parenting in relation to OXTR SNPs, and examine whether childhood trauma exposure moderates the relation between OXTR SNPs and parenting. Mothers (N = 100) were observed during 2 teaching interaction tasks with their 7-month-old infant, completed questionnaire and interview measures related to parenting and trauma history, and provided saliva specimens to derive OXTR genotypes. Mothers with OXTR rs1042778 TT genotypes demonstrated lower behavioral sensitivity, lower engagement, higher intrusiveness, and more frequent frightened/frightening behavior than mothers with TG or GG genotypes. Genotype interacted with childhood trauma history such that mothers who had experienced childhood trauma were more likely to demonstrate frightened/frightening behavior if they had the TT genotype on rs1042778 relative to the TG or GG genotype; however, small cell sizes for this interaction suggest replication is warranted. Contrary to expectations, mothers with the TT genotype on rs1042778 self-reported that they had less impaired bonding than mothers with TG or GG genotypes. Results are discussed with respect to prior work with oxytocin in lower versus higher risk samples, and the potential role of mothers' self-awareness in explaining discrepancies between results from observational versus self-report measures of parenting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Fathering across contexts: The moderating role of respiratory sinus arrhythmia in predicting toddler emotion regulation.

Caregivers play an integral role in promoting children's emotion regulation, while children's individual physiology affects how they respond to the caregiving environment. Relatively little is known about how fathering influences toddler emotion regulation, particularly within African American and low-income communities, where risk related to the development of emotion regulation is higher. This study investigated relations among fathering, toddler parasympathetic regulation, and toddler emotion regulation in a sample of 92 families. Fathering was assessed during two interactions: engagement following a stressor during a triadic task and a dyadic play task. Respiratory sinus arrhythmia (resting and reactivity) was obtained as an index of toddler parasympathetic arousal. Findings demonstrated an association between fathers' engagement poststressor and toddler emotion regulation. Toddler RSA moderated this association: toddlers with elevated levels of resting RSA benefitted from parenting engagement following a stressor. Fathering during play did not relate to toddler emotion regulation. The importance of fathering and physiologic contexts in early regulatory development is discussed.

Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity.

The current study examined the role of hypothalamic-pituitary-adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at-risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers' depression was measured five times during the infants' first 18 months. Infant cortisol was collected during a social stressor (the still-face paradigm) when infants were 6 months old, and mothers reported on toddlers' internalizing and externalizing symptoms at 18 months. Among this sample of high-risk mother-infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.

Sleep moderates the association between routines and emotion regulation for toddlers in poverty.

Routines in the family are a potential source of resilience for at-risk children and support children's emerging emotion regulation. Meanwhile, inadequate sleep has been linked with deficits in cognitive processes to attend to environmental stimuli and with poor emotion regulation for children. The detrimental effects of poor sleep are potentially worse in low-income children. The aim of the current study was to examine the moderating role of sleep in the association between family routines and emotion regulation in toddlers in poverty. We analyzed data of 130 toddlers (24-31 months; 58% boys) from low-income, primarily African American families. Mothers completed questionnaires about child routines (Child Routines Questionnaire; CRQ; Wittig, 2005).To measure emotion regulation, toddlers completed an observed behavioral task meant to elicit frustration (Lab-TAB-Locomotor Version; Goldsmith & Rothbart, 1991). As hypothesized, adequate sleep (> 11 hr) fully moderated the association between routines and observed emotion regulation. There was no effect of routines on emotion regulation for toddlers with inadequate amounts of sleep. Analyses controlled for toddler respiratory sinus arrhythmia (RSA) as well as maternal emotion dysregulation (the Emotional Dysregulation Scale; EDS; Westen, Muderrisoglu, Fowler, Shedler, & Koren, 1997). These results emphasize the importance of sufficient sleep in at-risk toddlers. Furthermore, the results suggest that the effectiveness of family interventions focusing on family health to increase toddler emotion regulation could be improved by incorporating sleep interventions/routines. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Feasibility of Internet-based Parent Training for Low-income Parents of Young Children.

Parent training programs promote positive parenting and benefit low-income children, but are rarely used. Internet-based delivery may help expand the reach of parent training programs, although feasibility among low-income populations is still unclear. We examined the feasibility of internet-based parent training, in terms of internet access/use and engagement, through two studies. In Study 1, 160 parents recruited from Women, Infants, and Children (WIC) centers completed a brief paper survey regarding internet access and use (all parents received government aid). We found high levels of access, openness, and comfort with the internet and internet-enabled devices. In Study 2, a pilot study, we assessed use of an online parenting program in a project with a sample of 89 predominately low-income parents (75% received government aid). Parents learned about a new, online parenting program (the "5-a-Day Parenting Program") and provided ratings of level of interest and program use 2-weeks and 4-weeks later. Local website traffic was also monitored. At baseline, parents were very interested in using the web-based program, and the majority of parents (69.6%) reported visiting the website at least once. However, in-depth use was rare (only 9% of parents reported frequent use of the online program). Results support the feasibility of internet-based parent training for low-income parents, as most parent were able to use the program and were interested in doing so. However, results also suggest the need to develop strategies to promote in-depth program use.

Family Rituals in Low-Income African American Families at Risk for Trauma Exposure and Associations with Toddlers' Regulation of Distress.

This study included 75 mother-father-toddler triadic low-income families. Mothers and fathers reported separately on their own posttraumatic stress disorder (PTSD) symptoms and family rituals while children were rated by an independent observer during an emotionally eliciting task on key indicators of regulation of distress. Regression analyses supported a significant association between key dimensions of family rituals and Toddlers' regulation of distress: occurrence, continuation, and spirituality. Effect sizes of tested relationships were strong, ranging from 25% to 36% of variance in children's distress explained. Family rituals are a salient intervention target in families and specifically help support children's developing emotion regulation competencies. Certain dimensions of family rituals may be particularly relevant to African American families, considering cultural resiliency factors. Clinical implications are discussed.

Longitudinal examination of infant baseline and reactivity cortisol from ages 7 to 16 months.

This study characterized the longitudinal evolution of HPA axis functioning from 7 to 16 months of age and identified individual and environmental factors that shape changes in HPA axis functioning over time. Participants were 167 mother-infant dyads drawn from a larger longitudinal study, recruited based on maternal history of being maltreated during childhood. Salivary cortisol levels were assessed before and after age-appropriate psychosocial stressors when infants were 7 and 16 months old. Maternal observed parenting and maternal reports of infant and environmental characteristics were obtained at 7 months and evaluated as predictors of changes in infant baseline cortisol and reactivity from 7 to 16 months. Results revealed that infants did not show a cortisol response at 7 months, but reactivity to psychosocial stress emerged by 16 months. Individual differences in cortisol baseline and reactivity levels over time were related to infant sex and maternal overcontrolling behaviors, underscoring the malleable and socially informed nature of early HPA axis functioning. Findings can inform prevention and intervention efforts to promote healthy stress regulation during infancy.

Forward progress of scientific inquiry into the early father-child relationship: introduction to the special issue on very young children and their fathers.

Research on fathering and the father-child relationship has made substantial progress in the most recent 15 years since the last special issue of the Infant Mental Health Journal on fathers and young children. This special issue on fathers and young children contains a series of papers exemplifying this progress, including advances in methodology-more direct assessment and more observational measures-in addition to the increasing dynamic complexity of the conceptual models used to study fathers, the diversity of fathers studied, and the growth of programs to support early father involvement. In assessing the current state of the field, special attention is given to contributions made by the papers contained in this special issue, and two critical areas for continued progress are addressed: (1) methodological and measurement development that specifically address fathers and fathering relationships and (2) cross-cultural and ecologically valid research examining the diversity of models of fathering.

Maternal psychological absence and toddlers' social-emotional development: interpretations from the perspective of boundary ambiguity theory.

The current study tests a novel latent construct reflecting psychological absence and examines its relations with maternal depression, mother-toddler interactions, and toddlers' social-emotional outcomes in a low-income sample (N = 2,632). Structural equation modeling confirmed a psychological absence construct and revealed that psychological absence, measured at the child's 36-month birthday-related assessment, is a significant predictor of children's social-emotional development at 36 months, mediated by mother-child interaction. Results are interpreted within a boundary ambiguity framework.