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Interprofessional education (IPE) is a growing focus for educators in health professional academic programs. Recommendations to successfully implement IPE are emerging in the literature, but there remains a dearth of evidence informing the bigger challenges of sustainability and scalability. Transformation to interprofessional education for collaborative person-centred practice (IECPCP) is complex and requires "harmonization of motivations" within and between academia, governments, healthcare delivery sectors, and consumers. The main lesson learned at the University of Manitoba was the value of using a formal implementation framework to guide its work. This framework identifies key factors that must be addressed at the micro, meso, and macro levels and emphasizes that interventions occurring only at any single level will likely not lead to sustainable change. This paper describes lessons learned when using the framework and offers recommendations to support other institutions in their efforts to enable the roll out and integration of IECPCP.

Every day, almost one billion children around the world experience violent punishment. Eliminating all violence against children is a key target of the United Nations' 2030 Agenda for Sustainable Development. This is a monumental challenge due to the diversity of cultural, economic and social contexts in which children live. Violence-prevention programs developed in wealthy countries cannot be assumed to be transferable to low- and middle-income countries. We assessed the relevance of Positive Discipline in Everyday Parenting (PDEP) to 525 parents living in countries with high (n = 201), medium (n = 166), or low (n = 158) Inequality-Adjusted Human Development Indices. The outcome measures were parents' satisfaction with the program and their perceptions of its impact on their parenting. Across IHDI categories, almost all parents were "mostly" or "very satisfied" with the overall program (98.4%), the PDEP parent book (97.9%), and the program activities (97.8%). Parent satisfaction scores were higher in the Low IHDI category than in the High IHDI category. Across IHDI categories, large majorities of parents perceived PDEP as having positive impacts on their parenting. While parents in the Medium IHDI category had the strongest perceptions of PDEP's positive impact, more than 90% of parents in the Low IHDI category believed that the program will help them to understand their children's development and feelings, communicate better with their children, control their anger, and build stronger relationships with their children. PDEP is a promising tool for preventing punitive violence against children across human development contexts.

Objective: The objective was to examine the roles of cognition and affect in maternal use of physical punishment. Method: Through a review of the literature, distal and proximal predictors (cognitive and affective) of physical punishment use were identified. One hundred and ten mothers of 3-year-old children were interviewed regarding two disciplinary situations that occurred during the previous 2-week period that elicited their strongest reactions: one which resulted in the use of physical punishment (if this occurred) and one which did not. The individual and combined contributions of the predictors of physical punishment use were analyzed through logistic regression. Results: The predictors of physical punishment following individual analyses were: maternal attitude toward physical punishment, maternal perception of the seriousness and intent of the child misbehavior, and maternal anger in response to the child misbehavior. Through multivariate analysis 54% of the variance in physical punishment use was explained. Conclusions: Both cognitive and affective factors affect the decision to use physical punishment with children. These findings can be useful in establishing parenting educational programming that is directed at decreasing the rates of physical punishment and subsequently child physical abuse. Keywords: Punishment; Discipline; Abuse; Parenting; Children

This 2.5-year longitudinal, Canadian tri-provincial study (Alberta, Saskatchewan, Manitoba) of women abused by intimate partners examined the nature of the partner abuse, physical and mental conditions, disabilities, child abuse history, and quality of life (QOL). The women retained at 30-months (419 of 665) were identified as Indigenous (48.5%), White (46.6%), or visible minority (4.9%). Physical and mental health conditions were noted by 62.3%; 41.8% of these were disabilities. Over half (54.5%) reported histories of child sexual abuse, with 24.2% reporting other childhood abuse, and 21.3% were not abused as children. Consistent with similar longitudinal studies, over time the women significantly improved their QOL and had less mental stress (SCL-10) and PTSD symptoms (PCL); however, neither PCL nor SCL-10 scores were clinically problematic at any time period. Depression symptoms (CES-D-10) remained constant over time but were not in the clinical range over the 2.5 years. Only IPV severity and having a disability were associated with more severe mental health/well-being scores at 30-months. Implications for practice such as training IPV advocates and counselors to better address disabilities and to avoid stigmatizing women abused by partners as necessarily having mental health issues are presented. [ABSTRACT FROM AUTHOR]

This research examines how mental health issues associated with intimate partner violence (IPV) relate to women's intersecting identities of race/ethnicity, disability status, and child abuse history. Data (N = 595) from a Canadian triprovincial study included women who were White (n = 263, 44.8%), Indigenous (n = 292, 49.7%), or visible minority (n = 32, 5.5%). Few demographic differences were found. None of the mental health measures (Symptom Checklist–Short Form [SCL-10], Centre for Epidemiological Studies–Depression [CES-D-10], Posttraumatic Stress Disorder [PTSD] Checklist) were in the clinical ranges. In a MANCOVA on the mental health scales, with IPV severity, racial group, disability status, and child abuse history as variables, only disability was significantly associated with more mental health symptoms. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV), mental health, disabilities, and child abuse history were examined for 292 Indigenous compared with 295 non-Indigenous Canadian women. IPV was assessed by the Composite Abuse Scale and mental health by the Symptom Checklist-10, Center for Epidemiological Studies–Depression 10, the Posttraumatic Stress Disorder (PTSD) Checklist, and Quality of Life Questionnaire. Scores did not differ nor were they in the clinical ranges for the two groups. In a MANCOVA on the mental health/well-being scales, with IPV severity as a covariate, only disability was significantly associated with more severe mental health symptoms. Suggestions for service providers are presented. [ABSTRACT FROM AUTHOR]

Physical and emotional punishment of children is highly prevalent in the Asia-Pacific region. These actions predict a range of physical and emotional harms, prompting a worldwide effort to eliminate them. A key strategy in this effort is to change parental beliefs regarding the acceptability of physical and emotional punishment. The Positive Discipline in Everyday Parenting (PDEP) program was designed to change those beliefs by teaching parents about child development and strengthening their problem-solving skills. A sample of 377 parents in the Asia-Pacific region completed the program: 329 mothers and 47 fathers of children ranging in age from infancy to adolescence. The parents lived in Australia (n = 135), Japan (n = 172) or the Philippines (n = 70). In all three countries, parents' approval of punishment in general, and physical punishment specifically, declined and they became less likely to attribute typical child behavior to intentional misbehavior. By the end of the program, at least 75% of parents in each country felt better prepared to respond nonviolently to conflict with their children. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has many negative outcomes for women, children, and families. However, researchers have opposing perspectives and findings with respect to the effects on mothering for abused women. The assumption by some service providers that abused mothers are compromised in their parenting generally ignores the larger issue of male violence and women's and children's safety. The question examined in this study was whether there were differences in reported positive parenting responses with children between women who have experienced IPV and those who have not experienced IPV. The sample consisted of 1,211 mothers and came from two studies: The National Longitudinal Survey of Children and Youth, and The Healing Journey: A Longitudinal Study of Mothers Affected by Intimate Partner Violence. The Positive Interaction and Rational Parenting scales, adapted from Strayhorn and Weidman's Parenting Practices Scale, were used to measure parenting interactions. Bivariate correlations between the outcome variables and maternal age, maternal education, child age, and child sex were calculated to determine whether any of these variables were significantly related to the Positive Interaction Scale or Rational Parenting Scale. This was followed by ANCOVA to determine whether mothers who had experienced IPV differed in their scores on the two parenting scales from mothers who had not experienced IPV. Findings did not support the notion that abused women are compromised in their parenting responses with their children in regard to positive interactions and behavior management. Recommendations include a greater focus on the prevention of IPV, addressing the source of violence and providing appropriate support for mothers who experience IPV. [ABSTRACT FROM AUTHOR]

Physical punishment of children is linked to negative developmental outcomes. The widely used Positive Parenting Program (Triple P) promotes alternative responses to physical punishment. Data on the effectiveness of the Triple P Seminar Series is limited. In this study, Canadian parents' reports of physical punishment, non-physical punishment, and non-punitive responses were compared before and after they attended the Triple P Seminar Series. Twenty-seven parents of children aged 2 to 6 years attended the Seminar Series and completed pre- and post-intervention questionnaires measuring the number of times they used various physical punishments, non-physical punishments, and non-punitive responses in the past month. Hypotheses were tested using univariate descriptive analyses, paired samples t tests, and Wilcoxon Signed Rank Tests. Parents' reports of physical punishment decreased on only one of the four physical punishment items (shaking/grabbing) from pre- to post-intervention. Over the course of the Seminar Series, parents became more likely to emphasise rules and to punish their children by taking things away from them. The findings suggest that the Seminar Series has limited effectiveness in reducing physical punishments or increasing non-punitive responses. Further research on this question is needed. [ABSTRACT FROM AUTHOR]

Exposure to intimate partner violence is detrimental to children, but can abused mothers protect them, and, if so, what can they do? This study of 350 Canadian abused women represents the first quantitative examination of such protective strategies. The actions that mothers most commonly used and perceived as effective include showing affection and being nurturing to their children. The strategies often suggested by professionals, such as contacting police and obtaining protection orders, were used less and considered less effective than informal strategies. Professionals are urged to ask mothers what strategies they use, especially those who do not involve formal systems. [ABSTRACT FROM AUTHOR]

Most physical violence against children is punitive in intent. The United Nations has called for the elimination of physical punishment of children and for the development of programs teaching nonviolent resolution of parent-child conflict. A focused effort is required to shift entrenched, intergenerationally transmitted, and culturally normalized belief systems about physical punishment. Positive Discipline in Everyday Parenting (PDEP ) was developed to meet this need. Its short-term objectives are to: 1) reduce approval of physical punishment; 2) normalize parent-child conflict; and 3) strengthen parenting self-efficacy. PDEP was delivered by trained program facilitators to 321 parents living in 14 cities in Canada. Responses to pre and posttest questionnaires suggest that parents who completed postprogram measures were less likely to both approve of physical punishment and view typical parent-child conflict as misbehaviour on the part of the child, and also to have greater parenting self-efficacy. More than 90% believed more strongly that parents should not use physical punishment, and that PDEP would help them control their anger and build stronger relationships with their children. PDEP is a promising approach to the prevention of punitive violence against children. [ABSTRACT FROM AUTHOR]

We examined self-reported use of spanking as a discipline strategy in a Canadian sample of mothers and fathers (N = 2,340) of children aged 2 to 12 years using data from the International Parenting Survey–Canada. Logistic regression was conducted to assess the association between reported use of spanking and child characteristics (age, gender, disability status, and behaviour problems), adult demographic characteristics (age at birth of child, marital status, education, employment, and income inadequacy), as well as parent attitudes toward spanking. Approximately one quarter of parents reported spanking their child. Child age, parent education, employment, and income inadequacy had significant associations with reported spanking. When controlling for child and parent demographic characteristics, parent reports of child behaviour and parent attitudes toward spanking also had strong relationships with reported spanking. Results are discussed in relation to previous findings and in terms of implications for parenting interventions. [ABSTRACT FROM AUTHOR]

Many studies examine the impact of interprofessional (IP) interventions on various health practice and education outcomes. One significant gap is the lack of research on the effects of IP interventions on health human resource (HHR) outcomes. This project synthesized the literature on the impact of IP interventions at the pre- and post-licensure levels on quality workplace, staff satisfaction, recruitment, retention, turnover, choice of employment and cost effectiveness. Forty-one peer-reviewed articles and five IECPCP project reports were included in the review. We found that IP interventions at the post-licensure level improved provider satisfaction and workplace quality. Including IP learning opportunities into practice education in rural communities or in less popular healthcare specialties attracted a higher number of students and therefore may increase employment rates. This area requires more high quality studies to firmly establish the effectiveness of IP interventions in recruiting and retaining future healthcare professionals. There is strong evidence that IP interventions at the post-licensure level reduced patient care costs. The knowledge synthesis has enhanced our understanding of the relationships between IP interventions, IP collaboration and HHR outcomes. Gaps remain in the knowledge of staff retention and determination of staffing costs associated with IP interventions vis-à-vis patient care costs. None of the studies reported long-term data on graduate employment choice, which is essential to fully establish the effectiveness of IP interventions as a HHR recruitment strategy. [ABSTRACT FROM AUTHOR]

In this article, we discuss findings of a hermeneutic phenomenological study that sought to describe the experiences of parents who have a child with autism. Qualitative interviews were conducted with parents from 16 families of children with autism residing in a western Canadian province. "Living in a world of our own" emerged as the essence of the parents' experiences. In "living in a world of our own," parents described a world of isolation. Three themes representing the essential challenging elements of the parents' experiences included vigilant parenting, sustaining the self and family, and fighting all the way. Although much is known about the fundamental importance of support to parents of children with chronic conditions and/or disabilities, findings from this study indicate that knowledge has not been adequately transferred to the care of children with autism. [ABSTRACT FROM AUTHOR]

Although parenting is one of the most important roles undertaken during an individual's lifetime, the amount of information and education that parents receive for this role is variable and often minimal. Parenting behaviors are influenced by a variety of factors and conditions such as knowledge levels, and parenting abilities vary with parents' own childhood experiences, value systems, education levels, and other life experiences. One ongoing parenting issue is the management of and appropriate response to child misbehavior. A review of the topics of discipline and physical punishment are discussed in this article in relation to definitions, practice, and outcomes. A study of parents' attitudes regarding physical punishment and their sources and needs for related parenting education are presented. Findings from this study (N = 170) indicate that parents receive parenting information from a variety of sources, most frequently through discussions with other parents, books on parenting, and their own experiences. The topics identified most frequently by respondents are age-appropriate disciplinary responses and expected child development and behaviors. These areas of information should be made available on a wide basis to parents of young children. [ABSTRACT FROM AUTHOR]

The investigators examined differences in perceived and performed infant care competence for younger (less than 17 years of age) and older (17 to 19 years of age) adolescent mothers. Associations were tested between perceived infant care competence measured at several time points and performed mothering at 12 to 18 months infant age. A convenience sample of 78 adolescent mothers was recruited from two major teaching hospitals in Winnipeg, Canada. The Infant Care Questionnaire (ICQ), a self-report measure of infant care ability, was completed during the 3rd trimester and the 1st and 4th postnatal weeks. Performed mothering was assessed with Caldwell's HOME scale administered in the adolescent mother's home when the infant was 12 to 18 months old. Significant increases in competence perceptions over time were demonstrated for both ICQ subscales, the Mom&Baby, F(2, 47) = 22.73, p = 0.000, and Emotionality, F(2, 47) = 43.16, p = 0.000. This increase in infant care competence mirrors the maternal role competence trajectory reported in studies with older mothers. While no significant age group differences were found for Mom&Baby or Emotionality, older adolescent mothers were rated significantly higher on one of the HOME subscales, Variety in Daily Stimulation, t(n = 45), = 2.12, p = .04, and a second approached significance, Responsiveness, t(n = 45) = 1.86, p = .07. Pearson correlations between the Mom&Baby and Emotionality and the HOME subscales, Responsiveness and Environment, ranged between -0.30 and -0.37. Future research is required to further explain the negative correlations between perceived and performed infant care competence, establish clinical validity of self-report methods with adolescent mothers, and assess the influence of social, cultural, and economic factors not considered in this study. [ABSTRACT FROM AUTHOR]