Search

Children with autism engage in active play in different ways than children who are neurotypical, but their active play behaviors are not well understood. Research with twins and triplets with autism offers a unique opportunity to gain a clear picture of the play behaviors of children with autism because twins and triplets share many similarities (age, access to toys, etc.). Through semistructured interviews, this descriptive phenomenological study aimed to describe the active play behaviors of 19 twins and triplets with autism from the perspective of their parents (N = 9). The interviews revealed two main themes: (a) parents' descriptions of active play and (b) parents' descriptions of social play. The results reveal the diverse active and social play behaviors of twins and triplets with autism; parents described their children's play behavior when engaging in sensory, indoor, outdoor, and organized play. These results suggest that children with autism may be meeting the definition of active play in nontraditional ways. [ABSTRACT FROM AUTHOR]

Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors. [ABSTRACT FROM AUTHOR]

Children naturally seek risk in play and adventurous play outdoors confers many benefits, including the potential to increase moderate-to-vigorous physical activity (MVPA). This study aimed to investigate the relationship between parent attitudes to risk and injury, and their elementary school-aged child's daily adventurous play and MVPA. A panel sample of 645 Australian parents/guardians completed an online survey consisting of several validated measures of risk and injury attitudes, and physical activity and play behaviour. Data were analysed via descriptive statistics, univariate and multivariable regressions using Stata 17. A series of exploratory univariate logistic regressions were conducted, followed by a series of multivariable logistic regressions fitted to test the association between parent risk and injury attitudes and (i) children's MVPA, (ii) active play and (iii) adventurous play, while adjusting for socio-demographic factors. Most adult participants (81%) were female. The mean age of the child participants (53% male) was 8.6 years (SD = 2.4). On average, parents were positive about children's engagement with risk, however, 78% of parents had low tolerance of risk when presented with specific play scenarios, and attitudes towards injuries varied, with mothers more concerned than fathers. After adjusting for confounders, children with parents who were tolerant of risk in play were more likely to meet the MVPA guideline of ≥60 min daily (OR 2.86, CI: 1.41, 5.82, p < 0.004) and spend more time playing adventurously (OR 3.03, CI: 1.82, 5.06, p < 0.001). Positive associations for MVPA and adventurous play were observed across all models examining parent attitudes to risk and injury. Younger children engaged in more play and physical activity, however, more positive parent attitudes appeared to moderate the age-related influences. We found a divergence between the outcomes parents desire for their children through engagement with risk and the play activities they are comfortable with in practice. Parent attitudes to risk and injury are potentially modifiable factors that may increase children's affordances for adventurous play and physical activity. Interventions that provide parents with practical approaches to address injury concerns and support children's risk-taking in play outdoors are recommended. • 78% of parents had low tolerance of risk when presented with a series of play scenarios. • However, on average, parents were positive about their children's engagement with risk in physical activity. • Attitudes towards injuries varied, with mothers more concerned than fathers. • MVPA was lower in children whose parents were less risk and injury tolerant. • Children of parents with more positive attitudes to risk and injury had more adventurous play. [ABSTRACT FROM AUTHOR]

The article presents the discussion on blended feeds were recognized to be much more viscous than formula, raising concern for tube obstructions. Topics include gastrostomy tube placement is among the most common procedures in the pediatric population; and nutrition service can arrange to evaluate and provide recommendations for the patient on the day of surgery.

Copyright of Interscientific Health Care is the property of University of Thessaly, Medical School / Technological Education Institute, Nursing Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ethnic-racial pride (positive feelings about one's ethnic-racial group) is critical to healthy identity development across the lifespan. Research on ethnic-racial pride development among Latinx populations has focused exclusively on youth, without regard to pride development amongst parents and relations between pride within family units. Using multivariate Latent Growth Curve Modelling among 674 Mexican-origin youth and their parents (673 mothers; 437 fathers), the trajectory of youth's pride from 5th grade through emerging adulthood (14 years/12 waves of data) as well as relations with parental pride trajectories were examined. Respondents' pride generally decreased from waves 1 to 7 (~age 11–17 in youth) and increased after wave 7. Youth's and mothers' trajectories were unrelated, but complex associations emerged between youth's and fathers' trajectories. This study supports the dynamic nature of ethnic-racial pride across distinct life stages and underscores the complex interplay of youth and parental pride trajectories, emphasizing the pivotal role parents may play in co-shaping identity development alongside their children. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of older adults with intellectual disabilities are living with ageing parents. These families need support to plan for the future to avoid crisis interventions following parental death. Method: Interviews and focus groups were conducted with people with intellectual disabilities (aged 40+) (N = 9), parents (N = 11) and siblings (N = 16) to understand their perspectives about living with parents and future planning. Data were analysed using framework analysis. Results: Four themes were identified: 'What matters to me', 'When should we plan', 'What are the options' and 'Who will help'. Participants knew they needed to make plans but did not feel supported to do so. While they viewed moving as an opportunity for independence, they feared there were no viable alternatives. Conclusion: Person‐centred resources and support are needed for families to plan for transitions in care, including proactive approaches from social services and help to prepare for conversations with social care professionals. [ABSTRACT FROM AUTHOR]

Background: Cooperation between parents and school nurses is essential for the successful completion of school courses and a healthy school life for children with long-term conditions. Therefore, this study aimed to develop and test a scale to measure parental perceptions of partnerships between school nurses and parents in the school health care (SHC) system for children with type 1 diabetes (T1D). Methods: The content validity, factorial structure validity, convergent validity, discriminant validity, known-group validity, internal consistency reliability, and test-retest reliability of the School Healthcare Partnership Scale for Parents (SHCPS-P) were evaluated. Data were analyzed by performing exploratory factor analysis (EFA), Pearson's correlation, Cronbach's α, and independent t -tests. The total sample included 155 parents for the EFA and 49 parents for the stability test. Seventeen items, grouped into 3 dimensions, were extracted through principal axis factoring. Results: The total variance explained by these factors was 53.57%. The scale demonstrated a high correlation with parental satisfaction regarding school nursing and a moderate correlation with diabetes-related safety, thereby showing convergent validity. A low correlation with empathy demonstrated discriminant validity. A significant difference existed in the partnership scores in known-group comparisons. Cronbach's α was 0.95, and the test-retest correlation coefficient was 0.95, which showed reliability. Conclusions: This study suggests that the SHCPS-P is a reliable and valid tool for measuring the perception of SHC partnership among parents of children with T1D and can be used as an indicator to measure parents' perspectives about SHC. [ABSTRACT FROM AUTHOR]

This study explores whether the frequency and diversity of behaviours observed during contact visits may be used as indicators of visit quality. We observed 20 contact visits and quantified the frequency and diversity of behaviours for both parent and child, classified as positive or negative with respect to the child's well‐being. Quality of visits was classified based on a list of parent and child behaviours and two indicators (diversity and frequency), to create two observational checklists and calculate an overall quality index. This observational tool will enable identification of areas where birth parents or their child require additional support. [ABSTRACT FROM AUTHOR]

Parent training programs aimed at improving language outcomes for children with complex communication needs have predominantly been evaluated on child-centered outcomes and less often on the impact on social life or parental well-being. This study examined parent perceptions of social life before and after ComAlong, a group intervention providing parents with knowledge and training in responsive communication, environmental-milieu teaching strategies and augmentative and alternative communication (AAC). Parents (N = 467) completed questionnaires during the first and last sessions of ComAlong groups held in Sweden 2012 to 2018. Main outcome measure was change in the Social Life Scale from the Family Impact Questionnaire. Associations between this measure and demographic factors of parents and children were analyzed, along with reported change in parents' use of AAC. Pre-post comparisons revealed small significant positive changes in perceived impact of social life following intervention. The magnitude of the positive change was larger among parents of children with non-syndromic diagnoses and parents of children with autism spectrum disorder or attention deficit hyper activity disorder (ADHD). Differences in social life impact was not associated with parents' gender, language proficiency, age, or educational background. In conclusion, communication-focused parent training programs can have a positive impact on social family life and may thereby influence children's participation. [ABSTRACT FROM AUTHOR]

Background: Routine height and weight screening of children accessing health services in South Western Sydney Local Health District (SWSLHD) was implemented to address childhood obesity. This qualitative study aims to explore the views of parents/carers regarding the role of healthcare professionals (HCPs) in measuring their child and raising the issue of weight when accessing health services. Methods: A qualitative study using semi-structured interviews was performed. Parents/carers of children who had their height and weight measured at a SWSLHD facility were invited to participate. Purposive sampling was used to select parents/carers of children from different body mass index (BMI) categories and different health settings. Interviews were digitally audio-recorded and transcribed verbatim. The de-identified data were coded and analysed thematically using NVivo. Results: A total of 24 semi-structured interviews were conducted. Of these, 14 were of parents/carers of children who were outside the healthy weight range. Three main themes were identified: parental perception of their child's weight, parental expectations, and parental challenges. We found that many parents/carers were unaware of their child's weight status and often underestimated it. Many were open to receiving advice and resources as long as it was addressed professionally and respectfully. Conclusions: Contrary to the views of some health professionals, parents/carers want to know their child's weight status. They valued the information and advice provided by well-trained clinicians who are confident to raise the issue of weight with parents/carers. Healthcare professionals (HCPs) are often reluctant to perform height and weight measurements or raise the issue of weight. In contrast, parents/carers often expect weight concerns to be addressed during episodes of care. Increasing HCP awareness of parents'/carers' views and expectations in the prevention and management of obesity may lead to clinical practice improvements and provide a first step in addressing excess weight gain in children. [ABSTRACT FROM AUTHOR]

Parents play an important role in scaffolding autonomy and independence as their children transition to adulthood. In the digital age, mobile phones allow for increased connection at this important developmental transition, but we know little about the extent to which digital connection may help (i.e., through developmentally appropriate support) or hinder (i.e., through intrusiveness or helicopter parenting) emerging adult (EA) autonomy development. We tested whether digital parent-EA interactions tapping engagement, monitoring, and responsiveness were associated with EA perceptions of parental autonomy support in a sample of 238 college students (M age = 19.85) who contributed all text messages exchanged with their parents over 2 weeks. Results indicate that many dimensions of parent-EA text message interactions are unrelated to perceived parental autonomy support, but those that did emerge point towards a potentially maladaptive role of overparenting in associations with less perceived parental autonomy support. Results underscore that, for most EAs, parental text messaging is not likely to be perceived as autonomy inhibiting, but that for a small minority of parent-EA dyads, intense levels of digital connection with parents may be associated with perceived autonomy inhibition. [ABSTRACT FROM AUTHOR]

Informed by the goodness-of-fit model, goal theories, and literature on support gaps, this study examines the associations between congruence/discrepancies in parent-adolescent expectations of the adolescent's educational and career goals and adolescents' perceived overparenting. Data were collected through a survey of 122 parent-adolescent dyads from four high schools in the U.S. Results from second-order polynomial regression with response surface analysis indicated that parental high educational or career goal expectation alone was not necessarily related to adolescents' perception of overparenting. Rather, adolescents' perception of overparenting depended on the congruence/discrepancies in parents' and adolescents' expectations. Compared to parent-adolescent congruence in high or low expectations, either direction of expectation discrepancies—either parents' expectation exceeds adolescents' expectation, or adolescents' expectation exceeds their parents—was more likely to be associated with adolescents' perception of overparenting. Parenting intervention and educational programs should acknowledge that discrepancies in parents' and adolescents' educational and career goals could potentially contribute to parental overparenting. Fostering communication and negotiation of goal expectations between parents and adolescents may help reduce the practice of overparenting. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about the early stress experiences of parents of infants with serious life-limiting/life-threatening conditions during the initial months after discharge from hospital. The aim of the study was to measure change, and predictors of change, in parenting stress at the time of transition from hospital to home (T1) with a medically fragile infant, and after a 3-month period (T2). Methods: Parents of infants identified as meeting ≥ 1 palliative care referral criterion were recruited in a Midwestern United States tertiary pediatric hospital (2012–2014) within 2 weeks of hospital discharge. A repeated measures design was used to assess change on a validated parenting stress inventory over the two timepoints (T1 and T2). Fifty-two parents (61 infants) participated at T1 and 44 (85%) at T2. Results: On discharge (T1) stress was moderately high 3 months post discharge (T2) overall and domain-specific stress scores improved, except stress related to parent role functioning and participation in their child's medical care. Independent predictors of improvement in overall parenting stress scores (T2-T1) were being a younger parent and having experienced prior pregnancy-related loss. Conclusions for Practice: The time of discharge from hospital to home is often stressful for parents of medically fragile infants. Improvements were found during the first 3 months at home, but improvement was minimal for stress related to role function and providing medical care. Past experience with pregnancy-related loss and being younger were associated with improvement in stress across theoretical domains. Screening for stress should be included as part of routine pre- and post-neonatal intensive care unit discharge psychosocial assessments of parents caring for infants with serious illness to ensure their unique support needs continue to be met over time. Significance: What is already known about the topic? Stress in parents of sick infants is well-documented in the post-birth hospitalization period. Early management of parent stress after a child is born with a life-limiting/life-threatening condition is critical in promoting healthy infant attachment and development. What this study adds? Parents of medically fragile infants experience notable stress during the initial months at home. Pre-hospital discharge attention to medical and psychosocial characteristics of infants and parents may help health care teams anticipate post-discharge parenting challenges and facilitate personalized home support strategies aimed at minimizing parent stress and poor parent–child outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Busyness as a construct within modern healthcare is complex and multidimensional. To date, few studies have sought to explore how busyness influences family‐centred care. This study explored the influence of busyness on the delivery of family‐centred care for nurses and parents. Design and Method: Ethnography was selected as the research design. The study site was a metropolitan tertiary hospital inpatient paediatric unit in Sydney, Australia. Semi‐structured interview and non‐participant observation techniques were used for data collection. Ten paediatric nurses and 10 parents were interviewed and 40 h of non‐participant observations were undertaken. The COREQ was used to report the study. Results: The findings are presented as three key themes: (i) 'Supporting family‐centred care' in which participants detail beliefs about the nurse‐parent relationships and how despite busyness nurses sought out moments to engage with parents; (ii) 'Being present at the bedside' identified the challenges in optimising safety and how parents adapted their way of being and interacting on the unit; and (iii) 'The emotional cost of busyness' and how this influenced nurse‐parent interactions, care delivery and family‐centred care. Conclusions: The ethnography has given shape to social understandings of busyness, the complexities of paediatric nursing and family‐centred care. The culture of care changed in moments of busyness and transformed parent and nursing roles, expectations and collaborative care that at time generated internal emotional conflict and tension. Practice implications: Given the increasing work demands across health systems, new agile ways of working need to ensure maintenance of a family‐centred approach. Strategies need to be developed during periods of busyness to better support collaborative connections and the well‐being of paediatric nurses and parents. At an organisational level, fostering a positive workplace culture that shares a vision for family‐centred care and collaboration is essential. Patient or Public Contribution: Parents of sick children admitted to an acute paediatric inpatient ward were invited to be a participant in a single interview. Parents were aware of the study through ward advertisement and informal discussions with the researchers or senior clinical staff. Engagement with parents was important as healthcare delivery in paediatrics is focused on the delivery of family‐centred care. To minimise the risk of child distress and separation anxiety, children were present during the parent interview. Whist children and young people voices were not silenced during the interview process, for this study the parent's voice remained the focus. While important, due to limited resources, parents were not involved in the design analysis or interpretation of the data or in the preparation of this manuscript. Data sharing: The data that support the findings of this study are available from the corresponding author upon reasonable request. [ABSTRACT FROM AUTHOR]

Aims: To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self‐management and transition readiness. Design: Cross‐sectional international study, reported following STROBE guidelines. Methods: Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State–Trait Anxiety Inventory short form). Perceptions of health self‐management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. Results: Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self‐management and transition readiness. Conclusion: Transition readiness should be determined by an assessment of knowledge, self‐management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. Implications for Patient Care: Transition readiness and self‐management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. Reporting Method: We have adhered to the STROBE statement, using STROBE checklist for cross‐sectional studies. Patient or Public Involvement Statement: No patient or public involvement. Trial and Protocol Registration: ClinicalTrials.org NCT04631965. [ABSTRACT FROM AUTHOR]

Background: The number of artificial intelligence (AI) literacy studies in K‐12 education has recently increased, with most research focusing on primary and secondary education contexts. Little research focuses on AI literacy programs in early childhood education. Objectives: The aim of this mixed‐methods study is to examine the feasibility of an AI literacy program called "AI4KG" and explore how it might affect kindergarteners' perceptions of robots and attitudes towards engineering and science. Methods: A total of 26 child–parent dyads recruited from a Hong Kong kindergarten were involved in this study, consisting of 26 children (Mage = 4 years, SD = 0.28) and their parents. Quantitative and qualitative data were collected through surveys and interviews designed to explore children's perceptions of robots and attitudes towards engineering and science, and parents' perceptions of the AI4KG intervention. Results: It is found that children have increased their perceptions of robots after the AI literacy program, but the AI4KG curriculum had no significant effects on kindergarten children's engineering and science attitudes. Most parents (22 out of 26) agreed that their children's AI knowledge, AI skills, and AI attitudes have been enhanced after learning through the AI4KG curriculum. Conclusions: This study suggests that the AI4KG curriculum is potentially effective in promoting early AI literacy and favourable attitudes towards the technology, but further research is needed to develop age‐appropriate measures and assess its long‐term impact on children's education and career paths. Lay Description: What is currently known about this topic?: AI literacy is becoming important as AI transforms society, but few studies have explored AI literacy in early childhood education.Prior research found AI activities can positively influence older children's views of robots and engineering. What does this paper add?: It evaluates an 8‐week AI literacy curriculum called AI4KG for kindergarteners in Hong Kong.The curriculum used tools like Teachable Machine and taught concepts through play and storytelling.It improved children's perceptions of robots but did not significantly impact engineering/science attitudes.Parents perceived improvements in children's AI knowledge, skills, and attitudes after the curriculum. Implications for practice/policy: The curriculum provides an example for developing age‐appropriate AI literacy activities.More rigorous research on impacts over time is needed, but results suggest potential benefits of AI literacy in early childhood.Policymakers could consider incorporating AI literacy into kindergarten curricula to prepare children for the future. [ABSTRACT FROM AUTHOR]

Background: In today's society, a growing body of literature attests to the importance of young children's early digital literacy skills in their home environments and how acquisition of these digital literacy skills relates to their future learning and digital literacy. Objectives: Research on young children's digital literacy practices at home was reviewed to explore the positive and negative influences on early learning. This is important due to the children's rapid uptake of online digital technologies over the past decade. Methods: Peer‐reviewed research articles on home digital literacy practices of children (aged 0–8 years old) published between 2010 and 2021 from four education databases were carefully selected based upon pre‐determined criteria and examined using content analysis. Results and Conclusion: A high proportion of studies (29 of the 31; 93.5%) demonstrated significant benefits of young children gaining a range of skills, including digital operational, early literacy and language, socio‐emotional, and STEM, through the use of digital technologies at home. Five of the 31 (16.12%) studies reported negative effects of digital technologies in the home context, including distraction, aggressive behaviour, and false self‐confidence. Tablets and smartphone use gained greater momentum in the home context, especially between 2015 and 2021, and there was a positive shift in parental mediation, family involvement, and the children's home digital literacy practices. Implications: By leveraging children's acquisition of digital literacy skills in the home and taking into account the sociocultural context, we can enhance young children's preparation for the future and provide opportunities for skill development across various learning domains. Lay Description: What is already known about this topic: The literature shows use of tablets in the home by children have gained momentum.Parents have different attitudes towards using digital technologies in the home context.Parents have used different mediation strategies to control, supervise and support their children's home digital literacy practices. What this paper adds: Within the past decade, parents have extended their mediation strategies to support their children's home digital literacy practices.Young children move from early digital literacy to proficient digital literacy within the home.Home digital literacy practices can foster important skills in young children such as language and literacy, operational, socio‐emotional, and STEM.Artificial intelligence devices such as smart robots are extending children's home digital literacy practices. Implications for practice and/or policy: Understanding the sociocultural differences of young children can help parents, teachers, and policymakers to facilitate digital literacy skill acquisition.Fostering young children's basic language literacy, operational, socio‐emotional, and STEM skills through technology use in the home before formal education is essential.Extending young children's home digital literacy practices to other contexts such as the classroom is necessary. [ABSTRACT FROM AUTHOR]

Introduction: Throughout the coronavirus disease 2019 (COVID‐19) pandemic, parents and children faced significant challenges as a result of prevention measures implemented to control the spread of the disease. Ensuring that families have access to essential health information is critical for improving health outcomes and adherence to public health recommendations. Understanding parents' experiences and information needs related to the pandemic and associated health measures (e.g., vaccination, mask wearing, social distancing, etc.) will inform the development and dissemination of resources tailored to parents' needs to support informed decision making. Methods: We conducted a qualitative descriptive study. Between September and November 2021, parents across Canada were recruited online via social media and community organisation newsletters and listservs to participate in focus groups via Zoom. Focus groups were audio‐recorded and transcribed verbatim. Data were coded and analysed using thematic analysis. Participants completed a demographic questionnaire before the focus groups (via SimpleSurveys). Results: Sixty‐seven parents participated in 12 focus groups between October and November 2021. In relation to experiences, parents felt they were (1) constantly trying to balance everything, and (2) trying to do their best with the information they had at the time when making decisions. Regarding information needs, parents reflected on (1) how difficult it was navigating copious amounts of changing information and finding credible sources to rely on, (2) the need for resources that were easily accessible, credible and in plain language and (3) the need for resources that were tailored to their needs to support them and their children make informed decisions. Conclusions: Trying to mitigate the risk of COVID‐19 infection and adhere to public health recommendations, while balancing various factors (work, online learning, and social interactions) and navigating changing information, was overwhelming for many parents. Reflecting on their needs, parents suggested tailored resources that provided concise, credible information in plain language to help them make informed decisions and navigate conflicting information. These findings reveal important knowledge gaps and highlight areas that need to be addressed to support parents during the pandemic period and beyond. Patient or Public Contribution: Members of our established Paediatric Parent Advisory Group (P‐PAG) were involved as collaborators throughout the planning (grant proposal), development and execution of the study. P‐PAG members gave input on the design of the questionnaire, interview guide, recruitment strategy and interpretation of findings. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents with Type 1 diabetes are a cohort whose self‐management of their diabetes care often declines during adolescence which can lead to adverse health outcomes. Research indicates that providers find it challenging to engage adolescents in communication exchanges during triadic encounters in diabetes clinics. Our study aimed to explore adolescents, parents, and providers' experiences of clinic encounters. Methods: A qualitative study was conducted with a convenience sample of 13 adolescents with Type 1 diabetes (aged 11–17), 14 parents, and seven providers. Participants were recruited from two outpatient diabetes clinics in two urban children's hospitals, Ireland. Data were obtained using a combination of interviews and focus groups. Data were analysed thematically. Results: Adolescents and their parents appeared to hold both positive and negative experiences of diabetes clinic encounters. Providers reported challenges associated with engaging adolescents in communication exchanges. The structure, focus and style of clinic encounters created barriers that potentially led to suboptimal adolescent participation and impaired provider–adolescent communication during clinic visits. Conclusions: The findings provide insights into the challenges associated with adolescents' engagement in communication encounters in diabetes clinics. Healthcare providers could encourage adolescents to be more actively involved in their diabetes management, by taking an adolescent‐centred approach and creating a nonjudgemental milieu. Focusing on adolescent's agenda could lead to more meaningful and relevant discussions between providers and adolescents and ensure more tailored education in the time available. Adolescence is a risky period for nonadherence and adverse health complications; therefore, it is critical that providers make every contact count in diabetes clinic encounters. Patient or Public Involvement: The study's design and delivery were guided by two advisory groups, comprising (1) five adolescents living with Type 1 diabetes (T1D) and (2) five parents of an adolescent with T1D. [ABSTRACT FROM AUTHOR]

The relationship between the change in the screen time of preschool children according to both parent–child characteristics and parental attitudes was investigated in an online study involving 403 mothers. Mothers completed a questionnaire on baseline characteristics and Parent Attitude Scale. Multiple logistic regression and generalized linear models revealed the associations. Change in screen time was grouped as "increase" and "no increase". 70% stated an increase in the screen time during the pandemic period. The overprotective score was low in the group with increased screen time after adjusting parental age, education, and working status, family type, number of the children, the enrolled child's age, gender, daily screen time before the pandemic, and caregiver of the child. The child having longer screen time also had higher risk for the history of an increase in screen time in the lockdown period. This situation shows a need for parental guidance for healthy screen use. [ABSTRACT FROM AUTHOR]

This study explores longitudinal influences of various factors on Black parents' involvement in their children's education. Guided by Hoover-Dempsey & Sandler's Model of Parent Involvement, this research examines whether parents' school climate perceptions, attitudes about involvement, self-efficacy, and children's academic performance predict parent involvement over time. Utilizing data from the Maryland Adolescence in Context Study with a sample of 560 Black parents, we found that positive school climate perceptions and favorable attitudes towards involvement significantly predict increased parent involvement in later years. The results underscore the importance of supportive school environments and parent attitudes in fostering their involvement. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Research shows the important role of parents' mental health literacy in detecting depressive symptoms and supporting their children to seek professional help. Improving mental health literacy in parents has recently gained even greater importance due to the negative impact of the COVID-19 pandemic on children and adolescents' mental health. The aim of the present experimental pre-post-follow-up study was to examine knowledge change after the reception of contents from an innovative web-based platform (www.ich-bin-alles.de/eltern) containing evidence-based information on youth depression and mental health in parents of adolescents with a history of depression. A second aim was to assess evaluation of the layout and the acceptance of the platform. N = 33 parents of adolescents with a history of depression (either current or remitted depression) were presented different content domains of the website. Participants' knowledge about depression was assessed at pre- and post-intervention, and at a four week follow-up. Moreover, parents evaluated the acceptance and the layout of the website. The trial was preregistered at clinicaltrials.gov (NCT05335564). The results showed a significant increase in total knowledge from pre to post, which remained stable over the course of four weeks. Explorative analyses showed that sociodemographic variables did not influence the extent of knowledge gain. Acceptance rates were high and evaluations of the website's layout were positive. The findings show that the web-based information portal is a promising and appealing means to increase parental knowledge on youth depression. Low-threshold psychoeducational approaches like websites are particularly relevant in times of crisis and increased prevalence rates of depressive symptoms and disorders (ehealth). These results are an important basis for future studies as well as approaches that aim to impart knowledge about mental disorders like youth depression via web-based means. Furthermore, they bear implications for policy decisions concerning mental health education and campaigns. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the relationship between nursing students' perceived parental child-rearing attitude, ego identity, and college adjustment in Korea and explore factors that influence college adjustment. Methods: This study surveyed 224 nursing students enrolled in universities located in two regions within South Korea. Data were collected from October 14 to November 31, 2019. Perceived parental child-rearing attitude (paternal emotional warmth, paternal rejection, paternal overprotection, maternal emotional warmth, maternal rejection, and maternal overprotection) and ego identity of nursing students were used as independent variables on college adjustment. Collected data were subjected to correlation analysis using SPSS version 26.0 for Windows. Further, regression analysis was performed on the influence of parental child-rearing attitude and ego identity on college adjustment. Results: Among the parental child-rearing attitudes, paternal emotional warmth (r =.30, p <.001), maternal emotional warmth (r =.38, p <.001), and ego identity (r =.71, p <.001) were positively correlated with nursing students' college adjustment, whereas maternal rejection was negatively correlated with ego identity (r = −.28, p <.001) and college adjustment (r = −.15, p =.025). Regression analysis of the effects of nursing students' perceived parental child-rearing attitude and ego identity on college adjustment, with grade as a control variable, revealed that ego identity (p <.001) had a significant effect on college adjustment, and the higher the ego identity (β = 0.712), the higher the college adjustment. Further, the explanatory power of explaining college adjustment was high at 49.9%. Conclusions: The nursing students' perceived paternal emotional warmth, maternal emotional warmth, and ego identity were positively correlated with college adjustment. Additionally, ego identity was found as the influencing factor in Korean nursing students' college adjustment. Therefore, programs to strengthen ego identity should be developed and implemented for college adjustment among nursing students. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to identify the common factors that help and hinder transgender and nonbinary youth accessing gender‐specific health care in Ireland and to identify how these factors may be perceived differently by young people seeking gender‐affirming care, their parents, and health‐care providers. Design: Qualitative investigation utilizing framework analysis (FA). Methods: In‐depth one–one interviews were conducted with transgender and nonbinary youth (n = 10), parents of youth (n = 10), and gender‐specific health‐care providers (n = 10). Maximum variation and snowball sampling were used to recruit participants across Ireland. An interview guide codesigned with an expert panel of gender‐diverse youth was utilized. Interviews were audio‐recorded and transcribed verbatim. FA was used to code the data and identify key issues and recommendations. Results: Four themes were derived: (1) "Needing bricks to build" (structural factors); (2) "Enduring and convincing" (diagnostic factors); (3) "Being me, hiding me"; (personal factors); and (4) "It takes a tribe" (interpersonal factors). Each stakeholder group perceived different factors as help or hindrance in accessing care with varying intensities. Conclusions: Paramount to the future of gender services in Ireland is the investment of resources for children and young adults. Assessment is likely to remain a component of gender care, but youth recommend distinct revisions to the assessment process. Additional research would be useful in exploring the intersection of neurodiversity and gender as it pertains to health‐care navigation. Family and peer support is a strong protective factor and enabler of health‐care access among youth. Clinical Relevance: Access to gender‐specific health care remains difficult for transgender and non‐binary youth. An understanding of the complexity of this healthcare navigation by healthcare professionals may help to mitigate future negative experiences. This study explores some of the clinical considerations that arise for this population from provider perspectives while elucidating the experiences of youth and parents attempting to access care. Further research is needed on longitudinal outcomes following medical and surgical interventions for transgender youth, including nonbinary identities. [ABSTRACT FROM AUTHOR]

Introduction: Transgender and nonbinary young adults (TNB YA) report high rates of depression and more suicidality than their cisgender counterparts. Parental rejection is a known predictor of worse mental health among TNB YA; however, less is known about TNB YA experiences of sibling acceptance‐rejection. The purpose of this study was to determine how TNB YA perception of sibling and parental acceptance‐rejection are related to TNB YA depression and suicidality. Design: Cross‐sectional. Methods: TNB YA (ages 18–25) who had disclosed their gender identity to an adult sibling were recruited to take part in an online study and completed measures of sibling and parent acceptance‐rejection, depression, as well as lifetime and past year suicidality. Stepwise regressions were conducted to evaluate associations between acceptance‐rejection and TNB YA depression and suicidality. Results: The sample consisted of 286 TNB YA (Mage = 21.5, SD = 2.2) who were predominantly White (80.6%) and assigned female sex at birth (92.7%). Each family member's acceptance‐rejection was associated with increased TNB YA depression scores when considered independently and combined. Independently, high rejection from each family member was associated with greater odds of reporting most suicidality outcomes. When all family members were considered together, only high rejection from a male parent was associated with four times greater odds of reporting lifetime suicidality. High rejection from both parents was associated with greater odds of reporting past year suicide attempt (OR: 3.26 female parent; 2.75 male parent). Conclusion: Rejection from family members is associated with worse depression and suicidality, and rejection from male parents may be particularly damaging. Sibling acceptance uniquely contributes to TNB YA's depression symptoms alone and in the context of parental support. [ABSTRACT FROM AUTHOR]

Objective: To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish. Design and methods: This study had a cross‐sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item‐total correlation coefficients, and test–retest method were used. Results: As a result of psychometric analysis, the scale was found to have a three‐factor structure. The factor loads of the items were between 0.838 and 0.715. The three‐factor construct showed a good fit in confirmatory factor analysis (X2(41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item‐total correlation of the scale was found to be between 0.355 and 0.626. The test–retest intra‐class correlation coefficient of the scale was 0.72. Conclusions: This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) and child maltreatment (CM) – together referred to as family violence (FV) – often co‐occur. In Finland, public health nurses play an important role in identifying FV. They regularly meet families and assess children's health until the child turns seven. This nationwide retrospective cross‐sectional survey (FinChildren) aimed to describe and compare help and support needs in violent families from the perspectives of the parents of four‐year‐old children and public health nurses for advancing families' and professionals' collaboration in preventing FV. The data (N = 7476 families) included the responses of one parent from each family and public health nurses, caring for that certain family. The data analysis encompassed statistical methods. The results showed that 47.0% of the parents reported FV. The public health nurses assessed that 0.7% of the parents would have needed support for CM and 1.3% for IPV. They assessed that the parents involved in FV needed more support for their personal coping (p < 0.001) and intimate relationship (p < 0.017) compared with parents without FV. These parents were also found to have other support needs. We concluded that public health nurses recognise only a fraction of FV occurring in families. Risk assessment tools are needed to enable child and family professionals to better intervene in and prevent FV. [ABSTRACT FROM AUTHOR]

Background: Assessing patient experiences is essential to provide high quality health‐care. The objectives of this study were to examine (1) child‐ and parent‐reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement. Methods: Children (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors. Before MRI n = 132 accompanying parents and n = 91 children provided data (after MRI: n = 93 parents; n = 71 children). The mean age of the children undergoing MRI was 10.5 years (SD = 4.9). Children had on average seven previous MRIs before our survey (Range: 1–33). Twenty‐three percent of the children were to be sedated during the examination. Results: Parents and children reported low to medium levels of burden, high knowledge and high information status. For the children, most stressful factors during the MRI were boredom and noise. Main information resources were the radiologists or self‐searches. Parents of children with their first MRI reported higher anxiety levels in their children and stated a worse information status (main information source: self‐searches/internet). Parents reported needs regarding organization of the MRI (e.g., reduction of waiting times), age‐appropriate information and communication during the MRI. Children wished to visit the MRI room prior the examination (44%) and to get more information (44%). Children suggested improvements such as better sound quality of films/music, more transparency about the procedure, being in contact with a parent and shorter examinations. Conclusion: Results suggest that preparation, information provision and care is perceived positively by families. Needs and suggestions for improvement were, for example, higher transparency of procedures, better communication and reduction of stress. Findings indicate that preparation in routine‐care should follow an individualized child‐focused approach, should focus on families without previous MRIs and should address children with high anxiety levels. [ABSTRACT FROM AUTHOR]

Background: Low participation in youth with autism spectrum disorder (ASD) has been reported, but age‐related and contextual information is rare. Objective: This study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5–11) and adolescents (age: 12–17) with ASD in Switzerland. Method: A cross‐sectional design used the German version of the Participation and Environment Measure‐Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change. Results: Participation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement. Conclusions: This study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD. [ABSTRACT FROM AUTHOR]

Objectives: The first 5 years of life are critical to children's health and development. Sociocultural and environmental factors play a prominent role as do variations in the quality of resources available. The objective of this study, grounded in Asset Based Community Development and the Model of Children's Health and its Influences, was to identify and understand these factors through the lens of parents living in predominantly African-American low-income communities within Washington, DC. Methods: An exploratory qualitative study employed semi-structured virtual interviews to discuss parents' priorities and challenges in raising their children. Results: Participants relayed perceptions of community assets as well as struggles with access to care, proper nutrition, and police activity within their communities. Results were presented to apprise community partners and encourage modifications in program delivery to enhance community resources. Conclusions for Practice: Lived experiences voiced by underrepresented parents can potentially inform design of community-centered programing. Policymakers must take into account community strengths and weaknesses during the development of community services. Due to inequities in childhood health outcomes, it is imperative that policymakers receive information from parents to make informed decisions. Significance: What is Already Known on this Subject? Parental input is critical to the health, development, and well-being of children, yet parents are often excluded in the design and implementation of resources and services offered to support positive health outcomes. What does this Study add? Due to the unique characteristics of communities throughout the country, programs should elicit residents' input to inform programs tailored to community strengths and weaknesses. Parents must act as primary advisors on the factors that play a role in the health and development of their children in order to identify the resources needed for children to thrive. [ABSTRACT FROM AUTHOR]

While most parents support their adolescents receiving school-based sex education, there is variability in which sex education topics receive the most support from parents. Conservative political orientation and greater religiosity have been independently associated with parents' lack of support for school-based sex education; however, no studies have examined the intersection of these two factors. The three goals of this study were to: 1) identify how specific sexual education topics cluster together to form content areas; 2) examine if religiosity and political orientation are uniquely associated with these content areas; and 3) examine if political orientation moderates the relationship between parents' religiosity and their perceived importance for the specific sex education content areas. Participants were a national sample of 881 US parents. The sex education topics clustered into three content areas: Factual Knowledge (e.g., STI transmission), Practical Skills (e.g., how to access condoms), and Pleasure and Identity (e.g., pleasurable aspects of sex). Politically conservative and more religious parents reported the lowest perceived importance for each content area. Importantly, these main effects were qualified by a significant interaction: parents who reported both political conservativism and high levels of religiosity reported the lowest perceived importance for these three content areas being taught. [ABSTRACT FROM AUTHOR]

Many trans young people seek mental health support and gender-affirming medical interventions including puberty suppression, gender-affirming hormones and/or surgeries. Trans young people and their parents face multiple barriers in accessing gender-affirming care and mental health support, however little is known about the parent perspective on accessing services for their trans child. This study aimed to understand the experiences of parents accessing medical and mental health services with and for their trans children within Australia. Using data from Trans Pathways, a large mixed-methods cross-sectional study, we examined the experiences of parents (N = 194) in Australia accessing primary care, psychiatry, therapy/counseling, mental health inpatient, and gender-affirming medical services with/for their trans children (aged 25 years or younger). Qualitative data on service experiences were thematically analyzed. Quantitative analyses included frequency of access to services, wait times, service satisfaction, and mental health diagnoses of the parents' trans child. Services were mostly first accessed when the young person was between 12 and 17 years of age, with primary care physicians being the most accessed service. Parents reported that some practitioners were respectful and knowledgeable about gender-affirming care, and others lacked experience in trans health. Across all services, common barriers included long wait times, complicated pathways to navigate to access support, as well as systemic barriers such as sparsity of gender speciality services. Across services, parents reported feeling as though they do not have the necessary tools to best support their child in their gender affirmation. This study highlights the crucial need for systemic changes in the processes of accessing gender-affirming care and mental health support to enable access to appropriate and timely care. These findings also indicate the importance of improving individual practitioner knowledge around trans health, to enhance the support provided to trans young people and their parents. [ABSTRACT FROM AUTHOR]

Background: Cognitive fatigue after childhood acquired brain injury (ABI) is known to negatively impact engagement in typical academic and social activities, yet limited evidence is available to inform speech-language pathologists' (SLPs') clinical practices. The purpose of this research study was to explore stakeholders' perspectives on cognitive fatigue for children with ABI to inform future directions for clinicians and researchers. Method: Twelve parents of children with traumatic brain injury and 35 SLPs participated in an online survey with 33 and 49 questions, respectively, including participant characteristics and perspectives on cognitive fatigue. Results: Parents reported being between "somewhat" and "highly aware" about cognitive fatigue, whereas SLPs reported being between "neither aware or not aware" and "somewhat aware." Parents reported being between "somewhat comfortable" and "very comfortable," whereas SLPs reported being between "neither comfortable or uncomfortable" and "somewhat comfortable" addressing cognitive fatigue in children with ABI. SLPs "somewhat" to "strongly" agreed that cognitive fatigue for children with ABI was within their scope of practice. Parents and SLPs reported accommodations and strategies useful to managing cognitive fatigue in children with brain injury, as well as factors that worsen and lessen cognitive fatigue. Conclusions: While additional foundational and translation research is needed, the perspectives of parents and SLPs begin to address a critical gap in SLPs' assessment and management of cognitive fatigue in children with ABI. [ABSTRACT FROM AUTHOR]

Participation in evidence-based parenting programs benefits parents and children, but these programs have limited reach. This study utilized a mixed-method design to investigate the parenting concerns and parenting program needs of Chinese immigrant parents in New Zealand. Parents (n = 159) were surveyed about their perceived levels of child adjustment problems, parenting confidence, and parenting risk and protective factors. Parents' knowledge and experience with parenting programs, and their program preferences were also examined. Eight Chinese parenting practitioners were interviewed about parenting challenges, parental concerns, and barriers to program participation of Chinese immigrant parents. Survey results showed that parents who gave their child higher ratings on behavior problems reported less parental self-efficacy, and more parental adjustment, family relationship, teamwork, and parenting difficulties. Parents' knowledge and experience of available parenting programs was low. Barriers to program participation included time constraints, lack of program awareness, cultural and language barriers, and no childcare provision. Parents indicated a preference for a range of delivery options including group-based, seminar, and individually tailored programs. Program features most likely to influence attendance were content that addresses personally relevant issues and children's self-development (such as coping with failure, managing negative emotions, and increasing confidence), and convenient location of program. Practitioners indicated that managing difficult child behavior and maintaining positive parent-child relationships were key parenting challenges. These concerns were linked to cultural expectations about child obedience, academic performance, and parent/grandparent relationships. Findings highlight program preferences that could be offered to meet Chinese immigrant parenting support needs and increase program participation. Highlights: Parents and practitioners highlighted challenges, concerns, and needs of Chinese immigrant parents. Parents who gave higher child behavior problems ratings reported more parenting and family relationship difficulties. Identified parenting program, delivery, and content options that could meet Chinese immigrant parenting support needs. [ABSTRACT FROM AUTHOR]

Maintaining vertical position and moving are essential to healthy development. Children with motor difficulties may need assistive devices to stand upright or move. The Dynamic Scaffolding System (DSS) device was developed to support these skills. This study aims to explain the DSS's developmental stages, compare the device's usage times based on diagnoses and motor impairment, and investigate the degree of satisfaction among parents of children using the device. The study included children with difficulty standing or stepping and their parents. We compared usage times of DSS depending on diagnosis (cerebral palsy (CP) or other diagnoses) and motor impairment levels. We assessed parental satisfaction by using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and recorded adverse events. The ages of the participants (n:100) were between 9 and 108 months (44.94 ± 17.59), and 60% of the children had CP, and 40% had other diagnoses (genetic, metabolic, neuromuscular diseases). The duration of daily use of DSS ranged from 44.17 (±26.16) to 110 (±97.98) minutes, and the duration was similar among children at different levels of motor impairment (p = 0.262). The parents were most satisfied with the size, simplicity of use, and effectiveness, and they were least satisfied with the ease of adjustment, safety, and durability. They did not report any adverse events during the study. DSS can be considered a useable assistive device option for children with CP and other diagnoses with difficulty standing or stepping and a satisfactory device for parents of such children. The Dynamic Scaffolding System (DSS) is a useable trunk-supported adaptive walker for children with moderate to severe motor impairment. Parents are most satisfied with DSS's size, simplicity of use, and effectiveness. Children with moderate and severe motor impairment have similar duration of daily use time of DSS. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is one of the most common cancers in women. Evidences show that, routine immunization of girls at age 14 year and immunization of girls at age 9 year through a 5 years extended interval between doses are the most efficient to control the disease. Despite this, there is very little information on parents' willingness to accept the human papilloma virus vaccine. Therefore, assessing willingness to accept human papilloma virus vaccination and its associated factors among parents with eligible daughter will help to designing, implementing and monitoring effectiveness of HPV vaccine immunization program. Methods: A community-based cross-sectional study was conducted among 386 parents with eligible daughters from 8July–6August, 2022. The multistage sampling technique was used. Data was collected using an interviewer-administered questionnaire. Responses were coded and entered into the computer using EPI data version 4.606 statistical packages, and SPSS version 23 was used for data analysis. Frequencies, percentages and means were as to describe the study variables in relation to the participants. Bivariable and multivariable logistic regression were employed. The statistical significance was set at a p-value of < 0.05 with its respected odds ratio. Results: A total of 386 study participants were included in the study. Among participants, 80.3% (95% CI: 76.3, 84) were willing to vaccinate their daughters for HPV vaccination. The parents' willingness was affected by the male parents ([AOR = 3.5; 95% CI (1.673–7.371)], fear of side effects [AOR = 0.385; 95% CI (0.206–0.718)], and with poor awareness on the HPV vaccine [AOR = 0.483; 95% CI (0.259- 0.900)]. Conclusion: The study has shown that willingness to accept the HPV vaccine is about 80% and significantly affected with parental sex, information on the HPV vaccine, and fear of side effects. As such, it may be helpful for the health care providers and the health care policy makers to emphasize on providing easily understandable information using mass media and social campaign. In addition giving trainings more targeted to female parents might be important. [ABSTRACT FROM AUTHOR]

Purpose: Studies on suicide-bereaved parents are scarce in South European and Eastern Mediterranean countries. We explored the experiences of Greek-speaking suicide-bereaved parents in Cyprus, with emphasis on the interpretations of their child's suicide, its aftereffects and their coping strategies. Methods: A qualitative methodology based on inductive content analysis of the interviews of ten mothers and two fathers was applied. Results: The participants described their efforts to make sense of the senseless, reporting numerous interpretations of their child's suicide. Some participants had achieved to move on by trying to keep the remaining family together. Others felt detached from their social network. The different coping strategies and support systems described, reflected participants' efforts to escape from obsessive, enduring and deeply traumatizing thoughts about their child's suicide. The analysis mirrored participants' ultimate desire to find existential relief and serenity through the management of distressing reminders of their child's suicide, and alleviate the burden of their own negative self-judgement and the criticism of others. They sought physical and emotional comfort in the inner realm of their psyche, through spiritual and psychological coping processes. Conclusion: Further exploration is suggested about intervention planning aiming to strengthen effective coping strategies and external supportive resources in mourning parents. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge and attitudes about genetic hearing loss are essential to prevent more hearing loss incidences in societies. However, limited studies have compared the knowledge and attitude toward genetic technology between parents of normal and impaired-hearing children. Methods: A descriptive, cross-sectional study was performed involving 105 parents with one or more children having a hearing impairment and 204 control parents with children having normal hearing. Parents completed surveys designed to investigate their knowledge and attitudes about the genetic basis of hearing impairment and recent technologies. Descriptive and inferential statistics were used to measure response differences between the two groups. Results: Both groups shared the same level of knowledge, with the average knowledge scores of parents with normal-hearing children (9.53/19±2.56 points) resembling those of parents with hearing-impaired children (10.08/19±3.17 points; F(1, 307)=-2.17, p=0.14). Moreover, parents had limited information about the genetic basis of hearing loss, specifically in estimating the recurrence of congenital hearing loss (n=26 of 105, 24.76%)and misunderstanding inheritance paradigms (n=24 of 105, 22.86%). Regardless of having children with auditory issues, parents expressed positive attitudes towards genetic testing. Conclusions: These findings suggest that more genetic specialists are needed to educate families of children with hearing loss about the genetic attributes of hearing impairment and the significance of genetic technology. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Despite widespread availability of COVID‐19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID‐19 vaccination rates are lowest among residents who are Non‐Hispanic (NH) Black and among school‐aged children. We assessed COVID‐19 vaccine hesitancy among staff and parents of students in DC K‐12 public and public charter schools. METHODS: We conducted a telephone‐based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school‐based COVID‐19 screening testing. COVID‐19‐related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID‐19 information sources. Utilizing time‐to‐event analyses, we evaluated differences across demographic groups. RESULTS: The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID‐19 information sources. CONCLUSIONS: Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Introduction: Many Australian Defence Force (ADF) and Veteran families are affected by the stressors of Defence family life, including frequent and prolonged parental deployments, and frequent relocations. Objective: To address a gap in information about Defence and Veteran (hereafter Defence) parents' knowledge, confidence and resources to support their young children's well‐being and build their resilience. Design: This study used a mixed methods design to explore Defence parent's perceptions of their young children's (aged 2–8 years) social and emotional well‐being and understanding of their children's responses to unique stressors as well as their confidence in providing support. Data from 41 parents were available. Findings: Overall, parents reported positive well‐being evaluation of their children. However, just over a third of parents also reported that their children rarely cope well on two indicators combined (adapting to new situations and sharing negative emotions with others). Significantly, more than half of the parents (61%) were only partially confident in their ability to assist their children to cope with unique stressors in military families. Qualitative data provided further insights into children's struggle with relocations and parental absence and the challenges parents face in supporting them. Parents reported having limited access to effective age‐ and culturally appropriate resources to support their young children. Discussion: In a first‐of‐its kind study, we found that Australian Defence parents reported their young children were coping on most of the key well‐being indicators. However, awareness of currently available supports for children remains a barrier as well as access to contextualised, age‐ and culturally appropriate resources are lacking. Conclusion: There is a need for access to free, quality, online, research‐based Australian resources to support young children from Defence families, especially for those living in regional and rural locations and are less likely to have access to mental health and other specialist supports. [ABSTRACT FROM AUTHOR]

Background: More than 90% of deaf children are born to hearing families who know little about deafness. Benefits from hearing screening at birth are often lost, as families find little information about pathways for deaf children but are key to ensuring deaf children receive relevant language and communication support. Systems surrounding deaf children and family members are crucial for children's health and social development. Experiences of hearing parents raising deaf children and understanding factors that influence families' experience of navigating pathways for deaf children through health and education services are currently underreported. Methods: An exploratory study was conducted in Wales, UK. Twenty participants were interviewed, including 10 hearing parents of deaf children and 10 people who work with deaf children using semistructured interviews. Bronfenbrenner's ecological systems theory was used as a lens to explore the micro‐, meso‐, exo‐, macro‐ and chronosystems that surround children and families. This study explores potential supports and barriers in those systems. Findings: Findings are reported under two broad headings: enablers and barriers. Under enablers, it was found that provision of resources, supporting people and knowledge were key factors. Under barriers, a lack of knowledge, lack of provision and battling services and attitudes were key issues that need addressing. Conclusion: Hearing parents of deaf children in Wales, UK reported experiencing a range of enablers and barriers that impact upon their experiences of raising a deaf child. Further provision is needed by policymakers and governments to recognise support needs to improve the outcomes for deaf children. Patient or Public Contribution: This project was developed from initial discussions with the stakeholder reference group and progressed with the group's deaf panel and hearing parents with deaf children. The project's steering group was involved in study design, recruitment and continuous feedback on all stages of the research process. [ABSTRACT FROM AUTHOR]

Background and Objective: To improve quality, child and adolescent mental health services (CAMHS) are expected to quantify families' views on healthcare with user satisfaction measures. As little is known about what influences satisfaction in CAMHS, this study aimed to examine predictors of adolescents' and parents' user satisfaction. Methods: Data from 231 adolescents and 495 parents in treatment at an outpatient clinic who returned a user satisfaction measure, the Experience of Service Questionnaire (ESQ), was analyzed. Registry data on background, clinical and service characteristics were predictors for the ESQ factors general satisfaction, satisfaction with care and satisfaction with environment. Results: In regression models, satisfaction with care for adolescents (r2 =.12) was significant and was predicted by low parent‐self‐reported mental health burden and low clinician‐rated overall symptom burden at intake. For parents, regression models for general satisfaction (r2 =.07), satisfaction with care (r2 =.06) and satisfaction with environment (r2 =.08) were significant. Parents general satisfaction was predicted by higher levels of hyperactivity, less family stress and longer travelling distances to the service. Satisfaction with care for parents was predicted by higher levels of hyperactivity at intake and longer travelling distances. Satisfaction with environment for parents was more likely if the adolescents was a boy, with low levels of family stress and longer travelling distances. Conclusion: Predictors for adolescent and parent user satisfaction in CAMHS differ. Hence, to improve quality CAMHS should enhance focus on collaborative practice with parents, and person‐centred care for adolescents with moderate to severe mental health illness. Patient or Public Contribution: Representatives from the hospitals' youth panel and the non‐governmental organization called The Change Factory have been consulted regarding study design and results. [ABSTRACT FROM AUTHOR]

We evaluated the effect of a trans-theoretical model–based intervention on child safety seat (CSS)‒use behaviors among parents of newborns in Shantou, China. Parents' knowledge, attitude, and self-efficacy scores on CSS use were significantly higher at one, three, and six months after the intervention compared with scores at baseline. Parents' stage of CSS use also advanced as the intervention progressed. The trans-theoretical model‒based intervention and evidence generated from this study may provide guidance for future individualized interventions to improve CSS use. (Am J Public Health. 2023;113(12):1271–1275. https://doi.org/10.2105/AJPH.2023.307415) [ABSTRACT FROM AUTHOR]

Children's early socialization shapes their development and well-being. To date, research examining the socialization of preschool-aged Latine children remains limited, and primarily focused on immigrant, Spanish-speaking families. Given the heterogeneity in language(s) spoken, nativity, and education within Latine families, the present study used focus groups among 112 Latine families of children attending Head Start to understand and compare salient parenting beliefs, attitudes, and self-reported practices as they pertained to supporting their children's development among both English- and Spanish-speaking caregivers. Results showed that English- and Spanish-speaking caregivers viewed their children's bicultural socialization as critical to supporting their development. Caregivers actively socialized their children to be bicultural through an emphasis on two superordinate goals: fostering bilingualism and simultaneous transmission of heritage and US values. Although caregivers across groups shared many of the same beliefs, attitudes, and practices concerning bilingualism and transmission of values (respeto, egalitarian gender roles), differences were also found. Specifically, ethnic pride was more salient for caregivers in the English than Spanish groups, and the value of familismo was only discussed in the English groups. Additionally, caregivers in the English and Spanish focus groups described experiencing different language-related challenges that undermined their efforts to raise bicultural children. These findings can inform future efforts seeking to support low-income, Latine families reach the goals they have for their children from a culturally and contextually informed lens. Highlights: Comparisons between English and Spanish-speaking Latine families showed both aimed to raise bicultural children early on. Bicultural socialization was promoted by fostering bilingualism and by simultaneously instilling US and heritage values in children. Nuanced differences between language groups were found in the ways families fostered bilingualism and instilled values. Spanish and English-speaking caregivers encountered different language-related challenges in socializing their children to be bicultural. [ABSTRACT FROM AUTHOR]

Parental burnout emerges as a response to chronic and overwhelming parenting stress and is related to dysfunctional parenting practices, such as neglectful or violent behavior. Grounded in Self-Determination Theory, the current study aims to evaluate parenting stress as an antecedent and the more general quality of parenting as an outcome of parental burnout. This objective is tackled within the context of the COVID-19 pandemic, which posed major challenges to parents, especially to those raising children with complex care needs (CCN; i.e., an intellectual and/or physical disability, and/or behavioral and/or emotional problems). Therefore, this study explores mean-level group differences in parenting stress, parental burnout, and parenting behaviors between parents raising children with and without CCN, and tests whether associations between these variables are similar for both groups of parents. A group of 506 parents (88% mothers, Mage = 44 years) participated in a widespread online survey during the first lockdown in Belgium. Based on mean-level differences, parents of children with CCN reported substantially higher levels of parenting stress and parental burnout but scored similarly on the assessed parenting behaviors. Multigroup structural equation models showed that in both groups, parenting stress was related positively to parental burnout which, in turn, was related to less autonomy-supportive and responsive parenting and to more psychologically controlling parenting. Although raising a child with CCN may be a risk factor for increased parental stress and burnout, the functional role of these parental experiences in the quality of parenting appears to be similar across both groups of parents. Highlights: This study examines associations between parenting stress, parental burnout, and parenting behaviors during COVID-19. Parenting stress positively related to parental burnout which, in turn, related to less need-supportive and more need-thwarting parenting. Although parents of children with CCN experienced more parental stress and burnout, they did not display lower quality of parenting. The role of parental stress and burnout in the quality of parenting was similar across parents of children with and without CCN. [ABSTRACT FROM AUTHOR]

Background: Brief Admission by self-referral is a preventive intervention here intended for individuals who recurrently self-harm and have a history of contact with emergency psychiatric services. Individuals with access to Brief Admission are empowered to self-admit to inpatient care for up to three days per stay and are encouraged to do so before experiencing crisis. Brief Admission was implemented relatively recently in child and adolescent psychiatric settings in Sweden. The purpose of this study was to phenomenologically explore the lived experience of parents whose teenagers, who recurrently self-harm and experience suicidal thoughts, use Brief Admissions. Methods: This is a qualitative study using phenomenological psychological analysis. We interviewed 17 parents who had experienced their teenagers using Brief Admissions. The interviews were recorded and transcribed verbatim and analyzed to arrive at the essential meaning structure of the phenomenon of Brief Admissions for the parent. Results: We identified two essential meaning structures of the parent's experience of their teenager's use of Brief Admissions: being gifted relief and hope or being robbed of everything you believed in. The experience of Brief Admissions as a gift was structured by the following constituents: 'a sense of safety and containment', 'liberation from a hostage situation', 'a return to wellbeing', and 'catalysts for relational shifts'. In contrast, the constituents of the experience of being robbed included 'a tug of war for control', 'an unworthy wasteland', 'abandonment and collapse of authority', and 'no sense of purpose and plan'. Conclusions: Brief Admissions may come across as challenging, futile and painful in the life of the parent, yet they may also support a process of recovery and healthy development for the entire family. To realize the full potential of the intervention, mental health professionals providing Brief Admission must be mindful of the challenges the parent may face as their teenager starts self-admitting, tactfully and sensitively preparing the parent for a new parental role. [ABSTRACT FROM AUTHOR]

We surveyed New Zealand parents of autistic children to identify their perceived barriers and facilitators to accessing support services, including the influence of a family's level of financial resourcing. A total of 173 completed surveys were analysed. Service pathway factors were the greatest barrier experienced by participants, whereas facilitators related to providers tended to be most helpful. Lower family income was associated with a higher number of reported barriers. Both lower family income and having a child who identified their gender as non-binary were predictive of rating the extent of barriers higher. Parents of younger or of non-speaking autistic children on average reported a greater number of facilitators. Implications of these results for support service delivery and potential areas for future research are discussed. Parents might have problems in getting support services for their autistic child due to certain barriers. However, there might also be things that can ease or facilitate parents' access to support services. In this study, New Zealand parents were asked about their experiences in getting support services for their autistic child. We also looked at differences in reported barriers and facilitators based on several demographic factors with a focus on family level of financial resourcing. A total of 173 parents completed a survey. The results suggested that parents experienced several barriers, particularly related to service pathways. Facilitators were also experienced, predominantly related to providers. Financial resourcing predicted the number of parent-reported barriers. Both lower level of family financial resourcing and having a non-binary child predicted parents' rating of the extent of barriers. Child age and level of speech were predictors for reports of experiencing a higher number of facilitators, with parents of younger children or of non-speaking autistic children reporting a greater number of facilitators. We discuss how these results may be useful to support service delivery and identify areas for future research. [ABSTRACT FROM AUTHOR]

The high prevalence of mental health and behaviour problems among autistic children and adults is an issue of concern to the autism community. Many studies have been undertaken to identify the factors that protect against/or increase the risk of such difficulties. However, this research is dominated by quantitative observational studies. In this study, we sought to investigate the same issue using a qualitative research approach, positioning parents as experts and eliciting their theories as to what influenced their child's mental health from diagnosis to the late teenage years. In-depth interviews were undertaken with 33 parents (30 mothers, 3 fathers) of 31 autistic teenagers (21 males, 10 females) aged between 15 and 19 years (median 17 years) purposively sampled from an existing cohort (QUEST). Parents believed a wide range of child-centred, developmental and socio-environmental factors had played a role in their child's mental health, alongside life events involving loss and separation. A number of these factors have received little or no research attention to date (e.g. aspects of the school environment). The findings have important implications, highlighting factors that should be given priority in future research, as well as interventions needed to support the mental health of autistic teenagers. Autistic people are more likely to experience mental health difficulties compared to neurotypical people. It is very important that we understand what increases the risk for mental health difficulties, and what helps to protect against them. So far, research on this for children and young people has only investigated a small number of factors and these have been chosen by researchers and clinicians. This study took a different approach in which parents' expertise in their children was recognised. Parents were asked to tell the story of their autistic teenagers' mental health from diagnosis in early childhood through to the present, and to explain the 'theories' they developed about what affected their child's mental health – positively and negatively – and how. Parents believed a wide range of factors played a role. These include: (1) aspects of their child (e.g. their autistic traits, intelligence); (2) aspects of their surroundings (e.g. the efforts parents make to prevent and respond to their child's difficulties, features of the school they attend, availability of social activities); (3) changes their child experienced growing up (e.g. puberty, awareness of being autistic); and (4) life events involving loss and separation. Many of the factors parents identified as important have received little or no research attention to date. The findings suggest issues that should be considered in future research and reveal ways that support for parents and autistic children and teenagers can be improved. [ABSTRACT FROM AUTHOR]