Search

Objective: To examine associations between cognitive stimulation in the home at 6 months and maternal feeding styles at 24 months, direct intervention effects of Smart Beginnings (SB) on feeding styles, and potential indirect effects of SB on feeding styles via earlier intervention effects on cognitive stimulation., Methods: Single-blind, two-site randomized clinical trial (RCT) of the SB intervention. SB integrates PlayReadVIP, a universal, pediatric primary care-based program, and Family Check-Up (FCU), a targeted secondary home-based parenting intervention. Mother-infant dyads (N = 327) were randomized at birth to standard pediatric care or the SB intervention. Linear regression analyses determined associations between cognitive stimulation at 6 months and maternal feeding styles at 24 months, a secondary data analysis. Direct intervention impacts on feeding styles, a secondary RCT outcome, were also assessed and mediation analyses explored intervention effects on feeding styles via earlier intervention impacts on cognitive stimulation., Results: Cognitive stimulation was significantly associated with higher responsive and lower indulgent feeding styles. SB mothers were less likely to exhibit pressuring styles compared with controls (Effect Size [ES]=-0.12, P = 0.02). Although no direct intervention effects were found on responsive or indulgent feeding styles, indirect effects of SB were evident on these feeding styles through intervention-induced increases in cognitive stimulation in the SB group., Conclusions: This study found positive linkages between cognitive stimulation in the home and later feeding styles. Additionally, the SB intervention was associated with less pressured feeding and indirect pathways mediated by intervention effects on cognitive stimulation. Implications for early childhood parenting interventions are discussed., Competing Interests: Declaration of Competing Interest The authors have no potential conflicts of interest to disclose, including financial relationships relevant to this article., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

We adapted the Family Check-Up Online (FCU-O) (1) to support families coping with pandemic-related stressors to prevent behavioral and emotional problems among middle school youth and (2) for smartphone delivery to increase access and reach during the COVID-19 pandemic. This study evaluated the direct and indirect effects of the adapted FCU-O at 4-months post-baseline. The FCU-O combines online parenting support with telephone coaching. Participants were primary caregivers of children ages 10 to 14 years. Eligibility included endorsing depression on the PHQ-2 or significant stress on a 4-item version of the Perceived Stress Scale. We randomly assigned participants to the adapted FCU-O (N = 74) or a waitlist control condition (N = 87). Participants predominantly self-identified as female (95%), 42.77 years old on average, and White (84.6%). Outcomes included caregiver reports of perceived stress and parenting, and youth conduct problems and depressive symptoms. Using a multilevel modeling approach, we tested intent-to-treat intervention effects at 4-months, with time points nested within participants. The FCU-O reduced caregiver stress and improved proactive parenting and limit setting but had no effects on youth outcomes. Effect sizes were small to moderate (Cohen's d ranged from .37 to .57). We examined indirect effects on youth outcomes at 4-months via changes in caregiver stress and parenting at 2-months. Mediation analyses suggested indirect effects on youth depressive symptoms via reductions in caregiver stress and increases in proactive parenting. Results indicate the FCU-O has potential as a public health intervention for families facing extreme stressors such as those during the COVID-19 pandemic. ClinicalTrials.gov Identifier: NCT05117099., (© 2024. The Author(s).)

Reliable and valid assessment of parenting and child behaviors is critical for clinicians and researchers alike, and observational measures of parenting behaviors are often considered the gold standard for assessing parenting and parent-child interaction quality. The present study sought to evaluate the reliability and validity of the Coder Impressions Questionnaire-Kindergarten (COIMP-K) measure. The present study was a secondary analysis of 274 parents and their children participating in a randomized control trial testing a brief parenting intervention for parents of children entering kindergarten. Families participated in baseline and follow-up assessments and videotaped observational tasks. Graduate and undergraduate coders completed the COIMP-K after achieving reliability. The aims of the present study were to assess COIMP-K's (a) internal consistency using intercorrelations among COIMP-K subscales, (b) construct validity, (c) convergent validity by comparing the COIMP-K subscales to parents' self-report of similar behaviors, (d) discriminant validity by comparing subscales to a parent-teacher communication measure as it is unrelated to parenting or child behaviors, and (e) congruence across time. The authors hypothesized that the COIMP-K would demonstrate adequate internal consistency (Cortina, 1993), adequate construct, convergent, and discriminant validity and find congruence of the measure across time. The results demonstrated that the factors had adequate internal consistency, construct, convergent, and discriminant validity, as well as longitudinal replicability and congruence over time. The study demonstrates that the COIMP-K is a reliable and valid tool for assessing observed family behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prior research points to the promotion of parenting self-efficacy (PSE) as an important component of parenting interventions; however, few studies have tested PSE as a mediator or moderator of the effects of parenting programs on child behavior. In the present study, we examined the efficacy of the family check-up (FCU), a brief, strengths-based parenting intervention adapted for kindergarten school entry. We tested the FCU's effects on reducing growth in parent-reported child conduct problems (CP) from kindergarten to fifth grade and whether PSE functioned as a mediator or moderator of intervention effects, using a latent growth curve model and intent-to-treat approach. Participants were parents of 321 children from five elementary schools in a northwestern U.S. city. Although we did not find a main effect of the FCU in reducing growth in CP from kindergarten through fifth grade, we found a significant indirect effect of the FCU on reducing CP growth via improving PSE in second grade and that the indirect effect was moderated by baseline levels of PSE. Together, our findings suggest that the FCU is effective in promoting PSE, which is subsequently associated with reduced CP growth, particularly for parents with initially low PSE. Our findings bolster existing work on the relationship between PSE and child CP in the context of a preventive parenting intervention and emphasize the importance of PSE as an agent of change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: There is scant empirical work on associations between current and past cannabis use and parenting skills in parents of young children. As recreational cannabis use is now legal in nearly half of states in the U.S., cannabis use is becoming more ubiquitous., Methods: In the current study, parents of toddler and pre-school age children were randomly assigned to participate in an app-based parenting skills program that included telehealth coaching (Family Check-Up Online; FCU-O), with a focus on parenting in the context of substance use. We aimed to test associations between adolescent-onset and current cannabis use and parent mental health and parenting skills, as well as whether effects of the FCU-O on parent mental health outcomes varied as a function of past cannabis use. Participants were 356 parents of children ages 1.5-5 participating in a randomized controlled trial of the FCU-O. Parents screened into the study if they reported current or past substance misuse or current depressive symptoms. After completing a baseline assessment, parents were randomly assigned to the FCU-O or control group and completed a follow-up assessment 3 months later. Parents retrospectively reported on the age when they initially used substances, as well as their current use., Results: After accounting for current cannabis use, adolescent-onset cannabis use was significantly associated with higher symptoms of anxiety and depression, but not with parenting skills. Adolescent-onset cannabis use was found to significantly moderate the effect of the FCU-O on parents' anxiety symptoms. Specifically, the FCU-O was particularly effective in reducing anxiety symptoms for parents with adolescent-onset regular cannabis use, after accounting for current cannabis use., Discussion: Adolescent-onset regular cannabis use may be a risk factor for later mental health challenges in parents of children under 5. An app-based parenting intervention may be particularly helpful in reducing symptoms of anxiety for parents who used cannabis regularly as adolescents. The findings have significant implications for the prevention of multigenerational risk for substance use and mental health challenges., Competing Interests: Conflict of interest ES has an ownership interest in Northwest Prevention Science, Inc. (NPS), and serves as CEO of that entity. KH serves as a consultant with NPS. The content of this manuscript overlaps with activities at NPS, and this conflict of interest has been managed by the University of Oregon. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Parents play a central role in supporting the early learning that positions young children for success when they enter formal schooling. For this reason, efforts to engage families in meaningful collaboration is a long-standing goal of high-quality early childhood education (ECE). Family-school engagement can take multiple forms; in this review, we focus on universal preschool-based outreach strategies that help parents support growth in child social-emotional and self-regulation competencies and prepare them for the transition into formal schooling. Recent research has expanded understanding of the neurodevelopmental processes that underlie child school readiness, and the impact of parenting (and the social ecology affecting parenting) on those processes. These new insights have fueled innovation in preschool-based efforts to partner with and support parents, expanding and shifting the focus of that programming. In addition, new approaches to intervention design and delivery are emerging to address the pervasive challenges of reaching and engaging families, especially those representing diverse racial, ethnic, cultural, and socioeconomic backgrounds. This paper reviews developmental research that underscores the importance of prioritizing child social-emotional learning (with attention to self-regulation and approaches to learning) in universal preschool-based parenting programs targeting young children. We highlight the intervention strategies used in programs with strong evidence of impact on child readiness and school adjustment based on randomized controlled trials (RCTs). New directions in intervention design and delivery strategies are highlighted, with the hope of extending intervention reach and improving family engagement and benefit., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This study examined how family factors impacted parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. We hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents' interest in IBH modalities., Methods: Parents of children ages 1.5-5 years (N = 301) from five primary care clinics completed a survey with measures assessing familial contextual factors (income, race and ethnicity, and parents' childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents' preferences for behavioral support in primary care. A subsample of parents (n = 23) completed qualitative interviews to provide deeper insights into quantitative relationships., Results: Higher COVID-19 impact was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Overall, lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews identified how pandemic stressors led to increases in parents' desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered., Conclusions: Findings have important implications for the provision of behavioral supports for families in primary care, underlying the need to increase parents' access to IBH services by proactively providing evidence-based resources and continuing to offer telehealth support., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Although school-based preventive parenting interventions have been found to promote children's social-emotional skill development and behavioral functioning, it is important to understand potential barriers to engagement in such programs to ensure that intervention access is equitable and likely to reach those who could most benefit. In the present study, we tested independent and interactive associations between parents' concerns about their child's hyperactivity behavior and their perceived stress in relation to their participation in a preventive parenting intervention, the Family Check-Up (FCU), delivered when children were in kindergarten. Participants were parents of 164 children who were randomized to the intervention group of a randomized controlled trial that took place at five elementary schools. Results indicated that parents who reported higher levels of hyperactivity in their children and high levels of perceived stress were less likely to initially engage in the FCU, but if they did engage, they were more likely to participate more intensively as measured by total treatment time. Parents' motivation to change mediated the association between high parent stress and child hyperactivity in relation to total treatment time. This study has important implications for the use of motivational interviewing strategies to engage parents in school-based, family-centered interventions., Competing Interests: Declaration of Competing Interest Elizabeth Stormshak has an ownership interest in Northwest Prevention Science, Inc. (NPS), and serves as CEO of that entity. Katherine Hails serves as a consultant with NPS. The content of this manuscript overlaps with activities at NPS, and this conflict of interest has been managed by the University of Oregon., (Copyright © 2022 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.)

Background: Heightened familial stress and distress during the COVID-19 pandemic may lead to increased negative parenting practices, particularly for parents with substantial adverse childhood experiences (ACES)., Objective: To determine whether families' COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' ACEs., Participants and Setting: Participants were 267 parents of children ages 1.5-5 years recruited from five primary care sites across the United States., Methods: Participants completed internet questionnaires including measures of demographics, parent ACES, negative parenting, parent mental health, and COVID-19 distress. We used regression analyses to test a moderated mediation model in which the relationship between COVID-19 distress and child emotional/behavioral problems is mediated by negative parenting, and both the direct and indirect effects of COVID-19 distress on child emotional/behavioral problems is moderated by parents' ACEs., Results: Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems (indirect effect β = 0.07). Parents' ACEs moderated the associations between COVID-19 distress and both negative parenting and child emotional/behavioral problems, such that each relationship was stronger in the context of higher parental ACEs. The model accounted for 42% of the variance in child emotional/behavioral problems., Conclusions: Findings have implications for managing risk and promoting well-being in young children during periods of significant stress and routine disruption. This study advances understanding of factors influencing negative outcomes in children during the pandemic's acute phase and may have implications for the development of targeted interventions to improve families' adjustment in the future., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: Pediatric primary care is an ideal setting to provide behavioral health services to young children and their families during the COVID-19 pandemic. However, it is unclear how the pandemic altered parents' priorities and preferences to obtain behavioral services in this setting., Method: Between July 2020 and January 2021, 301 parents of young children in 5 pediatric sites across the United States completed survey measures on their preferences for behavioral topics and service delivery methods in primary care. The current sample was compared with a previous sample of parents (n = 396) who completed the same measures in 2018., Results: Child self-calming was the only behavioral topic that was rated as significantly more important in the pandemic cohort in comparison with the prepandemic cohort. The pandemic cohort also reported significantly more interest in using certain media resources (e.g., mobile apps and videos) as a delivery method and less interest in group classes/seminars. After controlling for demographic differences between the samples, there was an increased preference for multimedia resources overall in the pandemic cohort, as well as a decreased preference for usual care., Conclusion: Parents generally endorse similar priorities for behavioral topics in primary care during the pandemic as they did before the pandemic. However, there is a clear preference for more remote and media-based services during the pandemic. Pediatric practices may consider augmenting behavioral health services with multimedia resources during and after the COVID-19 pandemic to meet parents' needs., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To test breastfeeding duration and responsive parenting as independent predictors of infant weight change from birth to 12 months, and to test the moderating effect of a tiered parenting intervention on relations between breastfeeding and responsive parenting in relation to infant weight change., Methods: Mother-infant dyads (N = 403) were participants in the ongoing Smart Beginnings (SB) randomized controlled trial testing the impact of the tiered SB parenting model that incorporates two evidence-based interventions: Video Interaction Project (VIP) and Family Check-Up (FCU). The sample was low income and predominantly Black and Latinx. Responsive parenting variables (maternal sensitivity and intrusiveness) came from coded observations of mother-infant interactions when infants were 6 months. Continuous weight-for-age (WFA) z-score change and infant rapid weight gain (RWG) from 0 to 12 months were both assessed., Results: Longer breastfeeding duration was significantly associated with less WFA z-score change. The relationship between breastfeeding duration and WFA z-score change was significant only for infants in the intervention group. Intrusive parenting behaviors were also associated with greater WFA z-score change after accounting for breastfeeding duration., Conclusions: This study is one of the first to test both breastfeeding and parenting in relation to infant weight gain in the first year. Findings may have implications for family-focused child obesity prevention programs., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background and Objectives: Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure., Methods: Two-site randomized controlled trial in New York City (84% Latinx) and Pittsburgh (81% Black), with postpartum enrollment and random assignment to treatment (SB) or control. At 6 months, we assessed parent-child interactions through surveys (StimQ, Parenting Your Baby) and observation (video-recorded play, coded by using Parent-Child Interaction Rating Scales - Infant Adaptation)., Results: A total of 403 families were enrolled at child's birth (201 treatment) with 362 (89.8%) assessed at 6 months. Treatment families had increased StimQ, including total score (Cohen's d = 0.28; P < .001) and domains reflecting reading ( d = 0.23; P = .02) and teaching ( d = 0.25; P = .01), and Parent-Child Interaction Rating Scales - Infant Adaptation, including a cognitive stimulation factor ( d = 0.40; P < .001) and domains reflecting support for cognitive development ( d = 0.36; P < .001), and language quantity (0.40; P < .001) and quality ( d = 0.37; P < .001). Thus, significant effects emerged across a broad sample by using varied methodologies., Conclusions: Findings replicate and extend previous VIP findings across samples and assessment methodologies. Examining subsequent assessments will determine impacts and feasibility of the full SB model, including potential additive impacts of Family Check-Up for families at elevated risk., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2021 by the American Academy of Pediatrics.)

Child birth order (CBO) in the family has received little attention in the field of prevention science. CBO is relevant to early interventionists from a public health perspective, as the most widely disseminated home-visiting program has traditionally targeted mothers and their first-born children. The current paper revisits a previous publication by Shaw et al. (2009) on the effectiveness of the Family Check-Up (FCU) to evaluate CBO (firstborn vs. middle vs. youngest) as a moderator of treatment effects of the FCU in relation to improvements in parenting, maternal depressive symptoms, and child outcomes from ages 2 to 4 in a sample of low-income, ethnically diverse families (N = 709) with multiple children. Results suggest that the FCU elicited improvements in observed parenting from ages 2 to 3 primarily for target children who were the youngest or middle children, but not for firstborns. Findings are discussed in the context of implications for prevention science research, dissemination, and public policy.

Objective: To test relations between exposure to poverty, in the forms of family income and neighborhood deprivation, during three developmental stages, and children's body mass index (BMI) in early adolescence., Methods: Data came from a longitudinal sample of racially diverse, urban, low-income boys. Interactions between family income to needs and census-derived neighborhood deprivation at three developmental stages-early childhood (18 and 24 months), preschool-to-school entry (3.5 and 6 years), and school-age (8 and 10 years)-were tested in relation to BMI at age 11., Results: There was a significant interaction whereby higher income predicted lower BMI only in the context of low levels of neighborhood deprivation in early childhood. In high-deprivation neighborhoods, higher income was associated with risk for overweight/obesity in early adolescence. This pattern was found to be specific to income and neighborhood deprivation measured in early childhood., Conclusions: Findings have implications for policy relevant to obesity prevention. More research on associations between early exposure to poverty and later risk for obesity on low-income samples is warranted, as the relationship is likely complex and influenced by many different factors, including the family and neighborhood food environments and child health behaviors., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Deficits in self-regulation (SR) have been proposed as a potential contributor to child overweight/obesity, a public health concern that disproportionately affects children living in poverty. Although poverty is known to influence SR, SR has not been considered as a potential mechanism in the association between poverty and child obesity. The aim of the current paper was to systematically review the current literature to determine whether SR is a viable mechanism in the relationship between child exposure to poverty and later risk of overweight/obesity. We systematically review and summarize literature in three related areas with the aim of generating a developmentally informed model that accounts for the consistent association between poverty and child weight, specifically how: (1) poverty relates to child weight, (2) poverty relates to child SR, and (3) SR is associated with weight. To quantify the strength of associations for each pathway, effect sizes were collected and aggregated. Findings from the studies included suggest small but potentially meaningful associations between poverty and child SR and between SR and child weight. The conceptualization and measurement of SR, however, varied across literature studies and made it difficult to determine whether SR can feasibly connect poverty to child obesity. Although SR may be a promising potential target for obesity intervention for low-income children, additional research on how SR affects risk of obesity is crucial, especially based on the lack of success of the limited number of SR-promoting interventions for improving children's weight outcomes.

The effect of parental depression on children's adjustment has been well documented, with exposure during early childhood particularly detrimental. Most studies that examine links between parental depression and child behavior are confounded methodologically because they focus on parents raising children who are genetically related to them. Another limitation of most prior research is a tendency to focus only on the effects of maternal depression while ignoring the influence of fathers' depression. The purpose of this study was to examine whether infants' exposure to both parents' depressive symptoms, and inherited risk from birth mother internalizing symptoms, was related to school age children's externalizing and internalizing problems. Study data come from a longitudinal adoption study of 561 adoptive parents, biological mothers, and adopted children. Adoptive fathers' depressive symptoms during infancy contributed independent variance to the prediction of children's internalizing symptoms and also moderated associations between adoptive mothers' depressive symptoms and child externalizing symptoms.

The original version of this article contained a mistake: The affiliations 1, 4 for author Thomas J. Dishion are incorrect and should be corrected to 2, 4 .

A key challenge of community-based prevention programs is engaging families in the context of services settings involving children and families. The Family Check-Up (FCU) program is designed to engage families in parenting support appropriate to their level of need by use of assessment-enhanced motivational interviewing. This study involved families screened for risk who were seeking services at women, infant, and children's offices in three geographical regions (N = 731). Families in the randomized intervention group (N = 367) were offered the FCU yearly, from age 2 through 10. The results of multivariate modeling indicated that caregivers reporting high levels of perceived caregiving stress (i.e., depression, low parenting satisfaction, daily hassles) participated at a higher rate in two critical components (feedback and follow-up support interventions) of the FCU program over the 8-year trial period than caregivers reporting lesser degrees of stress. The implications of these findings are discussed in the context of family-centered programs for the prevention of child behavior problems and directions for future research.

Maternal depression is among the most consistent and well-replicated risk factors for negative child outcomes, particularly in early childhood. Although children of depressed mothers are at an increased risk of adjustment problems, conversely, children with emotional or behavioral problems also have been found to adversely compromise maternal functioning, including increasing maternal depression. The purpose of this investigation was to examine transactional associations among maternal depression, parent-child coercive interaction, and children's conduct and emotional problems in early childhood using a cross-lagged panel model. Participants were 731 toddlers and families that were part of the Early Steps Multisite Study, a sample of diverse ethnic backgrounds and communities (i.e., rural, urban, suburban) recruited from Women, Infants, and Children Nutritional Supplement Centers. Analyses provided support for the existence of some modest transactional relations between parent-child coercion and maternal depression and between maternal depression and child conduct problems. Cross-lagged effects were somewhat stronger between children age 2-3 than age 3-4. Similar patterns were observed in the model with child emotional problems replacing conduct problems, but relations between coercion and maternal depression were attenuated in this model. In addition, the transactional hypothesis was more strongly supported when maternal versus secondary caregiver reports were used for child problem behavior. The findings have implications for the need to support caregivers and reinforce positive parenting practices within family-centered interventions in early childhood.