The impact of a music enrichment program during infancy and early toddlerhood on effortful control at age 3: A preliminary investigation.

Effortful control (EC), a self-regulation skill, is associated with long-term developmental outcomes. Music has been associated with infant self-regulation and may be an intervention strategy for enhancing EC during toddlerhood. This investigation included 32 parent-child dyads from a previously conducted randomized controlled trial (RCT). Participants (9-15-months old at baseline) attended either a music enrichment program or a playdate control once a week for 1 year and monthly for an additional year. At age 3, participants completed snack and gift delay effortful control tasks. Groups were compared using one-way ANOVA. We found that participants in the music group had a significantly higher score during snack delay (music mean = 3.47 ± 0.94; control mean = 2.45 ± 1.51; p = 0.03; Cohen's d = 0.84). We did not find a significant group difference for latency to peek (music mean = 39.10 ± 20.10; control mean = 30.90 ± 19.88; p = 0.25; d = 0.57) or latency to touch (music mean = 105.73 ± 417.69; control mean = 98.35 ± 28.84; p = 0.38; d = 0.29) for the gift task. This study provides initial evidence that early participation in a music enrichment program may benefit later development of EC. This study is registered at ClinicalTrials.gov (NCT02936284).

The effects of a music enrichment program on parent-infant interactions during mealtime: A randomized controlled trial.

BACKGROUND: Parent-child interactions are linked to childhood obesity. Music enrichment programs enhance parent-child interactions and may be a strategy for early childhood obesity prevention. OBJECTIVE: We implemented a 2-year randomized, controlled trial to assess the effects of a music enrichment program (music, n = 45) vs. active play date control (control, n = 45) on parent-child interactional quality and infant weight status. METHODS: Typically developing infants aged 9-to 15-months were enrolled with a primary caregiver in the Music Together ® or a play date program. Participants attended once per week group meetings for 12 months and once per month group meetings for an additional 12 months. Parent-child interaction was measured using the Parent Child Early Relational Assessment (PCERA) at baseline, month 6, 12, and 24. We used a modified intent-to-treat mixed model regression to test group differences in parent-child interactions and Weight for length z-score (zWFL) growth trajectories were modeled. RESULTS: There were significant differential group changes across time for negative affect during feeding (group*month; p = 0.02) in that those parents in the music group significantly decreased their negative affect score compared with the control group from baseline to month 12 (music change = -0.279 ± 0.129; control change = +0.254 ± 0.131.; p = 0.00). Additionally, we also observed significant differential group changes across time for parent intrusiveness during feeding (group*month; p = 0.04) in that those parents in the music group significantly decreased their intrusiveness score compared with the control group from month 6 to month 12 (music change = -0.209 ± 0.121; control change = 0.326 ± 0.141; p = 0.01). We did not find a significant association between any of the changes in parental negative affect and intrusiveness with child zWFL trajectories. CONCLUSION: Participating in a music enrichment program from an early age may promote positive parent-child interactions during feeding, although this improvement in the quality of parent-child interactions during feeding was not associated with weight gain trajectories.

Within-person decline in pregnancy smoking is observable prior to pregnancy awareness: Evidence across two independent observational cohorts.

Decreased consumption of nicotine and other drugs during pregnancy appears to be a cross-species phenomenon from which mechanism(s) capable of interrupting addictive processes could be elucidated. Whether pregnancy influences smoking behaviour independent of women's knowledge of the pregnancy, however, has not been considered. Using repeated measures analysis of variance (ANOVA), we estimated within-person change in mean cigarettes/day smoked across the estimated date of conception but prior to individually reported dates of pregnancy recognition using longitudinal smoking data from two independent observational cohorts, the Growing Up Healthy (GUH, n = 271) and Midwest Infant Development Studies (MIDS, n = 145). Participants smoked an average of half a pack/day in the month immediately before conception (M (SD) = 12(8.1) and 9.5(6.7) cigarettes/day in GUH and MIDS, respectively). We observed within-person declines in smoking after conception, both before (MGUH  = -0.9; 95% CI -1.6, -0.2; p = 0.01; MMIDS  = -1.1; 95% CI -1.9, -0.3; p = 0.01) and after (MGUH  = -4.8; 95% CI -5.5, -4.1; p < 0.001; MMIDS  = -3.3; 95% CI -4.4, -2.5; p < 0.001) women were aware of having conceived, even when women who had quit and women who were planning to conceive were excluded from analyses. Pregnancy may interrupt smoking-related processes via mechanisms not previously considered. Plausible candidates and directions for future research are discussed.

Cardiovascular diseases in survivors of childhood cancer.

Over the past few decades, the diagnosis and management of children with various malignancies have improved tremendously. As a result, there are an increasing number of children who are long-term cancer survivors. With improved survival, however, has come an increased risk of treatment-related cardiovascular complications that can appear decades after treatment. These problems are serious enough that all caregivers of childhood cancer survivors, including oncologists, cardiologists, and other health care personnel, must pay close attention to the short- and long-term effects of chemotherapy and radiotherapy on these children. This review discusses the effects of treatment-related cardiovascular complications from anthracyclines and radiotherapy and the methods for preventing, screening, and treating these complications.

Within- and between-family transactions of maternal depression and child engagement in the first 2 years of life: Role of prenatal maternal risk and tobacco use.

BACKGROUND: This study examined transactional associations among maternal depression, maternal sensitivity, and child engagement in the context of a low-income, diverse sample with maternal cigarette smoking during pregnancy (MSDP) as a moderator of these transactions. METHODS: A random-intercept cross-lagged panel model was used to investigate within- and between-family variability from infancy to toddlerhood. The sample included 247 mother-child dyads (47% girls; 51% African-American; 178 MSDP, 69 non-MSDP). Assessments were conducted once during each trimester of pregnancy and at 2, 9, 16, and 24 months of child ages. RESULTS: Between-family associations revealed that children exposed to higher levels of sensitive parenting across time had higher behavioral engagement from infancy to toddlerhood. At the within-family level, increased sensitive parenting at 9 months was predictive of increased child engagement at 16 months which in turn predicted increases in sensitive parenting at 24 months. Increased maternal depression was concurrently associated with lower maternal sensitivity at 2 months and lower child engagement at 16 months. Contrary to hypotheses, changes in maternal depression were not associated to changes in parenting or child engagement. These associations did not vary between prenatally smoking and nonsmoking mothers. However, there was significantly higher stability in maternal depression across time among nonsmoking mothers compared to those in the MSDP group. Additionally, increased maternal depression was related to lower-than-expected child engagement at 9 months only for the nonsmoking group. CONCLUSIONS: Results highlight transactional processes at the within-family level and the importance of timing for parent and child effects on transactional processes.

Prenatal substance exposure and maternal hostility from pregnancy to toddlerhood: Associations with temperament profiles at 16 months of age.

We investigated whether infant temperament was predicted by level of and change in maternal hostility, a putative transdiagnostic vulnerability for psychopathology, substance use, and insensitive parenting. A sample of women (N = 247) who were primarily young, low-income, and had varying levels of substance use prenatally (69 nonsmokers, 81 tobacco-only smokers, and 97 tobacco and marijuana smokers) reported their hostility in the third trimester of pregnancy and at 2, 9, and 16 months postpartum, and their toddler's temperament and behavior problems at 16 months. Maternal hostility decreased from late pregnancy to 16 months postpartum. Relative to pregnant women who did not use substances, women who used both marijuana and tobacco prenatally reported higher levels of hostility while pregnant and exhibited less change in hostility over time. Toddlers who were exposed to higher levels of prenatal maternal hostility were more likely to be classified in temperament profiles that resemble either irritability or inhibition, identified via latent profile analysis. These two profiles were each associated with more behavior problems concurrently, though differed in their association with competence. Our results underscore the utility of transdiagnostic vulnerabilities in understanding the intergenerational transmission of psychopathology risk and are discussed in regards to the Research Domain Criteria (RDoC) framework.

Prenatal Tobacco and Cannabis Exposure: Associations with Cortisol Reactivity in Early School Age Children.

BACKGROUND: The study examined the association between prenatal tobacco or co-exposure to tobacco and cannabis and children's cortisol reactivity at kindergarten age and the role of child sex, maternal negative mood (depression/perceived stress), and parenting behavior during play interactions as moderators of this association. METHODS: The sample was 238 mother-child dyads (67 tobacco users, 83 co-users of tobacco and cannabis, and 88 non-users). Data used were obtained from pregnancy assessments and six postnatal assessments at 2, 9, 16, 24, and 36 months and kindergarten age. Infant cortisol was measured in response to two laboratory stress paradigms. RESULTS: Co-exposed children had a significantly greater decrease from pre-stressor to post-stressor and overall lower cortisol response compared with non-exposed children. This association was moderated by maternal harshness during play interactions across early childhood. Co-exposed children had flatter cortisol responses regardless of the mother's level of harshness or stress/depression. However, non-exposed children who experienced low harshness had the normative cortisol peak 20 min post-stressor, while non-exposed children with high maternal harshness had a flatter cortisol pattern. Similarly, non-exposed children with more depressed/stressed mothers had higher pre-stressor cortisol levels, while those who experienced low maternal depression/stress had lower pre-stressor cortisol but peaked post-stress. CONCLUSIONS: Results suggest that prenatal polysubstance exposure is associated with greater risk for lower cortisol response in children and highlight the role of parenting behavior for non-exposed but not the co-exposed children.

The effect of prenatal adversity on externalizing behaviors at 24 months of age in a high-risk sample: Maternal sensitivity as a moderator.

The purpose of this study was to examine the moderating role of maternal sensitivity on the association between prenatal adversity and externalizing behaviors at 24 months of age in a diverse, high-risk sample. We hypothesized that among children with higher prenatal adversity, high maternal sensitivity would serve as a protective factor. Participants were 247 primarily low-income, diverse dyads. Results indicated a significant interaction effect of maternal sensitivity and prenatal adversity on externalizing problems. The association between prenatal adversity and externalizing behaviors was significant only among children who experienced low prenatal adversity, with higher maternal sensitivity associated with lower externalizing behaviors. These findings indicate that, in the absence of high prenatal risk, responsive and sensitive parenting can buffer children in an otherwise high-risk sample from the development of externalizing behaviors.

El propósito de este estudio fue examinar el papel moderador que la sensibilidad materna tiene sobre la asociación entre adversidad prenatal y las conductas de externalización a los 24 meses de edad en un grupo muestra diverso y de alto riesgo. Nuestra hipótesis es que entre los niños con más alta adversidad prenatal (PA), una alta sensibilidad materna serviría como un factor de protección. Participaron 247 díadas diversas, primariamente de bajos recursos económicos (173 infantes expuestos a sustancias). Los resultados indicaron un significativo efecto de interacción de la sensibilidad materna y la adversidad prenatal sobre los problemas de externalización. La asociación entre la adversidad prenatal y las conductas de externalización fue significativa sólo entre niños que habían experimentado una adversidad prenatal baja, mientras que una más alta sensibilidad materna se asoció con más bajas conductas de externalización. Estos resultados indican que, en ausencia de un riesgo prenatal alto, una crianza receptiva y sensible puede amortiguar el desarrollo de conductas de externalización en niños que, de lo contrario, están dentro de un grupo muestra de alto riesgo.

Le but de cette étude était d'examiner le rôle modérateur de la sensibilité maternelle sur l'association entre l'adversité prénatale et les comportements d'externalisation à l'âge de 24 mois chez un échantillon varié, et à haut risque. Nous avons pris comme hypothèse que chez les enfants avec une adversité prénatale élevée (PA), une sensibilité maternelle élevée servirait de facteur de protection. Les participants ont consisté en 247 dyades diverse et principalement issues de milieux défavorisés (173 bébés exposés à la toxicomanie). Les résultats indiquent un effet d'interaction important de la sensibilité maternelle et de l'adversité prénatale sur les problèmes d'externalisation. Le lien entre l'adversité prénatale et les comportements d'externalisation n'était important que chez les enfants ayant fait l'expérience d'une adversité prénatale peu élevée, avec une sensibilité maternelle plus élevée liée à des comportements d'externalisation moins élevés. Ces résultats indiquent que, en l'absence d'une risque prénatal élevé, le parentage réactif et sensible peut servir de tampon aux enfants contre le développement de comportements d'externalisation dans un échantillon qui est par ailleurs à haut risque.

Prenatal exposure to tobacco and marijuana and child autonomic regulation and reactivity: An analysis of indirect pathways via maternal psychopathology and parenting.

We examined a conceptual model for the associations of prenatal exposure to tobacco (PTE) and marijuana with child reactivity/regulation at 16 months of age. We hypothesized that PTE would be associated with autonomic reactivity and regulation that these associations would be indirect via maternal anger/hostility, depression/stress, or harsh parenting assessed at 2 months and that these effects would be most pronounced among children exposed to both tobacco and marijuana (PTME). Participants were 247 dyads (81 PTE, 97 PTME, and 69 nonexposed) who were followed up at 2 (N = 247) and 16 months (N = 238) of child age. Results from model testing indicated an indirect association between PTME and autonomic functioning during the second year of life, which was mediated by harsh parenting during caregiver-infant interactions. This study fills an important gap in the literature on PTE, PTME, and autonomic regulation during the toddler years, highlighting the role of maternal parenting as important intervening variables.

Smoking in Pregnancy and Fetal Growth: The Case for More Intensive Assessment.

INTRODUCTION: Many studies on prenatal tobacco exposure (PTE) effects have relied on single item retrospective measures of PTE. However, it is unclear how these single item measures may relate to more intensive maternal self-reports and to biological markers of maternal use and/or fetal exposure. It is also unclear whether these measures may be more valid predictors of fetal growth (gestational age, birthweight, head circumference, and birth length). METHODS: Data were obtained from 258 women during their pregnancy. PTE was assessed by four methods: a single item question, a calendar-based self-report measure from each trimester of pregnancy, maternal salivary cotinine assays, and nicotine and metabolites in infant meconium. We hypothesized that the more intensive measures and biological assays would account for additional variance in birth outcomes, above and beyond the single item measure. RESULTS: The single item self-report measure was not related to fetal growth. However, the more intensive calendar based self-report measure and the biological assays of PTE (ie, maternal salivary assays and infant meconium) were significant predictors of poor fetal growth, even with the single item measure in the model. CONCLUSIONS: The negative effects of PTE on important child outcomes may be greatly underestimated in the literature as many studies use single item self-report measures to ascertain PTE. Whereas more intensive self-report measures or biological assays may be cost prohibitive in large scale epidemiological studies, using a combination of measures when possible should be considered given their superiority both identifying prenatal smokers and predicting poor fetal growth. IMPLICATIONS: The present work underscores the importance of measurement issues when assessing associations between PTE and fetal growth. Results suggest that we may be greatly underestimating the negative effects of prenatal smoking on fetal growth and other important child outcomes if we rely solely on restricted single item self-report measures of prenatal smoking. Researchers should consider more intensive prospective self-report measures and biological assays as viable and superior alternatives to single item self-report measures.

Predictors of Changes in Smoking From Third Trimester to 9 Months Postpartum.

INTRODUCTION: While much has been written about postpartum smoking relapse prevention, few have examined changes in smoking behavior from pregnancy (third trimester) through 9 months postpartum among pregnant smokers, particularly for the large number of women who decrease tobacco consumption during pregnancy but do not quit altogether. METHODS: Data were obtained from 168 women who smoked during their pregnancy. Women were followed longitudinally from their first prenatal appointment through 9 months postpartum. Maternal substance use was assessed using the Timeline Followback and verified by maternal salivary analyses. Breastfeeding, other substance use, and partner smoking were assessed through maternal interviews at each time point and were considered as potential predictors of change in smoking. RESULTS: Women returned to more than half of their levels of preconception tobacco consumption by 9 months postpartum. There was one significant predictor of changes in smoking patterns pregnancy to postpartum. Women who breastfed their infants for at least 90 days smoked far less postpartum than women who breastfed for a short time or did not breastfeed at all. CONCLUSIONS: As noted in previous research of pregnant quitters, postpartum relapse prevention or harm reduction interventions should ideally be timed early in the postpartum period. Additionally, promoting breastfeeding among pregnant smokers and supporting women through at least 3 months of breastfeeding may be beneficial to such interventions.

Corrigendum: Systematic review on fiscal policy interventions in nutrition.

[This corrects the article DOI: 10.3389/fnut.2022.967494.].

Effective interventions for improving routine childhood immunisation in low and middle-income countries: a systematic review of systematic reviews.

OBJECTIVE: An umbrella review providing a comprehensive synthesis of the interventions that are effective in providing routine immunisation outcomes for children in low and middle-income countries (L&MICs). DESIGN: A systematic review of systematic reviews, or an umbrella review. DATA SOURCES: We comprehensively searched 11 academic databases and 23 grey literature sources. The search was adopted from an evidence gap map on routine child immunisation sector in L&MICs, which was done on 5 May 2020. We updated the search in October 2021. ELIGIBILITY CRITERIA: We included systematic reviews assessing the effectiveness of any intervention on routine childhood immunisation outcomes in L&MICs. DATA EXTRACTION AND SYNTHESIS: Search results were screened by two reviewers independently applying predefined inclusion and exclusion criteria. Data were extracted by two researchers independently. The Specialist Unit for Review Evidence checklist was used to assess review quality. A mixed-methods synthesis was employed focusing on meta-analytical and narrative elements to accommodate both the quantitative and qualitative information available from the included reviews. RESULTS: 62 systematic reviews are included in this umbrella review. We find caregiver-oriented interventions have large positive and statistically significant effects, especially those focusing on short-term sensitisation and education campaigns as well as written messages to caregivers. For health system-oriented interventions the evidence base is thin and derived from narrative synthesis suggesting positive effects for home visits, mixed effects for pay-for-performance schemes and inconclusive effects for contracting out services to non-governmental providers. For all other interventions under this category, the evidence is either limited or not available. For community-oriented interventions, a recent high-quality mixed-methods review suggests positive but small effects. Overall, the evidence base is highly heterogenous in terms of scope, intervention types and outcomes. CONCLUSION: Interventions oriented towards caregivers and communities are effective in improving routine child immunisation outcomes. The evidence base on health system-oriented interventions is scant not allowing us to reach firm conclusions, except for home visits. Large evidence gaps exist and need to be addressed. For example, more high-quality evidence is needed for specific caregiver-oriented interventions (eg, monetary incentives) as well as health system-oriented (eg, health workers and data systems) and community-oriented interventions. We also need to better understand complementarity of different intervention types.

PROTOCOL: The effects of agricultural output market access interventions on agricultural, socio-economic and food and nutrition security outcomes in low- and middle-income countries: A systematic review.

Development agencies and international donors' efforts are increasingly focusing on better integrating poor and remote farmers into agricultural markets to address the chronic issues of rural poverty and hunger in low- and middle-income countries. Using systematic methods for information retrieval, critical appraisal and evidence synthesis, this research aims to examine evidence on the effects of five focal types of agricultural market access interventions: (i) farm-to-market transport infrastructure interventions; (ii) output market information interventions; (iii) initiatives creating new marketplaces and alternative marketing opportunities; (iv) contract farming initiatives; (v) interventions improving storage infrastructure. In this review, we will study evidence of the magnitude and direction of intervention effects on agricultural, socio-economic, and food and nutrition security outcomes. We will examine evidence of the distribution of reported effects across different contexts, interventions and sub-groups of the population (e.g., according to sex, socio-economic status, farm size, etc.). We will also report on included studies' risk of bias and on what evidence is available on intervention costs, or their cost-effectiveness. This protocol outlines this review's planned methods and the criteria for selecting and including studies in its analysis.

Prenatal tobacco and cannabis co-exposure and offspring obesity development from birth to mid-childhood.

BACKGROUND: Although the association between prenatal tobacco exposure and child obesity risk is well-established, less is known about co-exposure to tobacco and cannabis. OBJECTIVE: Determine the relation between prenatal substance co-exposure and obesity risk. METHODS: In a diverse sample of pregnant women, we examined the association between prenatal substance exposure (tobacco-only and co-exposure) and child BMI (kg/m2 ) trajectories from birth to mid-childhood (n = 262), overweight/obese status based on BMI percentiles from toddlerhood (24 months) to mid-childhood (9-12 years), and adiposity outcomes at mid-childhood (fat mass [kg], fat mass [%] and fat free mass [kg]; n = 128). Given that the major goal of this study was to examine the associations between prenatal substance exposure and child outcomes, we oversampled pregnant women for substance use (with tobacco as the primary focus). RESULTS: Multilevel models demonstrated that children in both exposure groups had a steeper increase in BMI trajectory from birth to mid-childhood and among co-exposed children, girls had a steeper increase than boys. Odds ratio of having obesity by mid-childhood was 12 times higher among those co-exposed than non-exposed. Co-exposure led to significantly greater fat mass and fat mass % compared with no exposure, but exposure to only tobacco was no different than no exposure. CONCLUSIONS: Results highlight potentiating effects of cannabis exposure in the context of maternal tobacco use in pregnancy on obesity risk and the importance of multi-method assessments of obesity.

Examining the Relationship between Infant Weight Status and Parent-Infant Interactions within a Food and Nonfood Context.

Background: Most observational research examining factors in the home environment that contribute to child adiposity has focused on feeding and physical activity, although aspects of one's nonfood home environment such as parent-child interactions can also impact body weight. The main objectives of this study were to determine if parent-infant interactions under different contexts provide a unique contribution to infants' concurrent adiposity after accounting for known obesity-related covariates. Methods: This was a cross-sectional analysis of 121 9- to 15-month-old infants using data collected at the baseline visit of an ongoing intervention study. Mother-infant interactions during a feeding episode and a free-play task were recorded and coded. Anthropometrics of infants were measured by trained research staff. We used two-step hierarchical multivariable regression models to examine the unique contribution of mother-infant interactions to weight status after accounting for known obesity-related covariates (i.e., maternal age, BMI, education, parity, and gestational age, child sex, breastfeeding duration, age of solid food introduction, and birthweight). Results: Maternal intrusiveness, child negative affect, and child responsiveness during free-play, but not feeding were significantly associated with z-weight-for-length. For every 1-U increase in maternal intrusiveness and child negative affect there was a 0.321 (p = 0.011) and 0.415 (p = 0.028) unit increase in z-weight-for-length, respectively, whereas for every 1-U increase in child responsiveness there was a decrease of 0.386 U in z-weight-for-length (p = 0.025). Conclusion: This research contributes new findings support the idea that parent-child interactions outside of the feeding context may relate to obesity. Clinical Trial Registration Number NCT02936284.

Use of community engagement interventions to improve child immunisation in low-income and middle-income countries: a systematic review and meta-analysis.

OBJECTIVE: To support evidence informed decision-making, we systematically examine the effectiveness and cost-effectiveness of community engagement interventions on routine childhood immunisation outcomes in low-income and middle-income countries (LMICs) and identify contextual, design and implementation features associated with effectiveness. DESIGN: Mixed-methods systematic review and meta-analysis. DATA SOURCES: 21 databases of academic and grey literature and 12 additional websites were searched in May 2019 and May 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included experimental and quasi-experimental impact evaluations of community engagement interventions considering outcomes related to routine child immunisation in LMICs. No language, publication type, or date restrictions were imposed. DATA EXTRACTION AND SYNTHESIS: Two independent researchers extracted summary data from published reports and appraised quantitative risk of bias using adapted Cochrane tools. Random effects meta-analysis was used to examine effects on the primary outcome, full immunisation coverage. RESULTS: Our search identified over 43 000 studies and 61 were eligible for analysis. The average pooled effect of community engagement interventions on full immunisation coverage was standardised mean difference 0.14 (95% CI 0.06 to 0.23, I2=94.46). The most common source of risk to the quality of evidence (risk of bias) was outcome reporting bias: most studies used caregiver-reported measures of vaccinations received by a child in the absence or incompleteness of immunisation cards. Reasons consistently cited for intervention success include appropriate intervention design, including building in community engagement features; addressing common contextual barriers of immunisation and leveraging facilitators; and accounting for existing implementation constraints. The median intervention cost per treated child per vaccine dose (excluding the cost of vaccines) to increase absolute immunisation coverage by one percent was US$3.68. CONCLUSION: Community engagement interventions are successful in improving outcomes related to routine child immunisation. The findings are robust to exclusion of studies assessed as high risk of bias.

Systematic review on fiscal policy interventions in nutrition.

Introduction: Both the World Health Organization and the Lancet Series on Adolescent nutrition recommend that governments adopt fiscal policies to combat diet-related non-communicable diseases (NCDs). However, rigorous, systematic evidence regarding the effects of these interventions is lacking. Methods: We synthesize the available evidence regarding the impacts of taxes and subsidies that directly affect consumer prices on availability and accessibility of foods and beverages, purchasing behavior, diet quality, health and well-being outcomes as well as considerations for implementation, sustainability and equity. Results: Our initial search returned 2,113 de-duplicated studies, and ultimately 24 impact evaluations and two systematic reviews met final eligibility criteria and represented unique evaluations. Our meta-analysis of these studies suggests that taxes may decrease purchases of taxed beverages (SMD = -0.14 [95% CI: -0.29 to -0.07], n = 15). Results should be interpreted cautiously due to considerable heterogeneity (Q(14) = 335.19, p = 0.01, τ ^ 2 = 0.03 , I 2 = 95.82%). Discussion: The evidence base is too limited to draw conclusions about the effects of taxes on beverages and calorie-dense foods on purchases, or on the effects of subsidies on purchasing or diet quality. Overall, the evidence base is inconclusive on whether fiscal policies can meaningfully influence the availability and accessibility of foods and beverages, diet quality, and health outcomes. Policymakers implementing fiscal policies should consider information campaigns on health benefits and health risks associated with certain food and beverage consumption. For taxes, exposure to health information may amplify signaling effects of taxes and reduce avoidance behaviors, such as cross-border shopping. Future evaluations should diversify data sources to better understand impacts on diet and health outcomes.

Development of Bullying and Victimization: An Examination of Risk and Protective Factors in a High-Risk Sample.

This prospective longitudinal study from birth to late adolescence investigated how early risk predicted subsequent aggression in middle childhood and bullying perpetration, bullying victimization, and violence victimization in adolescence. In addition, the moderating role of protective factors (i.e., maternal sensitivity, positive peers, and school connectedness) on these associations were examined. Caregiver-infant dyads (N = 216; 72% Black/African American) were recruited as part of a longitudinal study on substance exposed youth. Data using multiple methods and informants (observations, interviews, caregiver, and child/youth self-reports) were collected from dyads in early childhood (EC, birth to 48 months), middle childhood (MC, i.e., 84 months), early adolescence (EA, M = 13.26 years, SD = .83) and later adolescence (LA, M = 15.08 years, SD = .83). A developmental cascading path model was tested. There were direct associations between EC maternal harsh parenting and aggression in MC. In turn, MC aggression was associated with higher violence victimization and bullying in EA. Finally, EA violence victimization was then associated with higher levels of bullying as well as victimization from bullying in LA. Consistent with predictions, there was also evidence that protective factors (i.e., maternal sensitivity and positive peers) moderated the impact of predictor variables on aggression and bullying outcomes. Specifically, maternal sensitivity moderated the link between EC and MC aggression, such that those with moderately high levels of maternal sensitivity showed a negative relation between EC and MC aggression, whereas those with low levels of maternal sensitivity showed continuity in aggression. Positive peer influence moderated the link between violence victimization in EA and bullying in LA, such that children high on both violence victimization and positive peers had the highest levels of bullying victimization.

Child Community Violence Exposure in an at-Risk Sample: Developmental Trajectories, Caregiving Risks, and the Role of Child Temperament.

Objective: To better understand early etiological pathways to trajectories of child exposure to community violence (CECV), we used person-centered latent class growth analysis (LCGA) to examine chronicity of CECV from early school age through early adolescence, and examined early risks of the identified CECV trajectories (i.e., prenatal cocaine exposure, harsh parenting and caregiving instability across infancy and early childhood, and child activity level and inhibitory control at kindergarten age). Method: An at-risk sample (N = 216; 110 girls) of primarily low-income participants (76% on Temporary Assistance for Needy Families) with high rates of prenatal substance exposure was used. The majority of the mothers were African American (72%), had high school or below education (70%), and were single (86%). Postnatal assessments occurred at eight time points during infancy and toddlerhood, early childhood through early school age, and early adolescence. Results: We identified two distinct linearly increasing CECV trajectories (high-exposure and low-exposure). An interaction between child activity level and maternal harshness emerged, such that children with high activity levels and experiencing high harshness had the highest probabilities of being in the high exposure-increasing trajectory, in addition to early caregiving instability (conditional effect). Conclusion: The current findings not only have important theoretical implications but also provide insights into early intervention.