Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 16 de 16
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Infant Ment Health J ; 41(3): 356-377, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32275084

RESUMO

Legacy for Children™ (Legacy) is an evidence-based program focused on promoting sensitive, responsive parenting for socioeconomically disadvantaged families. Legacy has recently been culturally and linguistically adapted for Spanish-monolingual Latino families and is being piloted in partnership with an early childhood education program. We conducted a mixed methods study to identify barriers and facilitators to engagement, using program monitoring data sources from both participant and group leader perspectives. We conducted qualitative analyses of open-ended data to identify distinct barriers (e.g., employment challenges, health-related challenges and appointments) and facilitators (e.g., other mothers in group, interest in program topics) to engagement that emerged across English and Spanish language curriculum versions; curriculum-specific barriers and facilitators were also documented. We interpret these findings in light of quantitative data on measures of engagement, showing that participants in the Spanish curriculum evidenced comparable levels of parent-group leader relationship quality relative to the English group, and higher levels of parent's group support/connectedness and overall satisfaction. These results offer promising considerations for optimizing families' engagement in parenting programs in the context of early care and education settings.

2.
J Public Health Manag Pract ; 26 Suppl 2, Advancing Legal Epidemiology: S45-S53, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32004222

RESUMO

CONTEXT: Nearly 1.2 million children with disabilities received federally administered Supplemental Security Income (SSI) payments in 2017. Based on a robust review of research and evaluation evidence and microsimulations, The National Academies of Sciences, Engineering, and Medicine committee identified modifications to SSI (ie, increasing the federal SSI benefit maximum by one-third or two-thirds) as 1 of 10 strategies that could reduce the US child poverty rate, improving child health and well-being on a population level. OBJECTIVE: Describing the availability and amount of SSI and State Supplementary Payment (SSP) program benefits to support families of children with disabilities may be a first step toward evaluating The National Academies of Sciences, Engineering, and Medicine-proposed modification to SSI as a potential poverty alleviation and health improvement tool for children with disabilities and their families. DESIGN: We used public health law research methods to characterize the laws (statutes and state agency regulations) governing the federal SSI program and SSP programs in the 50 states and District of Columbia from January 1, 1996, through November 1, 2018. RESULTS: The number of jurisdictions offering supplementary payments (SSP) was relatively stable between 1996 and 2018. In 2018, 23 US jurisdictions legally mandated that SSP programs were available for children. Among the states with SSP payment amounts in their codified laws, SSP monthly benefit amounts ranged from $8 to $64.35 in 1996 and $3.13 to $60.43 in 2018. CONCLUSION: Our initial exploration of SSI-related policies as a tool for improving the economic stability of children with disabilities and their families suggests that current SSPs, in combination with SSI, would not rise to the level of SSI increases proposed by The National Academies of Sciences, Engineering, and Medicine. Understanding more about how SSI and SSP reach children and work in combination with other federal and state income security programs may help identify policies and strategies that better support children with disabilities in low-income households.

3.
J Dev Behav Pediatr ; 40(5): 344-353, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30921104

RESUMO

OBJECTIVE: Evidence suggests that caring for a child with special health care needs can affect many domains of family life, including caregiver mental health. However, few studies have examined these outcomes among families impacted by the Zika virus (ZIKV). This study examines depressive symptom severity and care demands among primary caregivers of children, aged 15 to 26 months, with evidence of congenital Zika virus infection (ZVI). METHODS: A sample of primary caregivers of children with evidence of congenital ZVI in northeastern Brazil (n = 150) reported on depressive symptoms, care demands, and their children's development. Children were categorized into groups according to their developmental delay status. Bivariate analyses were run to test for differences between groups. A path analysis model was used to examine the indirect effects of developmental delay on depressive symptoms through economic challenges and time spent providing health care at home and whether these associations varied by child care support. RESULTS: Compared to primary caregivers of children without developmental delay, primary caregivers of children with developmental delay had higher depression scores (p = 0.002), reported more economic (p < 0.001) and child care (p < 0.001) challenges, and spent more time providing health care at home (p < 0.001). Among primary caregivers who did not have child care support, developmental delay had a significant indirect effect on depressive symptoms through economic challenges but not through time spent providing health care at home. CONCLUSION: For families impacted by the ZIKV outbreak in Brazil, economic and child care challenges may be associated with primary caregiver mental health.

4.
J Dev Behav Pediatr ; 40(4): 275-284, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30921105

RESUMO

OBJECTIVE: In an effort to promote the health and developmental outcomes of children born into poverty, the Centers for Disease Control and Prevention (CDC) conceptualized and designed the Legacy for Children™ (Legacy) public health prevention model. This article examines the impact of Legacy on children's cognitive and language development (intelligence quotient [IQ], achievement, language skills, and early reading skills) using both standardized assessments and parent-reported indictors through third grade. METHODS: Data were collected from 2001 to 2014 from 541 mother-child dyads who were recruited into the 2 concurrent randomized controlled trials of Legacy in Miami and Los Angels. Cognitive and/or language outcomes of children were assessed annually from age 2 to 5 years as well as during a follow-up visit in the third grade. RESULTS: Children experiencing Legacy at the Los Angeles site had significantly higher IQ and achievement scores at 2 and 6 years postintervention, equivalent to approximately one-third of an SD (4 IQ points). IQ results persisted over time, and the difference between intervention and comparison groups on achievement scores widened. There were no significant differences in cognitive outcomes in the Miami sample. There were no significant differences in language outcomes for either site. CONCLUSION: Legacy shows evidence of effectiveness as an intervention to prevent cognitive delays among children living in poverty. The mixed findings across sites may not only reflect the impact of heterogeneous risk profiles noted by other intervention research programs but also warrant additional study.

5.
MMWR Morb Mortal Wkly Rep ; 67(50): 1377-1383, 2018 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-30571671

RESUMO

Childhood mental, behavioral, and developmental disorders (MBDDs) are associated with adverse outcomes that can persist into adulthood (1,2). Pediatric clinical settings are important for identifying and treating MBDDs (3). Early identification and treatment of MBDDs can promote healthy development for all children (4), especially those living in poverty who are at increased risk for MBDDs (3,5) but might have reduced access to care (6). CDC analyzed data from the 2016 National Survey of Children's Health (NSCH) on MBDDs, risk factors, and use of federal assistance programs (e.g., Supplemental Nutrition Assistance Program [SNAP]) to identify points to reach children in poverty. In line with previous research (3,6), compared with children in higher-income households, those in lower-income households more often had ever received a diagnosis of an MBDD (22.1% versus 13.9%), and less often had seen a health care provider in the previous year (80.4% versus 93.8%). Among children living below 200% of the federal poverty level (FPL) who did not see a health care provider in the previous year, seven of 10 were in families receiving at least one public assistance benefit. Public assistance programs might offer collaboration opportunities to provide families living in poverty with information, co-located screening programs or services, or connection to care.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Família , Transtornos Mentais/epidemiologia , Pobreza/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Estados Unidos/epidemiologia
6.
MMWR Morb Mortal Wkly Rep ; 66(29): 769-772, 2017 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-28749927

RESUMO

Research suggests that many disparities in overall health and well-being are rooted in early childhood (1,2). Stressors in early childhood can disrupt neurologic, metabolic, and immunologic systems, leading to poorer developmental outcomes (1). However, consistent, responsive caregiving relationships and supportive community and health care environments promote an optimal trajectory (3,4). The first 8 years of a child's life build a foundation for future health and life success (5-7). Thus, the cumulative and lifelong impact of early experiences, both positive and negative, on a child's development can be profound. Although the health, social service, and education systems that serve young children and their families and communities provide opportunities to support responsive relationships and environments, efforts by these systems are often fragmented because of restrictions that limit the age groups they can serve and types of services they can provide. Integrating relationship-based prevention and intervention services for children early in life, when the brain is developing most rapidly, can optimize developmental trajectories (4,7). By promoting collaboration and data-driven intervention activities, public health can play a critical role in both the identification of at-risk children and the integration of systems that can support healthy development. These efforts can address disparities by reducing barriers that might prevent children from reaching their full potential.


Assuntos
Serviços de Saúde da Criança/organização & administração , Disparidades nos Níveis de Saúde , Centers for Disease Control and Prevention, U.S. , Criança , Pré-Escolar , Humanos , Estados Unidos
7.
Infant Ment Health J ; 38(4): 499-513, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28658506

RESUMO

This article presents the findings of a qualitative study of maternal perceptions of parenting following participation in Legacy for ChildrenTM (Legacy), an evidence-based parenting program for low-income mothers of young children and infants. To further examine previous findings and better understand participant experiences, we analyzed semistructured focus-group discussions with predominantly Hispanic and Black, non-Hispanic Legacy mothers at two sites (n = 166) using thematic analysis and grounded theory techniques. The qualitative study presented here investigated how mothers view their parenting following participation in Legacy, allowing participants to describe their experience with the program in their own words, thus capturing an "insider" perspective. Mothers at both sites communicated knowledge and use of positive parenting practices targeted by the goals of Legacy; some site-specific differences emerged related to these parenting practices. These findings align with the interpretation of quantitative results from the randomized controlled trials and further demonstrate the significance of the Legacy program in promoting positive parenting for mothers living in poverty. This study emphasizes the importance of understanding real-world context regarding program efficacy and the benefit of using qualitative research to understand participant experiences.


Assuntos
Educação não Profissionalizante/métodos , Relações Mãe-Filho/psicologia , Mães/educação , Mães/psicologia , Pré-Escolar , Feminino , Florida , Grupos Focais , Humanos , Lactente , Recém-Nascido , Los Angeles , Modelos Psicológicos , Percepção , Pobreza , Pesquisa Qualitativa
8.
MMWR Surveill Summ ; 66(8): 1-11, 2017 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-28301449

RESUMO

PROBLEM/CONDITION: Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. REPORTING PERIOD: 2011-2012. DESCRIPTION OF SYSTEM: The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. RESULTS: A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. INTERPRETATION: Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. PUBLIC HEALTH ACTION: Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Deficiências do Desenvolvimento/epidemiologia , Família , Disparidades em Assistência à Saúde/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Características de Residência/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , População Rural/estatística & dados numéricos , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos
9.
Child Dev ; 88(2): 388-397, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28138978

RESUMO

In this article, the authors posit that programs promoting nurturing parent-child relationships influence outcomes of parents and young children living in poverty through two primary mechanisms: (a) strengthening parents' social support and (b) increasing positive parent-child interactions. The authors discuss evidence for these mechanisms as catalysts for change and provide examples from selected parenting programs that support the influence of nurturing relationships on child and parenting outcomes. The article focuses on prevention programs targeted at children and families living in poverty and closes with a discussion of the potential for widespread implementation and scalability for public health impact.


Assuntos
Bem-Estar da Criança/psicologia , Programas Governamentais/métodos , Relações Pais-Filho , Poder Familiar/psicologia , Pobreza/psicologia , Saúde Pública/métodos , Pré-Escolar , Humanos , Lactente
10.
Child Youth Serv Rev ; 79: 299-308, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29681673

RESUMO

In recognition of the need to reach more families, the Legacy for Children™ (Legacy) program was translated and culturally adapted for Spanish-speaking Hispanic mothers and their infants. This study examined the cultural adaptations and logistical supports needed for successful implementation with Spanish-speaking mothers. The research team used purposive techniques to sample Hispanic bi-lingual providers (N = 14) and supervisors (N = 5) of local home-based parenting programs (Healthy Families, Parents as Teachers, and SafeCare®). The goal of the study was to determine from providers and supervisors the social validity (satisfaction, relevancy, importance, and acceptability of the intervention) and cultural congruency of the adapted Legacy curriculum. Researchers conducted a qualitative analysis of the transcriptions using a template approach within NVivo 10 software to identify broad themes within focus group data. Overall, results indicated many positive aspects of the Legacy program including content, approach, pace, topics, structure, social engagement, and straightforward curriculum language. Emergent themes from the focus groups included best practices in identifying, recruiting, and approaching Hispanic mothers, as well as key engagement strategies. Recommended revisions of the adapted Legacy curriculum focused on enhancing visual and auditory supplements, making minor improvements to lower the reading level, and reducing barriers to attendance. Implications for cultural adaptation of parenting programs are discussed.

11.
J Child Fam Stud ; 25(5): 1488-1504, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-28018122

RESUMO

Most children and adolescents older than five years spend at least six hours of their day in school settings. Like parents, education professionals can promote health and protect youth from harm by providing safe, stable, nurturing relationships and environments. The Centers for Disease Control and Prevention (CDC) has developed a framework which posits that safe, stable, nurturing relationships and environments are Essentials for Childhood and are fundamental to promoting health and well-being; protecting youth from maltreatment and other violence and victimization; and ensuring optimal, healthy development. In this paper, the authors propose an approach to applying safe, stable, nurturing relationships and environments to the school ecology; review select survey measures to examine these constructs within educational settings; and suggest available indicators to measure safety, stability, and nurturance within the school context.

12.
MMWR Morb Mortal Wkly Rep ; 65(9): 221-6, 2016 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-26963052

RESUMO

Sociodemographic, health care, family, and community attributes have been associated with increased risk for mental, behavioral, and developmental disorders (MBDDs) in children (1,2). For example, poverty has been shown to have adverse effects on cognitive, socio-emotional, and physical development (1). A safe place to play is needed for gross motor development, and accessible health care is needed for preventive and illness health care (3). Positive parenting and quality preschool interventions have been shown to be associated with prosocial skills, better educational outcomes, and fewer health risk behaviors over time (2). Protective factors for MBDDs are often shared (4) and conditions often co-occur; therefore, CDC considered MBDDs together to facilitate the identification of factors that could inform collaborative, multidisciplinary prevention strategies. To identify specific factors associated with MBDDs among U.S. children aged 2-8 years, parent-reported data from the most recent (2011-2012) National Survey of Children's Health (NSCH) were analyzed. Factors associated with having any MBDD included inadequate insurance, lacking a medical home, fair or poor parental mental health, difficulties getting by on the family's income, employment difficulties because of child care issues, living in a neighborhood lacking support, living in a neighborhood lacking amenities (e.g., sidewalks, park, recreation center, and library), and living in a neighborhood in poor condition. In a multivariate analysis, fair or poor parental mental health and lacking a medical home were significantly associated with having an MBDD. There was significant variation in the prevalence of these and the other factors by state, suggesting that programs and policies might use collaborative efforts to focus on specific factors. Addressing identified factors might prevent the onset of MBDDs and improve outcomes among children who have one or more of these disorders.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Família , Transtornos Mentais/epidemiologia , Características de Residência/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Assistência Centrada no Paciente/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
14.
Early Educ Dev ; 24(6): 813-828, 2013 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-24163572

RESUMO

This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children's effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children's effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children's effortful control primarily account for variation in children's academic adjustment. The associations between children's effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children's internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed.

15.
Disabil Health J ; 6(1): 26-35, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23260608

RESUMO

BACKGROUND: Previous research suggests that parents of a child with Tourette Syndrome (TS) have lower self-concepts, higher caregiver burden, and more difficulties with home activities. However, the contributions of TS and mental, emotional, or behavioral (MEB) conditions to family functioning are difficult to identify from previous research due to relatively small TS sample sizes and high rates of co-occurring conditions within samples of children with TS. OBJECTIVE: The current study hypothesized that families of children with TS would report significantly more family functioning difficulties (more parenting aggravation, more difficulty with coping with the child's care, less parent-child communication, and less consistent family routines). Specifically, co-occurring conditions would contribute substantially to reported parenting aggravation. METHOD: Parent-reported data from the 2007 National Survey of Children's Health were analyzed, including whether the child had been diagnosed with TS or an MEB. Weighted analyses were restricted to US children 6-17 years of age (n = 64,034) and adjusted for child age, sex, race and ethnicity. RESULTS: Parents of children with TS were more likely to fall into the high parenting aggravation index category compared with parents of children without TS (aPR = 3.8, 95% CI: 2.2-6.6). Controlling for the co-occurring MEB conditions attenuated the relations between TS and parenting aggravation; however, a significant effect for TS remained in some cases. CONCLUSION: Parents of children with TS may face significant challenges in raising their children, leading to increased parenting aggravation; these challenges appear to be primarily associated with the presence of co-occurring MEB conditions.


Assuntos
Adaptação Psicológica , Transtornos do Humor , Relações Pais-Filho , Poder Familiar , Pais , Estresse Psicológico , Síndrome de Tourette , Adolescente , Comportamento do Adolescente , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil , Comunicação , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos do Humor/complicações , Síndrome de Tourette/complicações
16.
J Trauma Stress ; 24(5): 586-90, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22095775

RESUMO

Exposure to potentially traumatic events often leads to a wide range of interpersonal difficulties, including the perpetration of intimate partner violence. Maladaptive, threat-relevant thoughts and beliefs regarding the trauma or its sequelae can play an important role in a person's emotional and behavioral responses. Among 185 trauma-exposed study participants who were currently in an intimate relationship, levels of maladaptive posttraumatic cognitions were associated with the perpetration of psychological aggression and physical violence in their current relationships. These links were mediated by misappraisal of anger in auditory emotion stimuli and emotion-regulation deficits. Results support a cognitive model of posttraumatic pathology, with implications for clinical intervention and a broad conceptualization of the effects of trauma.


Assuntos
Cognição , Emoções , Parceiros Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Violência/psicologia , Adolescente , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA