Early childhood intervention practitioners’ competence and confidence appraisals using recommended practices and relationship with parent involvement / Competencia y confianza profesional en atención temprana en el uso de prácticas recomendadas y su relación con la involucración parental

La involucración parental es un componente importante de las prácticas recomendadas en atención temprana (AT). Sin embargo, la forma en que los padres son involucradosen la intervención temprana de sus hi-jos difiere considerablemente entre los profesionales. En este sentido, la investigación actual muestra que el juicio de los profesionales en relación a su competencia y confianza influye el uso de prácticas de AT. Los objetivos de este estudio fueron (1) adaptar y validar la Early Childhood Intervention Practitioner Competence and Confidence Scale para su uso en España, (2) examinar las propiedades psicométricas de esta escala, (3) comparar las creencias de los profesionales en relación a su competencia y confianza en el uso de prácticas recomendadas, y (4) analizar la relación entre estas creencias y el juicio de los profesionales sobre la involucración parental en AT. A este fin, se contó con una muestra española de 130 profesionales de AT. Los resultados indicaron que la escala es un instrumento válido y fiable para medir la competencia y confianza profesional en el uso de seis prácti-cas recomendadas de AT en el contexto español. El juicio de los profesio-nales respecto a su competencia y confianza difirió entre las diversas prác-ticas recomendadas. Se encontraron correlaciones positivas y significativas entre las valoraciones de competencia y confianza de los profesionales y sus juicios sobre la involucración parental. Estos resultados muestran que una elevada competencia y confianza en el uso de diferentes tipos de prác-ticas recomendadas en AT está relacionada con una mayor involucración parental en la participación activa del niño en su aprendizaje y desarrollo en actividades cotidianas. Se discuten las implicaciones prácticas y de investigación.(AU)

Parent involvement in early childhood intervention (ECI) is considered an important component of recommended ECI practices. However, how parents are involved in their child’s early intervention dif-fers considerably between ECI practitioners. Current research indicates that practitioners’ competence and confidence appraisals influence the use of ECI practices. The purposes of this study were to (1) adapt and validate the Early Childhood Intervention Practitioner Competence and Confi-dence Scale for use in Spain, (2) examine the psychometric properties of the scale, (3) compare practitioners’ beliefs about their competence and confidence in using recommended ECI practices, and (4) evaluate the rela-tionship between belief appraisals and practitioners’ judgmentsof parent involvement in ECI. The sample included 130 Spanish ECI practitioners. The results indicated that the scale is a valid and reliable instrument for measuring practitioners’ competence and confidence in using six ECI-recommended practices in Spain. Practitioners’ appraisals of competence and confidence, however, differed across the recommended practices. Sig-nificant positive correlations were found between the practitioners’ ap-praisals of competence and confidence and their judgments of parent in-volvement. These results show that a strong sense of competence and con-fidence in using different kinds of ECI-recommended practices is related to increased parent involvement in active child participation in learning and development in everyday activities. Research and practical implications are discussed.(AU)

Perceived parental depression, intrusive rumination, and internalizing problems: A three-wave longitudinal study in adolescents

Background/objective: Research suggests that perceiving parental depression elicits internalizing problems in adolescents, but certain studies have indicated that adolescents’ internalizing problems also increase their perception of parental emotion. To further investigate the inconsistent findings about the nature of this relationship, the current study used longitudinal data to examine the causal association between adolescents’ internalizing problems and the parental depression they perceived, as well as the role of intrusive rumination in the relationship. Method: In this longitudinal study, 392 adolescents who experienced the catastrophic Jiuzhaigou earthquake in 2017 were surveyed at three time points after the earthquake: 12 months (T1), 21 months (T2) and 27 months (T3). A cross-lagged panel model was used to carry out the data analysis. Results: Mutual cause-and-effect relationships were found between intrusive rumination and both perceived parental depression and internalizing problems, respectively; a unilateral causal relationship in which internalizing problems positively predicted perceived parental depression was also found. In addition, internalizing problems predicted perceived parental depression via the mediating role of intrusive rumination; similarly, intrusive rumination predicted perceived parental depression via internalizing problems. Conclusions: Internalizing problems were a risk factor for perceived parental depression, and intrusive rumination played an important role in the relationship between internalizing problems and perceived parental depression. (AU)

Affect, Body, and Eating Habits in Children: A Systematic Review.

The present review investigates the complex associations between children's affective states, body perceptions, and eating habits, thus providing crucial insights for potential health interventions. Following PRISMA guidelines, three databases were searched for peer-reviewed studies exploring the relationship between eating habits, emotional states, and body image perceptions in a population of children (5 to 11 years old). A total of seven articles were included. Our findings revealed a pattern of associations between negative emotional states, like anxiety and depressive feelings, and maladaptive eating behaviors. Additionally, explicit influences from parental feeding practices, peer pressure, socioeconomic factors, and children's body perceptions were observed to shape eating habits, with a pronounced tendency among older girls towards dieting and food preoccupation. Our results underline the intertwining nature of age, gender, and emotional states. Furthermore, our findings accentuate the urgency for comprehensive interventions that acknowledge and address the complex interplay of emotional, familial, and socioeconomic factors alongside children's body image perceptions. The criticality of continued research, particularly ones employing longitudinal designs and diverse demographic samples, is highlighted as we strive to understand and navigate such multifaceted relationships to enhance children's health and well-being.

"This is not what I imagined motherhood would look like": pregnancy, postpartum, and parenting during COVID-19 - a qualitative analysis of the first year since birth.

BACKGROUND: Childbearing is one of the most emotional and transformative events in a woman's life. This study aims to explore the impact COVID-19 had on childbirth, postpartum, and the first year since giving birth. METHODS: This was a qualitative study using data previously collected for a larger study of women who had given birth during the COVID-19 pandemic in the United States. The findings presented here are from an analysis of a subset of open-ended questions. Sixty-six participants completed questions about how COVID-19 affected childbearing and postpartum experiences. Data was analyzed using inductive thematic analysis. RESULTS: Thematic analysis of the data identified five major themes and several subthemes, including: (1) amplification of new mother typical emotions (positive emotions and negative emotions), (2) financial impact on mothers and their families, (3) persistent impact of COVID-19, (4) new mom paradigm crash (first time mothers and experienced mothers faced different issues such as lack of education and support, adding a layer to the day-to-day, and negotiating time with others) and (5) validating the importance of maternal health. On the whole, participants were overwhelmed, isolated, and did not have enough physical and emotional support. There was a lack of supportive maternal healthcare both in the short-term and long-term, with an emphasis on poor postpartum support. CONCLUSIONS: This study supports previous findings that women who gave birth and entered motherhood during the COVID-19 pandemic were impacted in many ways. These findings contribute to the understanding of women's experiences not just in the immediate postpartum period, but in their daily lives one year after childbirth. The results highlight that our nation's traditional maternal healthcare model may be insufficient, especially when facing a national crisis. Strain placed on the healthcare system by COVID-19 impacted both the physical and mental health of mothers who were often left with inadequate care, education, and support. Our findings point to the need for more supportive maternal health both during childbirth and postpartum.

Parenting, Gender, and Perception of Changes in Children's Behavior during the COVID-19 Pandemic.

In a previous Argentine study, we found that, in the critical context of social isolation during the COVID-19 pandemic, there were changes in maternal practices that influenced the relationship with their children. We also found that the impact of mandatory isolation was moderated positively by protective factors such as positive parenting and maternal school support or negatively by risk factors such as maternal stress. Although this study only analyzed maternal behavior, we were interested in studying the behavior of both parents, comparing the parenting (positive parenting, parental stress, and school support) of the father and mother and the perceived behavioral changes in their children. A quantitative ex post facto study was carried out. The sample consisted of 120 Argentinean parents (70 mothers and 50 fathers) aged between 27 and 56 (M = 38.84; SD = 5.03). Questionnaires were administered on sociodemographic and behavioral data of the children, as well as a brief scale to assess parenting. Mann-Whitney U and MANOVA were used to analyze the influence of gender on perceived changes in children's behavior and perceived parenting, respectively. Mothers perceived more significant changes than fathers in their children's behavior. In addition, women reported more parental stress, greater child school support, and greater perceived positive parenting compared to men. These findings support the hypothesis that parenting developed differently in fathers and mothers. These results imply the need for psycho-educational intervention programs aimed at promoting greater involvement of fathers in parenting and better management of parental stress in mothers' and family psychological well-being.

Depression, parenting and the COVID-19 pandemic in Canada: results from three nationally representative cross-sectional surveys.

OBJECTIVES: Depression is associated with problems in functioning in many aspects of life, including parenting. COVID-19 has increased risk factors for depression. We investigated the prevalence of depression among parents during the pandemic and the association with dysfunctional parenting. DESIGN: Canadian nationwide cross-sectional study. SETTING AND PARTICIPANTS: The 2020 and 2021 Surveys on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015‒2019). Responding sample sizes for parents were 3121 for the 2020-SCMH; 1574 for the 2021-SCMH and 6076 for the CCHS. PRIMARY OUTCOME MEASURES: All three surveys collected information on symptoms of major depressive disorder (MDD). The SCMH measured harsh parenting. RESULTS: Based on data from the 2021-SCMH collected during wave 3 of COVID-19, 14.4% of fathers and 21.2% of mothers screened positive for MDD. These prevalence estimates were similar to those from the 2020-SCMH during wave 2, but at least two times higher than pre-COVID-19 estimates from the CCHS. Multivariate analyses revealed a linear association between MDD and harsh parenting. COVID-19-related stressors were associated with harsh parenting. Among mothers, feeling lonely or isolated because of COVID-19 was a risk factor for harsh parenting; among fathers, being a front-line worker was a risk factor. Meditation was a protective factor for mothers. CONCLUSIONS: After years of stability, the prevalence of MDD increased substantially among Canadian parents during the pandemic. Ongoing monitoring is vital to determine if elevated levels of depression persist because chronic depression increases the likelihood of negative child outcomes. Programmes aimed at addressing depression and bolstering parenting skills are needed as families continue to face stressors associated with COVID-19.

Lived experiences of pregnant and parenting adolescents in Africa: A scoping review.

BACKGROUND: Previous studies have not synthesized existing literature on the lived experiences of pregnant and parenting adolescents (aged 10-19) in Africa. Such evidence synthesis is needed to inform policies, programs, and future research to improve the well-being of the millions of pregnant or parenting adolescents in the region. Our study fills this gap by reviewing the literature on pregnant and parenting adolescents in Africa. We mapped existing research in terms of their substantive focus, and geographical distribution. We synthesized these studies based on thematic focus and identified gaps for future research. METHODS: We used a three-step search strategy to find articles, theses, and technical reports reporting primary research published in English between January 2000 and June 2021 in PubMed, Jstor, AJOL, EBSCO Host, and Google Scholar. Three researchers screened all articles, including titles, abstracts, and full text, for eligibility. Relevant data were extracted using a template designed for the study. Overall, 116 studies met the inclusion criteria and were included in the study. Data were analyzed using descriptive and thematic analyses. RESULTS: Research on pregnant and parenting adolescents is limited in volume and skewed to a few countries, with two-fifths of papers focusing on South Africa (41.4%). Most of the studies were African-led (81.9%), received no funding (60.3%), adopted qualitative designs (58.6%), and were published between 2016 and 2021 (48.3%). The studies highlighted how pregnancy initiates a cycle of social exclusion of girls with grave implications for their physical and mental health and social and economic well-being. Only 4.3% of the studies described an intervention. None of these studies employed a robust research design (e.g., randomized controlled trial) to assess the intervention's effectiveness. Adolescent mothers' experiences (26.7%) and their education (36.2%) were the most studied topics, while repeat pregnancy received the least research attention. CONCLUSION: Research on issues affecting pregnant and parenting adolescents is still limited in scope and skewed geographically despite the large burden of adolescent childbearing in many African countries. While studies have documented how early pregnancy could result in girls' social and educational exclusion, few interventions to support pregnant and parenting adolescents exist. Further research to address these gaps is warranted.

Considering equity and cost-effectiveness in assessing a parenting intervention to promote early childhood development in rural Vietnam.

Considering equity in early childhood development (ECD) is important to ensure healthy development for every child. Equity-informative cost-effectiveness analysis can further guide decision makers to maximize outcomes with limited resources while promoting equity. This cost-effectiveness study aimed to examine the equity impacts of a multicomponent ECD intervention in rural Vietnam. We estimated the cost-effectiveness of the intervention with a 30-month time horizon from the service provider and household perspectives with equity considerations. Data were from a cluster-randomized controlled trial comparing the intervention with the local standard of care. The incremental cost-effectiveness ratios (ICERs) per child cognitive development score gained were estimated by household wealth quintile and maternal education level, adjusted for cluster effects and baseline characteristics such as maternal parity and age. A 3% discount rate was applied to costs, and non-parametric cluster bootstrapping was used to examine uncertainty around ICERs. Children in the intervention had higher cognitive development scores than those in the control arm across all subgroups. Based on intervention recurrent cost, the ICER per cognitive development score gained was lower in children from the poorest quintile (-US$6) compared to those from the richest quintile (US$16). Similarly, the ICER per cognitive development score gained was lower in children whose mothers had the lowest education level (-US$0.02) than those with mothers who had the highest education level (US$7). Even though our findings should be interpreted with caution due to the insufficient study power, the findings suggest that the intervention could promote equity while improving child cognitive development with greater cost-effectiveness in disadvantaged groups.

Relationship focused mother-infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning.

We report on two preliminary evaluations of a group intervention, targeting vulnerable infants and their mothers within the first 6-months postpartum. The Mother-Baby Nurture® program aims to strengthen the developing infant-mother attachment relationship by increasing maternal mentalizing. These studies were undertaken with pre-post evaluations with the mothers of infants under 10-months of age. The mother-infant dyads participated in ten 2-h group sessions. Study one (N = 69 dyads) included self-reported maternal depression, anxiety, and parenting confidence. In study two (N = 27 dyads), parenting stress and reflective functioning were measured by self-report, and reflective functioning coded on the 5 min speech sample (completed by N = 22). Results from study one confirmed a decrease in depression (p < .001, d = .79) and anxiety (p < .001, d = .72) symptoms, and an increase in mothers' scores for parenting confidence (p < .001, d = -.98). Results from Study Two demonstrated a significant decrease in parenting stress (p < .001, d = .94) and significant improvement in measures of self-report reflective functioning (p = .007, .024; d = .56, .61). These findings are preliminary yet promising indications that this program could be effective in alleviating parenting stress, depression, and anxiety, and improving mother's reflective functioning and parenting confidence. Further research is needed, with a control group and long-term follow-up assessments.

Reportamos sobre dos evaluaciones preliminares de un grupo de intervención, con enfoque en infantes vulnerables y sus madres dentro de los primeros seis meses después del parto. El programa Naturaleza Mamá-Bebé® se propone fortalecer el desarrollo de la relación afectiva infante-madre por medio de incrementar el proceso de mentalización materna. Estos estudios se llevaron a cabo con evaluaciones anteriores y posteriores con las madres de infantes menores de 10 meses de edad. Las díadas madre-infante participaron en diez sesiones de grupo de 2 horas. El Estudio Uno (N=69 díadas) incluyó la auto reportada depresión materna, la ansiedad y la confianza en la crianza. En el Estudio Dos (N=27 díadas) se midieron el estrés de crianza y el funcionamiento con reflexión por medio de auto reportes, y el funcionamiento con reflexión se codificó en base a la Muestra de Cinco Minutos de Charla Oral (completada por N=22). Los resultados del Estudio Uno confirmaron una disminución en los síntomas de depresión (p<.001, d=0.79) y ansiedad (p<.001, d=0.72) y un aumento en los puntajes de las madres en cuanto a confianza en la crianza (p<.001, d=-0.98). Los resultados del Estudio Dos demostraron una significativa disminución en el estrés de crianza (p<.001, d = 0.94) y un significativo mejoramiento en las medidas de funcionamiento con reflexión auto reportadas (p=.007, .024; d=0.56, 0.61). Estos resultados son preliminares, pero aun así indicaciones prometedoras de que este programa pudiera ser eficaz para aliviar el estrés de crianza, la depresión y la ansiedad, y mejorar el funcionamiento con reflexión y confianza en la crianza de la madre. Se necesita una mayor investigación, con un grupo de control y medidas de evaluación a largo plazo.

Nous présentons deux évaluations préliminaires d'un groupe d'intervention ciblant des nourrissons vulnérables et leurs mères durant les six premiers mois postpartum. Le programme Mother-Baby Nurture® a pour but de renforcer la relation d'attachement infant-mère qui se développe en augmentant la mentalisation maternelle. Ces études ont été faites avec des évaluations pré-post avec les mères de nourrissons de 10 mois. Les dyades mère-bébé ont participé à dix séances de groupes, de heures chacune. La première étude (N=69 dyades) a inclus une dépression maternelle, de l'anxiété et la confiance de parentage, toutes auto-rapportées. Dans la deuxième étude (N=27 dyades), le stress de parentage et le fonctionnement de réflexion ont été mesurés par auto-déclaration, et le fonctionnement de réflexion a été codé à partir du de l'échantillon Five-Minute Speech Sample (complété par N=22). Les résultats de la première étude ont confirmé une décroissance de la dépression (p<,001, d=0,79) et des symptômes d'anxiété (p<,001, d=0,72) et une augmentation des scores des mères pour ce qui concerne la confiance de parentage (p<,001, d=-0,98). Les résultats de la deuxième étude ont révélé une décroissance importante du stress de parentage (p<,001, d = 0,94) et une amélioration importante dans les mesures de fonctionnement de réflexion auto-rapporté (p=,007, ,024; d=0,56, 0,61). Ces résultats sont préliminaires mais cependant ils s'avèrent présenter des indications prometteuses que ce programme pourrait être efficaces pour soulager et atténuer le stress de parentage, la dépression et l'anxiété, et améliorer le fonctionnement de réflexion des mères ainsi que leur confiance de parentage. De plus amples recherches sont nécessaires, avec un groupe de contrôle et des évaluations de suivi à long terme.

Attachment and trauma-informed programme to support forcibly displaced parents of youth in Sweden: feasibility and preliminary outcomes of the eConnect Online programme.

OBJECTIVES: To assess the feasibility, acceptability and the impact of an online parenting programme for forcibly displaced parents of adolescents. DESIGN: The study was a single-arm feasibility study using pre-intervention post-intervention and follow-up assessments. SETTING: Participants were recruited from municipality-based activities for refugee parents in a small city in the south of Sweden. PARTICIPANTS: Participants were forcibly displaced parents (n=23; 47.8% maternal figures) of youth (n=23; 8-17 years old; 26.1% female) from Syria, Afghanistan and Somalia participating in an online parenting programme (eConnect). INTERVENTION: eConnect is an attachment-based and trauma-informed parenting intervention and was delivered over the course of 10 weekly sessions. PRIMARY AND SECONDARY OUTCOME MEASURES: Feasibility was assessed by programme enrolment, attendance, completion and acceptability of the online platform and cultural fit of the programme. Primary outcome measures were programme impact on youth mental health problems. Secondary outcome measures were programme impact on family functioning and parent-child attachment insecurity. RESULTS: The eConnect programme was highly feasible in terms of overall enrolment (100%), attendance (89.6%) and retention rates (100%). The online platform was acceptable, with mixed feedback primarily related to the access and usage of technology. Cultural fit of the programme was acceptable. Youth mental health problems (η 2=0.29) and family functioning significantly improved (η 2=0.18) over the course of the programme. Unexpectedly, parent reports of youth attachment insecurity significantly worsened (η 2=0.16). CONCLUSIONS: The findings suggest that the online delivery of Connect was a promising way to reduce barriers to service access and improve mental health problems and family functioning among forcibly displaced parents and their children during COVID-19. Future research is needed to explore the acceptability and impact of this programme post-COVID-19, and to develop culturally tailored and psychometrically sound measures for parent and youth reports of attachment.

Perceived Parental Support and Psychological Control, DNA Methylation, and Loneliness: Longitudinal Associations Across Early Adolescence.

A broad range of factors have been associated with the development of adolescent loneliness. In the family context, a lack of parental support and high levels of parental psychological control have systematically been linked to loneliness. On the biological level, DNA methylation (which is an epigenetic process that suppresses gene expression) is believed to play a role in the development of loneliness. Specifically, high levels of DNA methylation in genes that play an important role in the functioning of the human stress response system are believed to elevate the risk of loneliness. Moreover, DNA methylation levels in these stress-related genes can be influenced by stressful environmental factors, suggesting a potential mediating role of DNA methylation in the association between parenting behaviors and loneliness. The current 3-year longitudinal study is the first study to examine the potential bidirectional longitudinal associations between loneliness, DNA methylation in stress-related genes, and both perceived parental support and psychological control. Furthermore, we explored the potential mediating role of DNA methylation in stress-related genes in the associations between perceived parenting and loneliness. The sample comprised 622 early adolescents (55% girls, Mage T1 = 10.77 years, SDage T1 = 0.48) who were followed from Grade 5 to 7. Parental support, psychological control, and loneliness were assessed annually by adolescent self-report questionnaires and DNA methylation was determined from saliva samples. Cross-Lagged Panel Models (CLPM) revealed that higher levels of loneliness predicted lower perceived parental support and higher perceived psychological control over time, as well as higher DNA methylation in some stress-related genes, that is, the glucocorticoid receptor gene (NR3C1) and the brain-derived neurotrophic factor (BDNF). In addition, higher NR3C1 methylation was predictive of lower perceived parental support and higher psychological control over time. No evidence was found for a mediating role of DNA methylation. Overall, our longitudinal findings challenge the current focus on DNA methylation and parenting behaviors as risk factors for adolescent loneliness. Instead, they suggest that the less considered direction of effects, which implies that loneliness predicts DNA methylation and aspects of parenting such as support and psychological control, should receive greater attention in future research.

[Family stressors on young children's emotional development]. / Familiale Belastungsfaktoren für die emotionale Entwicklung junger Kinder.

BACKGROUND: Adverse childhood experiences (ACE) have been pointed out as risk factors for physical and mental health, with consequences extending from childhood into adulthood. Based on research regarding the effects of selected ACE as well as the accumulation of ACE, this article investigates how different types of family stressors are linked to children's negative emotionality in infancy and early childhood. METHODS: Data are from the KiD 0-3 study (N = 5583) and the follow-up of a subsample after 2 years (n = 681). Based on 14 stress factors, we distinguish families with no/little stressors, socioeconomic stressors, parenting stressors, and multiple stressors. RESULTS: Children in multiply stressed families have the highest risk of high negative emotionality (compared to unstressed families: Odds Ratios [OR] ranging from 13.00 to 6.81), controlling for demographic characteristics, child-related stress factors (e.g., excessive crying), and caregiver childhood stress. Children in families primarily characterized by parenting stress also showed a significantly increased risk of high negative emotionality (OR ranging from 8.31 to 6.95), whereas this did not hold for children from socioeconomically stressed families (without parenting stress) compared to those from unstressed families. Longitudinal analyses of the follow-up subsample showed that changes in the number of stressors were also associated with parallel changes in children's negative emotionality. DISCUSSION: These results confirm findings from international research on ACE in Germany and for early childhood. They underline the importance of a well-developed early intervention system.

The Effectiveness and Cost-Effectiveness of a Universal Digital Parenting Intervention Designed and Implemented During the COVID-19 Pandemic: Evidence From a Rapid-Implementation Randomized Controlled Trial Within a Cohort.

BACKGROUND: Children's conduct and emotional problems increased during the COVID-19 pandemic. OBJECTIVE: We tested whether a smartphone parenting support app, Parent Positive, developed specifically for this purpose, reversed these effects in a cost-effective way. Parent Positive includes 3 zones. Parenting Boosters (zone 1) provided content adapted from standard face-to-face parent training programs to tackle 8 specific challenges identified by parents and parenting experts as particularly relevant for parents during the pandemic. The Parenting Exchange (zone 2) was a parent-to-parent and parent-to-expert communication forum. Parenting Resources (zone 3) provided access to existing high-quality web-based resources on a range of additional topics of value to parents (eg, neurodevelopmental problems, diet, and sleep). METHODS: Supporting Parents And Kids Through Lockdown Experiences (SPARKLE), a randomized controlled trial, was embedded in the UK-wide COVID-19: Supporting Parents, Adolescents and Children during Epidemics (Co-SPACE) longitudinal study on families' mental health during the pandemic. Parents of children aged 4 to 10 years were randomized 1:1 to Parent Positive or follow-up as usual (FAU) between May 19, 2021, and July 26, 2021. Parent Positive provided advice on common parenting challenges and evidence-based web-based resources and facilitated parent-to-parent and expert-to-parent support. Child conduct and emotional problems and family well-being were measured before randomization (T1) and at 1 (T2) and 2 (T3) months after randomization. Service use, costs, and adverse events were measured, along with app use and satisfaction. The primary outcome was T2 parent-reported child conduct problems, which were analyzed using linear mixed regression models. RESULTS: A total of 320 participants were randomized to Parent Positive, and 326 were randomized to FAU. The primary outcome analysis included 79.3% (512/646) of the participants (dropout: 84/320, 26% on Parent Positive and 50/326, 15% on FAU). There were no statistically significant intervention effects on conduct problems at either T2 (standardized effect=-0.01) or T3 (secondary outcome; standardized effect=-0.09) and no moderation by baseline conduct problems. Significant intervention-related reductions in emotional problems were observed at T2 and T3 (secondary outcomes; standardized effect=-0.13 in both cases). Parent Positive, relative to FAU, was associated with more parental worries at T3 (standardized effect=0.14). Few intervention-attributable adverse events were reported. Parent Positive was cost-effective once 4 outliers with extremely high health care costs were excluded. CONCLUSIONS: Parent Positive reduced child emotional problems and was cost-effective compared with FAU once outliers were removed. Although small when considered against targeted therapeutic interventions, the size of these effects was in line with trials of nontargeted universal mental health interventions. This highlights the public health potential of Parent Positive if implemented at the community level. Nevertheless, caution is required before making such an interpretation, and the findings need to be replicated in large-scale, whole-community studies. TRIAL REGISTRATION: ClinicalTrials.gov NCT04786080; https://clinicaltrials.gov/ct2/show/NCT04786080.

The emotional intelligence of today's parents - influences on parenting style and parental competence.

The emotional intelligence of parents and parental competence become two premises of effective parenting. This study contributes to the understanding of how parents' emotional intelligence exerts its effect on both their parenting style and parenting competence. The present research also sought to identify the factors that determine the level of parental competence. The research method used is the questionnaire-based survey. The research sample, represented by 610 respondents, was determined by the sampling strategy based on convenience, respectively by the snowball method. The results indicated that the emotional intelligence of parents is associated with an increased level of parental competence (r = 0.24, p < 0.001), and 15% of the variability of parental competence is determined by the level of parental emotional intelligence (R = 0.38, p < 0.00, R2 = 0.15). It was demonstrated that 6% of the variability of parental competence is determined by the level of parents' self-esteem (R = 0.24, p < 0.001, R2 = 0.06). The emotional intelligence and self-esteem of the parents contribute to the development of a high level of parental competence, while the level of education of the respondents according to this research partially influences the development of parental competence. Despite the fact that a high educational level of parents is assumed to give them access to quality information, the Barnum effect is experienced regardless of educational level. According to the field of parenting, the Barnum effect refers to consulting non-scientifically validated sources and trusting information that responds to parents' wishes, but not to children's educational needs.These results highlight the role of parents' emotional intelligence on the growth and education of children, but also the usefulness of training programs in the field of parenting with the aim of training parents in the necessary skills for effective parenting.

Parents' experiences of life after medicalised conception: a thematic meta-synthesis of the qualitative literature.

BACKGROUND: Medicalised Conception (MAC) assists many couples to achieve pregnancy worldwide. As the impact of MAC has been linked to increased pregnancy-specific anxiety and parenting difficulties, this review aimed to explore parental experiences of pregnancy and early parenting following MAC, identifying parents' psychological, social and health needs. METHOD: Five databases were searched systematically from inception to March 2023. Identified articles were screened for eligibility against the inclusion criteria and the results were analysed using thematic synthesis. The Critical Appraisal Skills checklist was employed to appraise methodological quality. RESULTS: Twenty qualitative studies, drawing on a total of 19 participant samples, were included in this review, most with samples with history of subfertility. The findings were synthesised into three main themes (consisting of seven subthemes): 1) The vulnerable parent: fear, doubt, uncertainty, 2) the stark realisation of the parental dream, 3) psychosocial needs and support. Parents lacked a sense of safety during pregnancy and reported acting protectively both antenatally and postnatally. Furthermore, their identity transition was complex and non-linear, influenced by sociocultural context. CONCLUSIONS: Considerable unmet psychosocial needs were identified including the potential for anxiety in pregnancy, the possibility of feeling excluded and marginalised, and a reluctance to share distress and experiences with healthcare professionals. These findings suggest a need for consistent, holistic care, integrating psychological services.

Parental perceptions, attitudes, and beliefs regarding vaccination of children aged 0-5 years: A qualitative study of hill-tribe communities, Thailand.

The widespread availability and use of vaccines have tremendously reduced morbidity and deaths related to infectious diseases globally. However, in hill-tribe communities in Northern Thailand, vaccination rates remain low, and there is limited literature on parental perceptions, attitudes, and beliefs about vaccination for children under five years of age. We conducted a qualitative study employing semi-structured interviews to understand parents' perceptions, attitudes, and beliefs about vaccinations. A purposive sample was used to recruit participants. Data were analyzed using thematic analysis. 74 hill-tribe parents (14 Akha, 11 Hmong, 12 Lahu, 13 Lisu, 12 Karen, and 12 Yao) were interviewed. Four themes emerged from the interviews: 1) traditional beliefs, and practices 2) traumatic experiences, 3) lack of information and effective communication, and 4) trust and support from the community. Findings highlight that it is crucial to build trust by providing knowledge, appropriate information, and advice about vaccinations in order to improve vaccine coverage in children under five years of age in the hill-tribe context.

Social support, resource utilization, and well-being: a survey of adolescent parents in Washington, DC.

BACKGROUND: Adolescent parents experience worse health and socioeconomic outcomes compared to older parents. Little is known about the factors that can lead to better health and well-being among teen-headed families. A city-wide collaborative conducted a comprehensive well-being assessment of expectant and parenting teens in Washington, DC. METHODS: An online, anonymous survey was conducted with adolescent parents in Washington, DC, using convenience sampling. The survey consisted of 66 questions adapted from validated scales of quality of life and well-being. Descriptive statistics were used to describe the data overall, by subgroups of mother and father, and by subgroups of parent age. Spearman's correlations were utilized to demonstrate associations of social supports with well-being metrics. RESULTS: A total of 107 adolescent and young adult parents from Washington, DC, completed the survey; 80% of respondents identified as mothers and 20% as fathers. Younger adolescent parents rated their physical health better compared to older adolescent and young adult parents. Adolescent parents reported accessing various governmental and community-based resources in the preceding 6 months. The most used resources were supplemental food programs, with 35% receiving Supplemental Nutrition Assistance Program benefits and 24% receiving support from the Special Supplemental Nutrition Program for Women, Infants and Children. There was no significant difference in health-related well-being metrics among those who did and did not receive resources. Having higher self-reported social support was positively correlated with higher self-rated physical health, mental health, and well-being, as well as experiencing positive emotions, and was negatively correlated with experiencing negative emotions. CONCLUSION: This snapshot of the well-being of expectant and parenting teens in Washington, DC, showed overall positive physical, mental, and emotional health. Greater social support was correlated with better outcomes in these areas. Future work will leverage the multidisciplinary collaborative to translate these findings into policies and programs that meet the needs of this population.

Maltreatment, harsh parenting, and parent-adolescent relationships during the COVID-19 pandemic.

The COVID-19 pandemic disrupted multiple aspects of family life, including normative tendencies for adolescents to establish independence from the family. This disruption has had profound, but variable impacts on parent-adolescent relationships, strengthening them in some circumstances and increasing the risk for harsh parenting and maltreatment in others. Factors that moderated this influence include a family's financial situation and pandemic-related job loss, pre-existing characteristics of the parent-child relationship, and parent and adolescent mental health. Further research is needed to examine the mechanisms through which the pandemic continues to influence parent-adolescent relationships, with attention to policy-related impacts.

Formative research to inform the future design of a multicomponent fatherhood intervention to improve early child development in Mwanza, Tanzania.

Fathers can influence child development through various pathways, such as via their caregiving behaviors, marital relationships, and their psychosocial wellbeing. However, few parenting interventions have been designed to target these multiple dimensions among fathers with young children in low- and middle-income countries. In June 2022, we conducted qualitative formative research to explore the perceptions surrounding fatherhood and the underlying barriers and enablers to engaged fathering in Mwanza, Tanzania. We completed individual in-depth interviews with 29 fathers and 23 mothers of children under aged 2 years along with 5 community leaders and 3 community health workers. We also completed 10 focus group discussions: 4 with fathers, 2 with mothers, and 4 mixed groups that combined both fathers and mothers. In total, the sample included 120 respondents stratified from across 4 study communities. Data were analyzed using thematic content analysis. Respondents highlighted that poor couples' relationships (e.g., limited male partner support, male dominance in decision-making) and fathers' mental health problems (e.g., parenting stress) were major priorities affecting fathers. Father involvement in parenting, childcare, and household activities were generally low. These dimensions of fatherhood were interlinked (e.g., poor paternal mental health constrained marital relationships and parenting). A constellation of determinants impacted engaged fathering. Common barriers included poverty, restrictive gender attitudes and norms, men's limited time at home, and inadequate knowledge about caregiving. Key enablers included mutual respect in marital relationships and men's desires to show their love for their families. Our results highlight the cultural relevance and the need for multicomponent strategies that jointly target fathers' caregiving, marital relationships, and psychosocial wellbeing for enhancing nurturing care and promoting early child development in Tanzania. Study findings can be used to inform the design of a future father-inclusive, gender-transformative parenting intervention for engaging and supporting fathers with young children in the local cultural context.

Mindfulness Parenting and Childish Play: A Clinical Trial With Parents of Children With Autism Spectrum Disorders.

BACKGROUND: Problems of behaviour, communication, and social interaction associated with Autism Spectrum Disorders can overwhelm parents. Disturbances in parents' psychological well-being (anxiety, depression) affect adherence to treatment, making it less effective. There is a need to investigate how to increase psychological wellbeing in parents of children with autism. METHOD: An 8-week brief training programme using the Mindfulness Parenting (MP) intervention was applied to fourteen parents (6 couples and two mothers). Participants were assigned to one of two groups, both groups received the same treatment but at two different time points. Measures of anxiety (SCAARED), parental stress (PSI-4), autism severity level (AIM) and mindfulness awareness (FFMQ), were assessed. RESULTS: Analysis indicates that MP training increased mindfulness awareness, increasing non-judgment and reactivity, and consequently, reduced anxiety (parental, general, social), improving parent-child interaction. This improvement did not influence parents' perception of the severity of the disorder. CONCLUSIONS: The small number of participants precludes generalisation of the results. More clinical trials are needed to demonstrate the usefulness of including these programmes in early intervention services, as well as profiles of parents who may potentially benefit from it.