Family experiences reported by healthcare worker parents during the COVID-19 pandemic.

PURPOSE: Parents, who were working as essential frontline healthcare workers experienced unique stressors during the COVID-19 pandemic including disruption of regular routines, long lapses away from family, extreme work stress and subsequent difficulty in compartmentalizing work-related concerns when at home. The purpose of this study was to assess COVID-19 exposure and impact of frontline healthcare workers who are parents. DESIGN & METHODS: This study quantitatively assessed the COVID-19 exposure and impact and qualitatively explored perceptions of parents of children 9 to 17 years of age, who were also frontline healthcare workers. RESULTS: Participants (N = 79) using the COVID-19 Exposure and Family Impact Survey (CEFIS) reported exposure mean scores of 10.03 (SD = 2.63); and impact scores mean scores of 3.18 (SD = 0.46). Thematic analysis identified four themes, each with 2 subthemes: 1) family stressors increased (e.g., concerns about health and safety, losses of lifestyle patterns); 2) changes in children's health and well-being (e.g., isolation from family and friends, mental health problems); 3) virtual school difficulties (e.g., parent and student challenges, home school option); 4) skill building opportunities (e.g., enhanced emotional connections, increased family activities). CONCLUSION: The CHAMPS Family Health Study suggests that families of essential workers are especially vulnerable to the effect of COVID-19, as are those families of essential workers who include child/ren with special health care needs. PRACTICE IMPLICATIONS: Preparation for future emergencies requires strategies to mitigate consequences and promote well-being. These results highlight the need for supportive approaches to decrease the negative consequences of stress and to augment skills for family connection and cooperation.

Families with young children in homeless shelters: Developmental contexts of multisystem risks and resources.

We apply a multisystem perspective to three aims relevant to resilience for young children in emergency and transitional homeless shelters. We consider profiles of risks and resources before shelter, early childhood program enrollment during shelter, and the likelihood of returning to shelter or having a subsequent child welfare placement. We used longitudinal, city-wide data from multiple sources integrated at the individual level across the lifespan for 8 birth cohorts. Young children (N = 1,281) stayed in family shelters during an 18-month period during a multisystem intervention. Risk factor rates were high as were rates of early childhood program enrollment (66.1% in any program; 42.3% in a high-quality program), which may suggest positive effects of the multisystem intervention. Multilevel latent class analysis revealed four profiles, considering prior shelter stays, prior child welfare placements, prior elevated lead levels, perinatal factors (teenage mother, prenatal care, low maternal education, and poor birth outcomes), demographics, and early childhood program enrollment and quality. One profile with higher rates of child welfare placement before the shelter stay and considerable enrollment in high-quality early childhood programs corresponded to lower rates of subsequent child welfare placement. Profiles did not differ on the likelihood of returning to shelter.

Using spreading activation to understand repetitive negative thinking.

Repetitive negative thinking (RNT) describes a recursive, unproductive pattern of thought that is commonly observed in individuals who experience anxiety and depression. Past research on RNT has primarily relied on self-report, which fails to capture the potential mechanisms that underlie the persistence of maladaptive thought. We investigated whether RNT may be maintained by a negatively biased semantic network. The present study used a modified free association task to assess state RNT. Following the presentation of a valenced (positive, neutral, negative) cue word, participants generated a series of free associates, which allowed for the dynamic progression of responses. State RNT was conceptualised as the length of consecutive, negatively valenced free associates (i.e. chains). Participants also completed two self-report measures that assessed trait RNT and trait negative affect. Within a structural equation model, negative (but not positive or neutral) response chain length positively predicted trait RNT and negative affect, and this was only the case for positive (but not negative or neutral) cue words. These results suggest that RNT tendencies may be reflected in semantic retrieval and can be assessed without self-report.

Profiles and Predictors of Neurodevelopmental Functioning among Young Children Experiencing Family Homelessness.

In the context of family homelessness, children experience acute adversities related to loss of housing and residential mobility compounded with more chronic, poverty-related adversities and stressors. Among children in families experiencing homelessness, variability in experiences and outcomes warrant person-centered approaches to better delineate patterns of risk and resilience. Using latent profile analysis as a person-centered approach, we identified five distinct profiles of neurodevelopmental functioning within a sample of 231 children (ages 3-5 years old) staying in emergency homeless shelters with their families. Latent profiles were informed by indicators from parent-reported items for ten different domains of neurodevelopmental functioning. We examined whether demographic and ecological factors including age, ethnicity, adverse childhood experiences, parent mental health, and overreactive parenting would predict profile membership. Overall, half of the children in the sample demonstrated a profile of resilient functioning across developmental domains. Profiles of maladaptive functioning differed in areas of strength and challenge, with a small percentage of children showing poor functioning across all domains. Children whose parents had more mental health problems or overreactive parenting were significantly more likely to show profiles of poor functioning than to show resilient functioning. Implications for future research, practice, and policy are discussed.

Perceptions of support in shelter environments for caregivers and young children experiencing family homelessness.

BACKGROUND: Young children who stay with their families in homeless shelters face chronic challenges related to extreme poverty and acute risks from stressful events surrounding the loss of housing and move to shelter. These adversities increase the likelihood of a range of poor developmental outcomes. Consistent with the risk and resilience perspective, however, many children who experience family homelessness succeed, functioning as well or better than their non-homeless peers. As such, efforts to support resilience should consider how best to enhance protective factors, such as supportive environments within shelter settings. METHODS: With data from 60 caregivers of children ages birth to 5 years recruited from family shelters, we assessed caregivers' perceptions of community support as well as child and family well-being in terms of recent adverse experiences, parenting stress, access to social support, and child social-emotional functioning. RESULTS: Many caregivers experiencing family homelessness perceived negative aspects of the shelters where they were staying with their children. Furthermore, children whose caregivers had more negative perceptions of the shelter environment displayed worse social-emotional functioning, even when accounting for differences in parenting stress, recent family adversity, and other sources of social support. CONCLUSIONS: Because young children rely on their caregivers as primary resources for nurturance and support, we encourage family homelessness service providers to work in partnership with caregivers to create more inclusive and empowering practices within the shelter context. Doing so is likely to improve children's developmental outcomes and the overall well-being of the families.

Adolescent Homelessness and Associated Features: Prevalence and Risk Across Eight States.

This study utilizes data from the Youth Risk Behavior Survey to estimate the prevalence of adolescent homelessness and relations to five indicators of poor functioning among students attending public high school in eight states. About 3.27% of students experienced homelessness, and nearly 7% of teens who identified as lesbian, gay, or bisexual (LGB) experienced homelessness. Homelessness was related to higher rates of sexual/dating violence as well as having been bullied and feeling unsafe at school. Homelessness and LGB identification predicted higher rates of more-severe problems with alcohol, hard drug use, poor grades, suicidality, and risky sexual behavior, controlling for other factors. There was no interaction effect between homelessness and LGB status, suggesting that these risks are additive.

Promoting parent-infant responsiveness in families experiencing homelessness.

My Baby's First Teacher is an intervention designed specifically for parents with infants staying in emergency homeless shelters. Infants are overrepresented in shelter populations and face considerable risk to their development, including mental health. We utilized a randomized controlled design across three family shelters to evaluate the program's effectiveness with 24 dyads assigned to the intervention compared to 21 dyads in care-as-usual. Dyads were randomized by round at each site to account for shelter effects. We used path analysis to illustrate change over time and in relation to intervention assignment.

El Primer Maestro de mi Bebé es una intervención diseñada específicamente para progenitores con infantes que se alojan en refugios de emergencia para personas sin casa. En la población de los refugios, los infantes están sobrerrepresentados y enfrentan un considerable riesgo en cuanto a su desarrollo, incluyendo la salud mental. Utilizamos un diseño de control al azar a través de tres refugios de familias para evaluar la eficacia del programa con 24 díadas asignadas al grupo de intervención que fueron comparadas con 21 díadas bajo el cuidado usual. A las díadas se les colocó al azar por etapas en cada lugar para tener en cuenta los efectos del refugio. Usamos un análisis de trayectoria para ilustrar el cambio a través del tiempo y en relación con la asignación de intervención. Resultados claves: los resultados indicaron mejoras en la observada sensibilidad de progenitor-infante relacionada con la intervención en el lugar, con un control en cuanto a los niveles iniciales de sensibilidad. Los resultados fueron consistentes entre un modelo de intención de tratar y un modelo para probar la participación cierta en la intervención. No encontramos ningún efecto significativo para el estrés de crianza o la ansiedad del progenitor, aunque las tendencias sugirieron más altos puntajes para las familias de la intervención. Implicaciones para la práctica y las políticas: presentamos los resultados considerando retos específicos en contextos de casos sin casa para la salud mental infantil. Este trabajo puede servir de base para los esfuerzos de quienes proveen servicios y encuentran familias que experimentan el estar sin casa, así como también las políticas sobre los recursos para programaciones en albergues de emergencia.

Le Premier Enseignant de Mon Bébé est une intervention conçue spécialement pour les parents dont les bébés restent dans des foyers d'urgence pour sans-abris. Les bébés sont sur-représentés dans les populations de ces foyers et ils font face à un risque considérable pour leur développement, y compris pour ce qui concerne leur santé mentale. Nous avons utilisé un schéma expérimental contrôlé pour 3 trois foyers familiaux afin d'évaluer l'efficacité du programme avec 24 dyades désignées pour l'intervention comparé à 21 dyades dans le groupe de soins habituels. Les dyades ont été randomisées par ronde sur chaque site afin de contrôler les effets du foyer. Nous avons utilisé une analyse causale pour illustrer le changement au fil du temps et en relation au groupe d'intervention. Constatations Clés: Résultats a indiqué des améliorations dans la réaction observée parent-bébé liée à l'intervention en fin d'étude, contrôlant les niveaux initiaux de réaction. Les résultats sont cohérents entre un modèle intention-de-traiter et un modèle testant la véritable participation à l'intervention. Nous n'avons trouvé aucun effet important pour le stress de parentage ou la détresse du parent, bien que des tendances suggèrent des scores plus élevés pour les familles d'intervention. Nous présentons des résultats en considérant les défis uniques aux contextes de la vie des sans-abris pour la santé mentale du nourrisson. Ce travail peut orienter les efforts des prestataires de services qui rencontrent des familles faisant l'expérience d'une vie sans abri ainsi que les lois et pratiques concernant les ressources pour des programmes dans des foyers d'accueil d'urgence.

Housing Interventions and the Chronic and Acute Risks of Family Homelessness: Experimental Evidence for Education.

This study considers risk associated with family homelessness for school functioning and experimental evidence on the effects of different housing interventions over time. Students in homeless families (N = 172; Mage  = 7.31; SD = 4.15) were randomized to housing interventions that focus on acute risks (community-based rapid rehousing), chronic risks (permanent subsidy), or usual care (UC). A matched group of low-income, housed students served as an additional reference for effects on attendance, school mobility, and reading and math achievement across 4 years. Findings partially support the chronic-risk hypothesis that family homelessness interferes with achievement through its relation to deep poverty. Children randomly assigned to UC perform as well or better than children assigned to housing interventions in this municipality.

Academic achievement trajectories of homeless and highly mobile students: resilience in the context of chronic and acute risk.

Analyses examined academic achievement data across third through eighth grades (N = 26,474), comparing students identified as homeless or highly mobile (HHM) with other students in the federal free meal program (FM), reduced price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General > RM > FM > HHM). Achievement gaps appeared stable or widened between HHM students and lower risk groups. Math and reading achievement were lower, and growth in math was slower in years of HHM identification, suggesting acute consequences of residential instability. Nonetheless, 45% of HHM students scored within or above the average range, suggesting academic resilience. Results underscore the need for research on risk and resilience processes among HHM students to address achievement disparities.

School mobility and developmental outcomes in young adulthood.

School mobility has been shown to increase the risk of poor achievement, behavior problems, grade retention, and high school dropout. Using data over 25 years from the Chicago Longitudinal Study, we investigated the unique risk of school moves on a variety of young adult outcomes including educational attainment, occupational prestige, depression symptoms, and criminal arrests. We also investigated how the timing of school mobility, whether earlier or later in the academic career, may differentially predict these outcomes over and above associated risks. Results indicate that students who experience more school changes between kindergarten and 12th grade are less likely to complete high school on time, complete fewer years of school, attain lower levels of occupational prestige, experience more symptoms of depression, and are more likely to be arrested as adults. Furthermore, the number of school moves predicted outcomes above and beyond associated risks such as residential mobility and family poverty. When timing of school mobility was examined, results indicated more negative outcomes associated with moves later in the grade school career, particularly between 4th and 8th grades.

Infant fearful distress, parent intrusiveness, and adversity in families experiencing homelessness.

Infants experiencing homelessness face risk for developing mental health problems in the future. Parents residing in shelters experience adverse events at elevated rates compared to non-homeless individuals, which can impact their infants during a time of rapid development depending on how the parent copes. For some, trauma linked to these events may manifest in an intrusive parenting style that interferes with the child's developing capacity for self-regulation. We utilized a sample of 60 parent-infant dyads recruited while residing in emergency homeless shelters to evaluate associations among parents' history of adversity, intrusive parenting behaviors, and infants' fearful distress. Observed parent intrusiveness during a free play interaction was significantly associated with infant fearfulness observed in a separate behavioral task during which infants viewed a series of masks. Furthermore, there was a moderating effect for parent history of adversity such that the association between parent intrusiveness and infant fearful distress was stronger among parents with more past experiences of adversity.

Social support as a resilience factor for parent-infant dyads experiencing homelessness.

Despite the considerable prevalence of homelessness among very young children in the United States, there is a notable lack of research on risk, resilience, and developmental well-being of infants who experience family homelessness. In the present study, we considered social support as a resilience factor for quality of parent-infant relationships and parent depression among a sample of 106 parents and their infants (ages birth to 12 months) residing in emergency shelters for families experiencing homelessness. We assessed social support, parent histories of adverse experiences during childhood and adulthood, and parent current depression symptoms via structured interview measures, and we assessed quality of the parent-infant relationship with an observational approach. Results showed different patterns for the roles of adversity the parents had experienced during childhood compared to adversity experienced more recently, as adults. Childhood adversity predicted parent-infant responsiveness, with a positive association that was moderated by level of perceived social support. Parents with more childhood adversity showed more responsiveness with their infants only when they had access to high levels of social support. Adulthood adversity predicted higher scores for parent depression, while social support predicted lower parent depression scores. This work contributes to the very limited literature on the functioning of families with infants in shelters. Our discussion includes implications for research, policy, and prevention and intervention efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adaptive systems for student resilience in the context of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic is a disaster, defined as an event that suspends normal activities and threatens or causes severe, community-wide damage (Masten & Motti-Stefanidi, 2020). While all school children and their families have been impacted by COVID-19 to some degree, the burdens are disproportionately being borne by children experiencing poverty and children from minority racial and ethnic groups. In this article, we consider resilience and risk in the context of the COVID-19 pandemic by focusing on children's developing adaptive systems. When adaptive systems are functioning well, most children will demonstrate resilience to disaster. The capacity of children's adaptive systems to function well depends upon their developmental histories and the social and community resources available to them. We discuss how these factors contribute to children's adaptation and close with recommendations for communities looking to support resilience to the varied adversities of COVID-19. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Childhood homelessness, resilience, and adolescent mental health: A prospective, person-centered approach.

School districts and other service providers are increasingly aware of the substantial mental health needs of students experiencing family homelessness. Past findings are mixed regarding whether homelessness conveys unique risk beyond the risks associated with extreme poverty. With prospective longitudinal data on homelessness experiences across childhood, we utilized latent profile analysis as a person-centered approach to conceptualizing mental health outcomes in adolescence for 3,778 youth. We considered literal family homelessness as well as families living doubled-up, and we employed propensity score matching to identify a comparison group of non-homeless students balanced across a range of covariates to address systematic bias. Results indicated that students who experienced literal homelessness during childhood were significantly less likely to demonstrate profiles of resilience in mental health functioning. We considered our approach and findings in light of challenges and opportunities particularly relevant to the school context.

Medical and Psychosocial Risk Profiles for Low Birthweight and Preterm Birth.

OBJECTIVES: Low birthweight and preterm birth are risk factors for infant mortality and persistent problems. This study uses representative data to assess whether distinct latent profiles of co-occurring medical and psychosocial factors have implications for preterm birth and low birthweight. METHODS: Data are from the Pregnancy Risk Assessment Monitoring System, a cross-sectional survey constituting representative data on pregnancies from 2012 to 2013. Latent class analysis derived classes of pregnant women potentially at risk for low birthweight and/or preterm birth. RESULTS: Latent class analysis identified five homogenous profiles of interrelated psychosocial and medical factors. Risk was greatest for the profile marked by high rates of medical factors, followed by a high risk for a profile marked by a combination of very low income and psychosocial factors. Two profiles involving low income and very low income also indicated greater risk for adverse birth outcomes related to socioeconomic status. CONCLUSIONS: More attention should be paid to screening for and addressing psychosocial risk in concert with prenatal care. Women who show high-risk profiles can be monitored and supported by an interdisciplinary care team, when warranted.

Unique contributions of dynamic versus global measures of parent-child interaction quality in predicting school adjustment.

This study investigates the unique contribution of microsocial and global measures of parent-child positive coregulation (PCR) in predicting children's behavioral and social adjustment in school. Using a community sample of 102 children, ages 4-6, and their parents, we conducted nested path analytic models to identify the unique effects of 2 measures of PCR on school outcomes. Microsocial PCR independently predicted fewer externalizing and inattention/impulsive behaviors in school. Global PCR did not uniquely relate to children's behavioral and social adjustment outcomes. Household socioeconomic status was related to both microsocial and global measures of PCR, but not directly associated with school outcomes. Findings illustrate the importance of using dynamic measures of PCR based on microsocial coding to further understand how the quality of parent-child interaction is related to children's self-regulatory and social development during school transition. (PsycINFO Database Record

Adversity and children experiencing family homelessness: Implications for health.

This study tests links between adversity and health problems among children in family emergency housing. Children who experience family homelessness are at risk to also experience high levels of stress, health problems, and need for pediatric care. Understanding the connection between stress and health holds the potential to reduce persistent health disparities. Analyses tested whether experiencing a greater number of stressful life events during the early years of life was related to worse health conditions, emergency health care utilization, and hospitalizations. Parents noted children's experience of negative stressful life events, health problems, emergency room (ER) use, and hospitalization. Two cohorts of kindergarten-aged children staying in emergency family housing participated in the study in 2006-07 (n = 104) and in 2008-09 (n = 138), with the results examined separately. In both cohorts, more health problems were acknowledged for children exposed to more negative stressful life events. Stressful life events were not related to ER use but did relate to hospitalization for the 2006-07 cohort. Results affirm links between stress in early childhood and health problems among children living in emergency housing. Findings are consistent with the hypothesis that adversity in early childhood contributes to income and racial disparities in health.

Youth Homelessness: Prevalence and Associations with Weight in Three Regions.

This study investigated the utility of the Youth Risk Behavior Survey (YRBS) to document associations between homeless status and weight while estimating the prevalence of youth homelessness in three regions. A school-based survey, the YRBS includes youths who have been difficult to involve in past research. Analysis of 2011 YRBS data produced population-weighted estimates of youth homelessness prevalence separately for Connecticut, Delaware, and Philadelphia. Public high school students anonymously reported their housing status, height, and weight on the YRBS. Height and weight were converted to body mass index (BMI) percentile-for-age scores. Homelessness was associated with higher BMI percentile scores for youths compared with nonhomeless peers. Associations between BMI percentile and different forms of homelessness (homeless with family, unaccompanied homeless without family) were explored at each site. Estimates of one-month homelessness prevalence ranged from 3.9 percent to 5.9 percent at each site. Homelessness, especially family homelessness, is associated with risk for higher BMI. The YRBS is an informative tool for estimating the prevalence of youth homelessness, expanding on what is known through other, more commonly used methods.

Parenting and coregulation: Adaptive systems for competence in children experiencing homelessness.

The role of effective parenting in promoting child executive functioning and school success was examined among 138 children (age 4 to 6 years) staying in family emergency shelters the summer before kindergarten or 1st grade. Parent-child coregulation, which refers to relationship processes wherein parents guide and respond to the behavior of their children, was observed during structured interaction tasks and quantified as a dyadic construct using state space grid methodology. Positive coregulation was related to children's executive functioning and IQ, which in turn were related to teacher-reported outcomes once school began. Separate models considering parenting behavior demonstrated that executive function carried indirect effects of parents' directive control to school outcomes. Meanwhile, responsive parenting behaviors directly predicted children's peer acceptance at school beyond effects of executive function and IQ. Findings support theory and past research in developmental science, indicating the importance of effective parenting in shaping positive adaptive skills among children who overcome adversity, in part through processes of coregulation.

Academic Risk and Resilience in the Context of Homelessness.

Family homelessness in the United States has increased over the past two decades, raising concerns about associated risks for child development. In this article, we describe a translational research program focused on academic risk and resilience in homeless and highly mobile children. We find that although these children share many risk factors with other disadvantaged children, they are higher on an underlying continuum of risk. Additionally, marked variability has been observed among children who experience homelessness, both in risk level and achievement, with many children manifesting resilience. We discuss implications for research and efforts to address disparities in achievement.