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To understand the pathways of children with disability participating in gymnastics in Victoria, Australia. A sequential explanatory mixed-method study design was used. Participants completed an online survey, with selected participants purposively invited to undertake semi-structured interviews via videoconference. Quantitative survey data was analysed using descriptive statistics with preliminary findings informing the invitation of interview participants and refinement of interview questions. Qualitative survey and interview data were analysed together using thematic analysis to create themes. Data was combined to create a conceptual model. Fifty-eight parents consented to participate in the study with eight interviews conducted. Key themes were: (1) Tailored, accessible, supportive environments and programs make a difference, (2) An explicitly inclusive club culture helps young people get and stay involved, (3) Coach knowledge about engaging children with disability is valued, (4) Enjoyment, recognition, and achievement facilitate ongoing participation, and (5) Gymnastics has physical and social benefits for children with disability. The findings inform a conceptual model that describes three key stages along a pathway to participation including; choosing gymnastics as a sport, selecting a club, and ongoing participation. To our knowledge, this is the first study to explore participation of children with disability in gymnastics in Australia. These findings provide guidance to those supporting children with disability to participate in gymnastics (e.g., policy makers, club owners, coaches, and allied health professionals) regarding creating more inclusive environments and experiences at each stage of participation. This study furthers our understanding of the impact of childhood disability on participation in sport and recreation, with a focus on gymnastics. A combination of accessible environments, inclusive club cultures, recognition and enjoyment, and knowledgeable coaches facilitated participation in gymnastics. Parents perceive gymnastics to have physical and social benefits for their child. A conceptual model has been developed based on the findings to support gymnastics clubs and assist rehabilitation professionals to understand the challenges and enablers to participating in gymnastics. [ABSTRACT FROM AUTHOR]

The mental health of young people in youth sport has received growing academic attention and sporting clubs are identified as important settings for prevention and early intervention. Despite this, very few studies have explored the perceptions of multiple stakeholders about youth sporting clubs as spaces for mental health awareness, education, and training. The purpose of the study was to understand the capacity of youth sporting clubs1 to become a site for general mental health support and explore parents, coaches, club leaders and youth participants perceptions about their sporting club's readiness for mental health awareness, education, and training initiatives. Using an Interpretive Description (ID) research methodology, 26 participants (parents, youth, club leaders/coaches) involved in community-level youth sport participated in a qualitative telephone interview. Data was analyzed thematically, leading to the construction of three themes about the barriers for building and maintaining a culture of mental health support in youth sport: (a) initial resistance, (b) teething issues and (c) turbulence. The themes reflected perceptions about varying levels of club readiness for meaningfully supporting positive mental health and indicated that many youth sporting clubs may find it difficult to sustain long-term, positive change. The study suggests that while sport can be a promising avenue to promote positive mental health, it is not without multiple forms of resistance, which if not navigated, may discourage efforts to establish and maintain club settings as sites for mental health, education, awareness, and first aid training. Implications for the field are discussed. Lay Summary: Parents, youth sport participants and club leaders/coaches were interviewed for the purpose of understanding their views of youth sporting clubs' capacity to become a site for mental health support. The thematic findings suggest that clubs are differentially equipped to support meaningful cultural change surrounding mental health and sport. Clubs seeking to become a site for mental health support encounter various barriers and therefore display differential levels of "readiness" for change. To meaningfully and sustainably create clubs that support mental health, additional intervention methods are necessary to support mental health education, awareness-raising activities and first aid training in youth sport. [ABSTRACT FROM AUTHOR]

Echolalia has been described as the repetition of words, phrases, songs or other more elaborate dialogues uttered by another person, which may be immediate or delayed (International Classification of Diseases, 11th Revision; Diagnostic and Statistical Manual of Mental Disorders, 5th ed.). Some classify echolalia as a communication impairment reflective of delay, while others consider it a restricted, repetitive pattern of behaviours, without meaningful communicative function. Little attention is given to the experiences of non-clinicians, such as parents or teachers who may hold valuable insights to further our understanding of this phenomenon. This study forms part of a larger programme of inquiry which interviewed parents (N = 133) about their experiences of their sons' and daughters' echolalia. Using hermeneutic phenomenological analysis in an abductive framework, we present a perspective of echolalia that has largely remained silent in literature: echolalia as an expression of neurodiversity. Participants push back against the status quo of intervention, reclaiming echolalia as being a part of their child's identity. Participants want their children to not only enjoy their echolalia but to fully embrace it as being a part of their individual identity. We propose alternatives to a purely clinical perspective of echolalia; alternatives that may place the neurodiversity-affirmative perspectives of our participants in a co-existing tension with clinicians. Echolalia is a commonly found speech and language condition in autistic children. Children with echolalia repeat words and phrases they previously hear in place of proving a non-repetitive response. In research and when visiting speech and language services, one of the common goals is to modify these repetitions so that these children may, more socially, engage with their surrounding environment. In our research, we identified that not all parents want their children's echolalia to be modified. Some parents want their child to be able to enjoy echolalia and others don't want anyone to intervene because they see it as something that makes their child unique and being unique is something to be celebrated. We believe that there might be a way for speech and language services who want to modify echolalia and the parents in our study who do not want their child's echolalia to be modified, to be able to exist side-by-side. [ABSTRACT FROM AUTHOR]

Autistic students experience elevated rates of school exclusion, whether this be through expulsion, suspension, informal suspension, refusal of enrolment, or school refusal. This exclusion can come about from a range of factors, including sensory or cognitive overload, a lack of training in neurodiversity for teachers, an absent sense of safety by the student at school, or poor attitudes towards the inclusion of autistic students in schools. The impacts of this exclusion on parents can be logistical, financial, and psychological, with a range of mental health outcomes. This Australian qualitative study presents case studies of seven parents of autistic students, as well as four themes that capture the recommendations of parents to address school exclusion. The findings demonstrate that parents experience stress in finding a suitable school for their child, working with staff to meet the needs of the child, and attempting to maintain employment and other commitments when the child experiences exclusion. Parents recommend greater acceptance of autism by education systems, better communication and use of neuro-affirming language, the option for flexible learning, and individualised support by the school for the student. [ABSTRACT FROM AUTHOR]

In this study, an investigation was conducted into the types of attitudes that parents may have of gifted students and gifted education, and the predictors of these attitudes. Using data collected from 331 parents of students enrolled in a Christian faith-based school system in one of the eight states/territories of Australia, multiple analyses, including exploratory factor analysis and latent profile analysis, were performed. The results revealed three subgroups of parents, each representing distinct attitude profiles (i.e., "strong", "moderate" and "weak" supporters of gifted students and gifted education). Furthermore, we found nine variables to be potential predictors of parent attitudes, including perceptions of the giftedness of one's child, and the anticipated socio-emotional and academic impacts of giftedness and gifted education. Some of the important contributions of the study to the research literature included the distinction made by parents between attitudes toward gifted education adaptations and attitudes toward special gifted education settings, and the comparatively large number of parents who are moderately (rather than strongly or weakly) supportive of gifted students and gifted education. [ABSTRACT FROM AUTHOR]

Online youth-focused health programs often include parent modules—that equip parents with skills to assist their child in improving their health—alongside youth-specific content. BRAVE Self-Help, an evidence-based program designed for children and teenagers with early signs of anxiety, is a popular Australian program that includes six parent modules. Despite its popularity and proven efficacy, BRAVE Self-Help shares the same challenge as many online self-help programs—that of low participant engagement. Using parents registered in BRAVE Self-Help as 'information rich' participants, we explored (a) factors that influenced parent engagement in online health programs, and (b) their recommendations for enhancing parent engagement. We conducted semi-structured interviews with 14 parents registered in BRAVE Self-Help. Data were analysed through reflexive thematic analysis. Social-, family- and program-related factors drove parents' program engagement and recommendations. Social sub-themes related to the benefits of professional and community support in promoting more engagement. Family sub-themes included difficulties with program engagement due to competing priorities, perceptions that condition severity influenced engagement, and feelings that previously-acquired health knowledge reduced motivation to engage. Program sub-themes included perceived usefulness and ease-of-use. Program designers could target support systems, include flexible delivery options, and use iterative design processes to enhance parent engagement. [ABSTRACT FROM AUTHOR]

The proportion of children walking or riding to school is dwindling in Australia, while pedestrian injuries are among children's leading causes of death. A mixed-methods survey was conducted on children and parents of two schools in Australia to understand travel behaviours and attitudes towards active transport to school (ATS). Results showed that road safety perceptions predicted ATS, unlike distance to school and stranger danger. The design of the routes to school was found to be crucial in facilitating ATS, to address the fear of road danger. Practical implications include the need for more controlled pedestrian crossings and protected bike paths. [ABSTRACT FROM AUTHOR]

The spread of COVID-19 resulted in restrictive lockdowns. For families supporting young people with autism spectrum disorder (ASD), the service system was stripped away. The aim of this study was to explore the impact of this challenging situation on a group of Australian carers and parents of children and young people with ASD, with an intention to inform policy and practice based on the lived experiences of these families. A survey of parents of children and young people with ASD in Australia returned 117 responses, of which 86 responded to open-ended questions about COVID-19 lockdowns. Twelve parents responded to the invitation to be interviewed. Interview and survey data were analysed thematically. Five themes emerged: accessing support services, receiving support services online, changes in behaviour, higher levels of conflict, and impact on health and relationships. The experience of lockdowns under COVID-19 undermined informal and formal support systems, and had a particularly strong negative impact on the experiences of children with ASD and their families. These findings also provide support for understanding the social model of disability as a mainstay in the lives of children with disabilities and their carers. IMPLICATIONS The social model of disability was dismantled for children and young people and their carers during the COVID crisis. This unacceptable attack on the human rights of disabled people (people with a disability) needs future planning to ensure that it does not occur again. Future crises require more nuanced policy and practice responses that do not close off all child and family supports to children with ASD and their carers. [ABSTRACT FROM AUTHOR]

Aim: To assess parental awareness of respiratory syncytial virus (RSV) and the level of acceptance of future RSV prevention strategies. Methods: A cross‐sectional online survey was implemented targeting "future" and "current" parents of children aged ≤5 years in Australia. Results: From 1992 eligible participants, two non‐mutually exclusive subgroups were formed: "current" parents (N = 1931) and "pregnant/planning" parents (N = 464: 403 also "current" parents and 61 "future" parents). Participants were predominantly (86.6%) aged 25–39 years and 68.5% with university education. The majority (89.6% current; 78.7% future) had heard of RSV. Of those, 64.2% (current) and 50.0% (future) were aware that pneumonia is associated with RSV; 71.8% (current) and 52.1% (future) were aware that bronchiolitis is associated with RSV. In multivariable logistic regression analyses, Australian‐born parents (aOR = 2.47 [95% CI: 1.48–4.12]), living in the eastern states (e.g., New South Wales: aOR = 6.15 [95% CI:2.10–18.04]), with a university‐level education (aOR = 2.61 [95% CI:1.38–4.94]) and being a current parent (aOR = 12.26 [95% CI:2.82–53.28]) were associated with higher RSV awareness. There was a high level of acceptance for maternal vaccines (future: 79.3%) and infant immunisation (all: 81.7%). Conclusion: While RSV awareness and immunisation acceptance were high, there was limited knowledge of severity of RSV, especially in future parents. Education campaigns need to be developed to increase RSV knowledge. [ABSTRACT FROM AUTHOR]

Despite efforts to promote gender diversity, the construction industry in Australia remains one of the most male-dominated industries. Women, compared to their male counterparts, progress more slowly and encounter major obstacles to career development in the construction industry. Existing research tends to focus on broad factors that impact women's career development in all career stages despite the fact that women's career priorities often change as they progress through different career stages. This study applied Super's career development model to investigate the influential factors on women's career development across four career stages: explore (precareer), establishment (early career), midcareer, and late career. By conducting a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this research identified influential factors related to women's career development in the construction industry, namely, attitude, capability, interest, past experiences, family responsibilities, parental influences, role models, support, culture, organizational practice, and policies and regulations. Based on the women's empowerment framework, the identified factors were coded and synthesized into three dimensions: individual, relational, and environmental. The research finds there is a significant focus on providing relational and environmental support to women in construction, and less attention is given to individual factors. The review revealed that personal interest and parental perceptions in construction influence women's career development in precareer and early career stages, while masculine culture significantly impacts women's career development in all career stages. This study also summarizes the theoretical contributions and practical implications drawn from existing research on different stages of women's career development and provides guidance for further research. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has created many challenges for families across the world, with those who have recently had a baby particularly vulnerable to increased stress Study Aim: The current study aimed to explore the experiences of the COVID-19 pandemic of families who have recently had a baby in Melbourne, Australia. Methods: Interviews were conducted with sixteen parents participating in a family-based intervention during early parenthood and seven clinicians who delivered the program. Results: Parents and clinicians described impacts of the pandemic on parent and family functioning included mental health concerns, stress and irritability, feelings of isolation, and increased relationship tension. Parents discussed coping strategies used during the crisis, including activities with their family, connecting with others, trying to stay positive, and self-care activities such as spending time outdoors. Both parents and clinicians acknowledged the importance of mental health and parenting support during and following the pandemic, and for these services to be promoted and easily accessible. Discussion: The study highlights the mental health and parenting support needs of families during times of crisis and emphasises the importance of early intervention for families exhibiting poor communication and relationship tension. [ABSTRACT FROM AUTHOR]

Despite significant evidence worldwide that parents support school-based delivery of relationships and sexuality education (RSE), Australian data has generally lacked larger, nationally representative samples. Furthermore, misguided perceptions of parental attitudes are known to impact delivery. In response, online survey data were collected from 2,427 parents (56.5% female) nationwide, to examine their attitudes towards school-based RSE. Most had a child enrolled in a government school (65.3% primary, 55.7% secondary); and reported diverse religious affiliations (38.7% no religion, 21.3% Catholic, 11.1% Anglican) and voting preferences (26.7% Australian Labour Party, 25.1% Liberal/National, 23.6% undecided). Overall, 89.9% of parents supported schools to deliver RSE, with some modest differences being associated with particular demographic variables. Beyond widespread support for RSE, parents emphatically endorsed schools to address a diverse range of RSE-related issues (n = 40 topics). Parents' responses also provided insight regarding when certain topics should first be introduced and the quality of current RSE provision in schools. Findings from this descriptive overview challenge the currently overstated assumption that parents do not support RSE in schools. Such persistent and obstructive discourse is counterproductive to evidence-based strategies that seek to strengthen young people's personal and social development in a comprehensive and contemporary manner. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. Methods: This study utilized data from the Longitudinal Study of Australian Children (Waves 1–7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. Results: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Conclusion: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population. [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]

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]

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]

Background: Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD. Aims: To test the predictive relationship between parent‐reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population‐based sample. Methods: Data were leveraged from the prospective Raine Study (n = 1626 second‐generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well‐established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years. Results: No single parent‐reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85–1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59–1.32, p = 0.563) were also non‐significant. Conclusions: Parent reports of early indicators of DLD are well‐intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed. WHAT THIS PAPER ADDS: What is already known on the subject: DLD is a relatively common childhood condition; however, children with DLD are under‐identified and under‐served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge: No one parent‐reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work?: The broad dissemination and use of 'red flags' is well‐intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation‐based interventions. [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]

Markets for international surrogacy often arise in jurisdictions with limited regulations regarding assisted reproductive technologies. In some countries, like Australia, regulated domestic surrogacy services are often sidestepped for international providers. This study describes how Australian intended parents decide where to pursue surrogacy and compares the characteristics and outcomes of arrangements completed within and outside of Australia. The findings show that, although intended parents preferred undergoing surrogacy in Australia, perceiving the process as too long and complicated was a common reason to pursue an international arrangement. Multiple embryo transfer, anonymous gamete donation, and a lack of counselling were common in international surrogacy arrangements. When compared to surrogacy arrangements completed in Australia, where single embryo transfer is mandatory for surrogacy cycles, the rates of multiple birth, preterm birth and neonatal intensive care in international surrogacy were higher. These findings raise concerns about the health and welfare of international surrogacy participants, particularly the surrogates and children. In lieu of any international instrument regulating surrogacy, improving access to surrogacy at a domestic level would reduce the number of people engaging with international arrangements and in turn, reduce the potential for harm. [ABSTRACT FROM AUTHOR]

• "Deliberators" concerned about vaccine effectiveness and risk outweighing benefits. • "Rejecters" tended to refuse vaccination and distrust all vaccines. • Young parents with low educational attainment tended to be "rejectors" and "deliberators". • Promotion strategies were similarly preferred. • Results may aid in identifying and addressing vaccine hesitancy. The COVID-19 vaccine coverage among children in countries where COVID-19 vaccines are recommended has been suboptimal. Conflicting information in the media leads to parental anxiety and confusion around COVID-19 vaccination in children. The scepticism expressed by certain experts regarding the importance of COVID-19 vaccines in children has also had a negative impact on parental attitudes towards COVID-19 vaccination. This study aimed to understand parental concerns and preferences for paediatric COVID-19 vaccination, and identify potential vaccination promotion ("nudge") interventions to optimise paediatric COVID-19 vaccine uptake. Mixed methods including Focus Group Discussions and a Discrete Choice Experiment survey were used. The Discrete Choice Experiment survey design was based on a literature review and the findings of Focus Group Discussions. The study was conducted on a nationally representative sample of parents in Australia. In total, 1039 parents participated in the study. Parents showed strong preferences for a COVID-19 vaccine with lower risk of serious side effects and longer protection duration, followed by higher vaccine effectiveness and delivery via oral tablets. Promotion strategies were similarly preferred by parents. Latent class logit analysis identified three groups, interpretable as COVID-19 vaccine "accepters (35.3%)", "deliberators (31.7%)", and "rejecters (33.1%)". The "deliberators" composed of more parents, residing in metropolitan areas, having concerns about vaccine effectiveness, and believing that disease risks outweigh vaccine benefits than the "accepters". The "rejecters" were more likely to not be vaccinated themselves, and generally have less trust in vaccines than the "accepters". The "deliberators" and "rejecters" were less likely to be parents aged ≥25 years and complete final year of high school than the "accepters". Parents' sociodemographic factors and vaccine perceptions were associated with different levels of acceptance toward paediatric COVID-19 vaccination, which may help to better understand how to "nudge" vaccine hesitancy. [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]

Separations that occur in the family courts are often characterised by high conflict and lengthy proceedings. For parents with a mental illness, the court can offer additional barriers which may lead to less time with their children and mental distress. This study aimed to (a) identify and critique research relating to parental mental illness in the family courts and (b) understand the experiences of parents with a mental illness who engage with the family courts in parenting matters. This scoping review was conducted on five databases (CINAHL, HeinOnline, ProQuest, PsycInfo and Scopus) following PRISMA-ScR guidelines. The search yielded 5392 unique articles, 12 of which met criteria and were included in this review. These articles included qualitative, quantitative and mixed method studies from family courts located in several countries. Through thematic analysis, four themes were constructed, (1) Actual and perceived influence of parental mental illness on outcomes, (2) Family violence and the courts, (3) The impact of the legal process on parents who have a mental illness, and (4) Supports for parents with a mental illness. The results indicate that parents with a mental illness face many obstacles that impact their ability to engage in the court processes and the outcomes of parenting cases. There were, however, many gaps within the current research. Limitations of the current research and directions for future research in parental mental illness in the family courts are offered. Highlights: Parents with a mental illness involved in parenting disputes perceived that their mental illness negatively impacted their case. Key barriers for parents included the exacerbation of their mental illness during ongoing family law proceedings, the impacts of family violence, and a lack of continuous and sensitive legal representation. Parents indicated that family law professionals and systems need to be informed of the effects of family violence, trauma and mental illness. Further research is needed focusing specifically on the experiences of parents with a mental illness as they navigate family court systems. [ABSTRACT FROM AUTHOR]

Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy. [ABSTRACT FROM AUTHOR]

Immigration brings particular challenges to older Chinese immigrants' wellbeing because they make a new home in a foreign country. Based on 30 semi-structured in-depth interviews, this study aims to understand the immigration history of this specific group and unravel the complex links between family relationships and wellbeing. Four themes emerged from the interviews. First, the decision to immigrate is the result of the combined influence of family values, affinities and the need for aged care. Second, after immigration, housework normally negatively influences their wellbeing. The third theme pertains to the interactions amongst family members. The final theme shows that Chinese immigrants' perceived wellbeing is influenced by family relationships, an independent lifestyle and social networks. This research highlights older Chinese immigrants' complex feelings of family commitment, personal values and the need for aged care. Practical implications for policymakers to better facilitate this group's wellbeing are provided. [ABSTRACT FROM AUTHOR]

Purpose: Corporal punishment (CP) and physical abuse (PA) in childhood are associated with increased risk of child-to-parent violence (CPV). Without context of discipline (i.e., the intention of behavior change, and use of reasonable force), both CP and PA represent the use of physical force against a child. It is still unclear if their associations with CPV are similar when they co-occur, or when they occur in isolation. The current study examined the differential and cumulative association of different types of physical force in childhood with rates of CPV. Method: The sample consisted of 1,132 participants, between 18 to 87-years-old (M = 50.95, SD = 14.24) and included 59.5% female and 39.2% male participants who completed an online survey measuring CP, PA and CPV. Participants formed three groups: low CP or PA (group low), high CP only (group HCP), or high PA and CP (group PA + CP). Results: Two one-way ANOVAs with planned contrasts were conducted separately for CPV against mothers and fathers. The group HCP reported significantly higher CPV against both the mother and the father than group low and there was no significant difference between group HCP and group PA + CP. Conclusions: Higher rates of CP are associated with higher rates of CPV; however, this rate does not increase further when there is concurrent PA. This suggests that there may be a low sensitivity for retaliation from a young person, or coercive training (through high parent–child conflict), in environments where there is physical force from a parent. [ABSTRACT FROM AUTHOR]

Aims: To map the pathway and service provision for pregnant women whose newborns require admission into the surgical neonatal intensive care unit at or soon after birth, and to examine the nature of continuity of care (COC) provided and the facilitators and barriers to woman‐ and family‐centred care from the perspective of women/parents and health professionals. Background: Limited research exists on current service and care pathways for families whose babies are diagnosed with congenital abnormality requiring surgery. Design: A mixed method sequential design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. Methods: Data collection methods included: (1) a workshop with health professionals (n = 15), (2) retrospective maternal record review (n = 20), prospective maternal record review (17), (3) interviews with pregnant women given a prenatal diagnosis of congenital anomaly (n = 17) and (4) interviews with key health professionals (n = 7). Results/Findings: Participants perceived care delivered by state‐based services as problematic prior to admission into the high‐risk midwifery COC model. Once admitted to the high‐risk maternity team women described care 'like a breath of fresh air' with a 'contrast in support', where they felt supported in their decisions. Conclusion: This study highlights provision of COC, in particular relational continuity between health providers and women as essential to achieve optimal outcomes. Relevance to Clinical Practice: Provision of individualised COC offers an opportunity for perinatal services to reduce the negative consequences of pregnancy‐related stress associated with diagnosis of foetal anomaly. Patient or Public Contribution: No patient or public was involved in the design, analysis, preparation or writing of this review. [ABSTRACT FROM AUTHOR]

The International Society for Pediatric and Adolescent Diabetes has identified school as a critical context for adolescents with type 1 diabetes (T1D) who typically hold a fluctuating, though growing, amount of responsibility for diabetes self-management across this time. When parents use frequent autonomy-supportive communication to maintain a mutually agreeable sharing of responsibility for diabetes management with their adolescent, better outcomes are achieved. There is, however, a dearth of research examining the way adolescent responsibility is managed at school. This cross-sectional study investigated adolescents' perspectives of sharing responsibility for T1D management at school and the extent to which these were concordant with parent perceptions. Sixty adolescents (10–19 years) and fifty-five parents completed questionnaires measuring the perceived impact of diabetes on adolescents' school activities and respective involvement in the management of responsibility for school-based diabetes care. Adolescent questionnaires also measured perceptions of autonomy supportiveness (Health Care Climate Questionnaire) and communication quality (frequency, mode, autonomy), in relation to diabetes management. Differences by age and inter-rater agreement between parent and adolescent dyads were examined. Results showed that parents and adolescents did not agree about their relative involvement in setting up diabetes management strategies or the impact of diabetes on school activities. There was no difference in the involvement of older adolescents relative to younger students. Adolescents predominantly communicated about school diabetes care in person, though some reported no communication with school staff (25%) or healthcare workers (36%). Only thirty nine (65%) reported having a diabetes school plan. Nineteen (32%) perceived little or no involvement in setting up diabetes care strategies for the year and most had not attended a school-related meeting. These results suggest more explicit inclusion of adolescents in formal school support strategies may better represent their unique perceptions of responsibility, enabling the consensual sharing of responsibility that is associated with better outcomes. [ABSTRACT FROM AUTHOR]

The proportion of Aboriginal peoples in a variety of Australian sports are at a much higher levels than their proportion of the overall population in Australia. Given the relative absence of Aboriginal parents in discussions of parenting, and the strong involvement of Aboriginal peoples in sport, the experiences of Aboriginal parents within Junior Rugby League (JRL) were explored in this study. The aim was to consider the key factors impacting the behaviours and emotional reactions of parents with a view to supporting parents in JRL settings. Participants were parents of JRL players (aged 8 to 16 years) in Queensland and New South Wales, Australia. As part of a large-scale online survey (N = 1418), 117 Aboriginal parents reported their demographic background, spectator behaviour and emotions, sport-related beliefs and attitudes, child behaviour, parenting, and personal wellbeing. Analyses comparing Aboriginal parents to remaining sample of non-Aboriginal parents revealed that Aboriginal parents identified more highly with rugby league and had a greater investment in the sport than their non-Aboriginal parenting peers. The findings allow further explorations in relation to aspects of connection and kinship, and we argue that JRL may be positioned as a potentially generative site of support for Aboriginal parents. [ABSTRACT FROM AUTHOR]

Background: The aim of this project was to identify the top 10 priorities for childhood chronic conditions and disability (CCD) research from the perspectives of children and young people with lived experience, their parents and caregivers and the professionals who work with them. Methods: We conducted a three‐stage study based on the James Lind Alliance priority‐setting partnership methods. It comprised two online surveys (n = 200; n = 201) and a consensus workshop (n = 21) with these three stakeholder groups in Australia. Results: In the first stage, 456 responses were submitted, which were coded and collapsed into 40 overarching themes. In the second stage, 20 themes were shortlisted, which were further refined in stage 3, before the top 10 priorities being selected. Of these, the top three priorities were improving awareness and inclusion in all aspects of their life (school, work and social relationships), improving access to treatments and support and improving the process of diagnosis. Conclusions: The top 10 priorities identified reflect the need to focus on the individual, health systems and social aspects of the CCD experience when conducting research in this area. Patient or Public Contribution: This study was guided by three Advisory Groups, comprising (1) young people living with CCD; (2) parents and caregivers of a child or young person with CCD and (3) professionals working with children and young people with CCD. These groups met several times across the course of the project and provided input into study aims, materials, methods and data interpretation and reporting. Additionally, the lead author and seven members of the author group have lived and experienced CCD. [ABSTRACT FROM AUTHOR]

There is considerable evidence that parents/guardians play an important role in their children's education. The supportive behaviours of parents have important implications for children's learning. However, most research in this area has focused primarily on the perspectives of school leaders, teachers and parents. One area that thus remains relatively under‐studied is student perspectives on what constitutes beneficial parental supports. This research explores two case studies: one with primary school students, the other with secondary students. Both studies interviewed students from former‐refugee and non‐English speaking backgrounds who had recently settled with their families in Australia. The students were asked to reflect on supportive behaviours of their parents/guardians relating to their education. Findings suggest that despite many barriers, parents demonstrated high levels of support for their children's education. By foregrounding student voice, this study identifies several types of parental behaviours that students find most helpful for effective learning. These include: affirmation, role‐modelling, backup supports, conversations and discussions, encouragement and advice, and decision‐making and problem‐solving. Students' responses suggest that slightly different sets of behaviours may be required at primary and secondary levels. This study highlights the types of supportive parental behaviours which schools could encourage, to help parents maximise the impacts of their supports for students, so these students are enabled to achieve effective learning and—more broadly—educational and career aspirations. [ABSTRACT FROM AUTHOR]

Fly-in/fly-out (FIFO) work practices have become common place in Australia over the past two decades. Research has documented the personal impact of these work practices, but little peer-reviewed research is available on the family impact of this work. The study aimed to better understand (1) the impact of FIFO work arrangements on children, parents and relationships; (2) strategies parents use to manage the home-away cycle; and (3) preferences for parenting support. Interviews were conducted with six FIFO workers and 15 partners of FIFO workers with at least one child aged 2–12 years. Inductive thematic analysis revealed six themes: effects on children; effects on family relationships; effects on parenting; managing transitions; managing separations; and the need for flexible, tailored parenting support. The findings provided important insight into the experiences of working FIFO with a family and can inform the development of parenting support targeted at FIFO families. [ABSTRACT FROM AUTHOR]

This study examined whether parent-reported atypical development in their child's first year was associated with age of diagnosis and age when parents first needed to consult a specialist about their child's development. It involved 423 children who participated in the Australian Autism Biobank. Most parents retrospectively identified ≥ 1 domain of atypical child development. Atypical development in most domains was associated with an earlier age when parents felt specialist consultation was needed. Atypical development in the "gaze abnormalities", "lack of response to social stimuli", and "no social communication" subdomains within the social domain was associated with an earlier age of diagnosis, as was atypical development in the "hypo/hypersensitivity" and "preoccupation with parts of objects" subdomains within the stereotyped/restricted behavior domain. [ABSTRACT FROM AUTHOR]

Background: Persistent enteral tube feeding beyond the point of medical and/or physical necessity provides important nutrition to a child but may have implications for their development, gastrointestinal tract and quality of life. Tube dependency can affect parent–child relationships and sibling and family dynamics and place additional medical demands upon parents. It is therefore important to transition children from tube to oral eating and drinking as soon as is medically safe to do so. Tube weaning requires a skilled team to support the transition to oral intake; however, access to experienced teams is inconsistent. Without transparent discussions with their treating teams, many parents are left to navigate tube weaning options independently. Methods: Fourteen parents were interviewed using semi‐structured interviews. We explored the experiences of parents across their child's progression towards oral feeding, from the decision‐making process to undertaking an intensive multi‐disciplinary tube weaning programme. Thematic analysis of the parents' stories shaped the development of seven themes. Results: Parents were unaware that tube weaning would be required and how that would be facilitated. They expressed a strong belief that their child could learn to eat—if afforded an opportunity. Furthermore, parents are prepared to disengage from current services if they feel they are not respected members of their child's therapeutic team. Three key learnings were identified relating to the need for tube exit plans, parents as key team members and parents as change agents. Conclusions: Parenting a tube‐fed child, initiating and engaging in tube weaning, is a stressful and emotional journey. However, by establishing care partnerships, parents are willing to put trust in a process if provided with options and afforded autonomy, empowerment, acknowledgement and relevant support. [ABSTRACT FROM AUTHOR]

Background: Parents' beliefs and behaviours affect children's nutrition, eating behaviours, and health outcomes; however, little is known about parents' experiences and perspectives on establishing a healthy diet with young children. Methods: A community‐recruited sample of 391 parents of young children (under age 5) completed an anonymous cross‐sectional online survey assessing the degree to which their children met recommendations outlined in Australian nutrition guidelines, perceived barriers to establishing a healthy diet with their child, and interest in receiving tips/information about establishing healthy eating habits with their children. Descriptive statistics illustrated proportions of children adhering to recommendations. Thematic analysis was used to analyse qualitative data. Results: Adherence to recommended nutrition guidelines varied across age groups. Most children across all age groups had water as their main drink, routinely consumed a variety of fruit, and consumed sweet drinks or fast foods only rarely. In contrast, less than half of 2‐ and 3‐year‐olds regularly consumed a variety of vegetables. The proportion of children consuming discretionary "treat" foods increased sharply over the first 2 years of life, and two thirds of 2‐, 3‐, and 4‐year‐olds consumed treat foods a few days per week or more. Parent‐reported barriers to establishing a healthy diet with young children included child behavioural factors (e.g., dislike of vegetables), parental influences (e.g., lack of time), family dynamics (e.g., influence of extended family) and external influences (e.g., external environment). Parents were most often interested in ways to modify child behaviour and information about child nutrition. Conclusions: Parents cite child behavioural issues as a major barrier to establishing a healthy diet with young children. Behavioural interventions that provide parents with information and support on how to establish a healthy diet with young children, as opposed to educational interventions focusing mainly on what children should be eating, may better meet families' needs. [ABSTRACT FROM AUTHOR]

Parents and carers often have limited knowledge and confidence in providing comprehensive sexuality education (CSE) and support to children and young people with intellectual disability (ID) and/or autism spectrum disorder (ASD). To address this need, six workshops were delivered and evaluated in New South Wales (NSW), Australia in 2018. Pre/post-workshop surveys were completed (n = 145) along with three-month follow-up surveys and interviews (n = 34) to evaluate the perceived effectiveness of the workshops in improving parents' and carers' knowledge and confidence in providing CSE and support to their child or young person. The evaluation also sought to understand additional barriers for parents and carers in providing CSE and support to people with ID and/or ASD. Significant improvements in self-reported knowledge and confidence were identified following the completion of the workshop, which were retained at the three-month follow-up. Barriers to the provision of CSE and support included feelings of isolation and stigma, a preference for reactive approaches to CSE, and a lack of accessible information and resources. Findings suggest that while the provision of workshops to parents and carers can increase their knowledge and confidence in providing CSE and support, significant barriers persist. This evaluation provides insight into how the parent and carer approach to CSE and support for children and young people with ID and/or ASD can be improved. [ABSTRACT FROM AUTHOR]

Limited research has directly sought the input of parents involved in the child protection system during pregnancy and with their infants. As the focus of these policies and practices, parents have a unique and important insight not available to others, so it is vital to obtain their input. As part of a larger Australian study, qualitative interviews were undertaken with 13 parents asking about their views and experiences. Parents predominantly became involved with child protection services during pregnancy through a prenatal report. Parents who previously had their newborn removed from their care described it as sudden and unexpected, leaving them distressed and unsupported post‐removal, with a growing list of requirements for them to see their baby or for restoration to be considered. Domestic violence was a particular issue of concern for some mothers who expressed distress that their partners, perpetrators of violence, were allowed access to their infant with fewer requirements than for them. Improvements recommended by the parents included greater communication and preparation for the removal, better recognition of improvements in their situations and increased supports to be provided to parents both pre‐ and post‐removal. Parental experiences provide an important guide to improving child protection practice with these families. [ABSTRACT FROM AUTHOR]

Background: The Immunisation Register of Australia reports that childhood vaccination rates in some regional areas are below herd immunity levels. This is a concern for the health and well‐being of society, as regions with low vaccination rates have an increased risk of disease outbreaks. Objective: This study explored psychological motivators as predictors of anti‐vaccination attitudes amongst parents living on the Sunshine Coast (Queensland), Australia. Methods: A cross‐sectional survey design explored anti‐vaccination attitudes, conspiratorial thinking, psychological reactance, trust in government and magical beliefs about health in 1050 parents (968 mothers). Results: The predictor variables significantly accounted for 42% of the variance in parental anti‐vaccination attitudes. The strongest predictor of anti‐vaccination attitudes was lower levels of trust in government. Conclusion: The findings contribute to understanding of psychological factors motivating anti‐vaccine attitudes in Australian parents. The findings may help inform health communication campaign effectiveness in their alignment with individual underlying motivations. [ABSTRACT FROM AUTHOR]

Issue addressed: In Australia, one in four (24.9%) children live with overweight or obesity (OW/OB). Identifying infants at risk of developing childhood OW/OB is a potential preventive pathway, but its acceptability is yet to be investigated in Australia. This study aimed to (1) investigate the acceptability of predicting childhood OW/OB with parents of infants (aged 0‐2 years) and clinicians and (2) explore key language to address stigma and maximise the acceptability of predicting childhood OW/OB in practice. Methods: This was a cross‐sectional and qualitative design, comprising individual semi‐structured interviews. Participants were multidisciplinary paediatric clinicians (n = 18) and parents (n = 13) recruited across public hospitals and health services in Queensland, Australia. Data were analysed under the Framework Method using an inductive, thematic approach. Results: Five main themes were identified: (1) Optimism for prevention and childhood obesity prediction, (2) parent dedication to child's health, (3) adverse parent response to risk for childhood obesity, (4) language and phrasing for discussing weight and risk and (5) clinical delivery. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child's health that superseded potential feelings of judgement or blame. When discussing weight in a clinical setting, the use of sensitive (ie, "overweight", "above average", "growth" versus "obesity") and positive, health‐focused language was mostly supported. Conclusions: Multidisciplinary paediatric clinicians and parents generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. So what?: Clinicians, public health and health promotion professionals and policymakers can act now to implement sensitive communication strategies concerning weight and obesity risk. [ABSTRACT FROM AUTHOR]

This study aimed to explore how foster carers conceptualize and engage in self-care using interviews with 8 participants. Results suggest that self-care practices are an important component of maintaining the physical and mental health of foster carers, preventing burn-out and enhancing therapeutic parenting practices. Several barriers to self-care are identified, including systemic barriers as well a foster carers' own feelings of guilt for prioritizing their own needs. Results indicate that self-care requires a collaborative approach between foster carers and the broader child welfare system. Improved self-care specific training, resources and coaching from agencies were also identified as important outcomes. [ABSTRACT FROM AUTHOR]

Physiotherapy is an essential component in the management of cystic fibrosis (CF). To explore how parents of infants with CF experience physiotherapy clinic consultations. A qualitative study, informed by hermeneutic phenomenology, utilizing in-depth semi-structured interviews and daily diaries was conducted with 13 parents of infants (aged 0–2 yrs.) receiving physiotherapy care for CF in Australia. Three themes arose from the text. The first was that parents' physiotherapy clinic experience is influenced by the manner in which health professionals communicate to parents about physiotherapy in CF, as well as their own prior experience and knowledge. Secondly, parents receive conflicting messages from the physiotherapy consultation, but perceive the key message to be to prioritize adherence to physiotherapy. The final theme was that parents' expectations of the physiotherapy interaction were often not met, in particular a lack of practical physiotherapy education and training was reported. Parents of infants with CF seek an optimistic, practical and hands on approach during physiotherapy consultations. Exploring options for providing physiotherapy input outside of traditional clinic environments may help accommodate individual needs. Investigation into the manner in which physiotherapy education is communicated to parents is warranted in light of the influence on parents' expectations of physiotherapy. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines for paediatric neuromuscular disorders (NMDs) recommend timely provision of wheelchair equipment. The aim of this qualitative study was to understand healthcare professionals' clinical perspectives and practices when recommending wheelchair equipment for the first time, as well as perceived barriers and enablers to timely wheelchair provision. Twenty-one healthcare professionals (HCPs) from Australia and the United States participated in an interview (response rate: 88%, 16/21 women). Participants were from diverse disciplines, based in hospital or community health settings, and had at least one year of experience working in paediatric neuromuscular care. Child fatigue, falls and engagement in age-appropriate activity were common reasons for HCP's wheelchair recommendation. HCPs were acutely aware of parents' experiences of grief and loss throughout the wheelchair prescription process, and over half acknowledged the lack of psychological care available to families affected by NMDs. Multi-disciplinary collaboration, psychologically-informed care, and shared decision-making with stakeholders were perceived enablers of wheelchair transition. Barriers included limited access to equipment, lengthy funding processes and lack of funding for home and vehicle modifications. Integrated psychosocial care is needed to support families throughout their child's disease progression, including wheelchair transition. Implementation of readiness for change tools, and development of tailored informational resources is recommended. Improved access to equipment options and trials, and more efficient funding processes are highly likely to improve parental engagement throughout the wheelchair prescription process. Healthcare professionals express a strong demand for integrated psychosocial care within paediatric neuromuscular clinics to support families throughout transitions, including wheelchair introduction. Identifying parents' readiness for change can inform their information and support needs, strengthen their decision-making capacity and facilitate timely wheelchair introduction. Stronger collaboration between hospital- and community-based health professionals working in paediatric neuromuscular care is recommended to facilitate knowledge exchange and support families' transition to wheelchair use. Access to equipment options for extended loan or trial in the community can support timely wheelchair introduction. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of life-limiting conditions in children and young people warrants an evaluation of paediatric palliative care, hospice services and delivered care. Aim: First, this study aimed to develop a deeper understanding of how extended viewing is experienced by the parents of a deceased child (or young person) with a life-limiting condition, based in Australia. Second, this study aimed to evaluate the quality of bereavement care delivered during the first few days after death. Findings: A total of 17 bereaved parents of 13 children completed an interview. In-depth interviews were audio-recorded, transcribed verbatim and thematically analysed. While the authors acknowledge the complexity and individual nature of grief, four broad themes were identified, namely the importance of the 'physical environment' being conducive to spending time with their child; 'seeing their child'; 'time to say goodbye'; and 'supportive care'. Conclusion: The findings of this study reinforce that extended viewing can provide therapeutic benefits for parents, as well as the importance of a skilled palliative care nursing workforce in assisting with grief management. [ABSTRACT FROM AUTHOR]

Background: Children with chronic kidney disease (CKD) generally have worse educational and psychosocial outcomes compared with their healthy peers. This can impair their ability to manage their treatment, which in turn can have long-term health consequences through to adulthood. We attempted to capture the experiences of children with CKD and to describe the perspectives of their parents and caregivers on access to educational and psychosocial support. Methods: Children with CKD (n = 34) and their caregivers (n = 62) were sampled via focus groups from pediatric hospitals in Australia, Canada, and the USA. Sixteen focus groups were convened and the transcripts were analyzed thematically. Results: We identified four themes: disruption to self-esteem and identity (emotional turmoil of adolescence, wrestling with the sick self, powerlessness to alleviate child's suffering, balancing normality and protection); disadvantaged by lack of empathy and acceptance (alienated by ignorance, bearing the burden alone); a hidden and inaccessible support system (excluded from formal psychological support, falling behind due to being denied special considerations); and building resilience (finding partners in the journey, moving towards acceptance of the illness, re-establishing childhood). Conclusions: Children with CKD and their caregivers encountered many barriers in accessing psychosocial and educational support and felt extremely disempowered and isolated as a consequence. Improved availability and access to psychosocial and educational interventions are needed to improve the wellbeing and educational advancement of children with CKD. A higher resolution version of the Graphical abstract is available as Supplementary information. [ABSTRACT FROM AUTHOR]

Mothering and motherhood can be a very challenging experience in the 21st century, where cultural pressures, on the one hand, and health experts' regular parenting surveillance, on the other, continue to influence mothering decisions and practices. The socially constructed "good mother" discourses and associated pressures/influences can be amplified for vulnerable mothers who may feel marginalized from or judged by the broader society. This article presents findings from a study that involved interviews with ten young mothers and 12 staff working at a leading family welfare agency supporting young parents in Melbourne, Australia. The study examined how digital technology could promote a sense of agency for vulnerable mothers as well as barriers and enablers of accessing digital knowledge and online parenting support. In addition, the study explored how technology could assist community organizations' staff in helping their clients better. This paper argues that, overall, digital technologies can positively influence the experience of mothering and can empower vulnerable mothers by increasing their access to various sources of support. Furthermore, our findings suggest that technology can enhance community and family service providers' practice, opening possibilities for a more supportive relationship with clients by empowering them and increasing agency over their situation. [ABSTRACT FROM AUTHOR]

Paediatric acquired brain injury (ABI) negatively impacts parental wellbeing and family functioning. Adaptive coping, that is behaviours promoting emotional wellbeing and addressing distressing problems, may support wellbeing and family functioning. This study compared wellbeing, coping, and family functioning between parents of a child with ABI and parents in the community, and examined coping as a predictor of wellbeing and family functioning. Forty parents of a child with ABI and 40 parents in the community participated in this cross-sectional survey using the Personal Wellbeing Index, Coping Scale for Adults Short Form, McMaster Family Assessment Device (General Functioning Subscale). The ABI group had statistically significantly lower wellbeing, t(68.70) = −4.01, p < 0.001, lower adaptive coping, t(73.95) = −3.27, p = 0.002, and poorer family functioning, t(77) = 4.26, p < 0.001. Family composition (single-parent/couple), having a child with ABI, adaptive coping, and non-productive coping predicted 47.7% of the variance in wellbeing, F(5, 70) = 12.75, p < 0.001. Parental education, having a child with ABI, and non-productive coping predicted 35.9% of the variance in family functioning, F(5, 69) = 7.71, p < 0.001. Adaptive coping may contribute to better family outcomes in paediatric ABI. Paediatric ABI may have a significant impact on the child with ABI and the family, leading to poorer outcomes for some families. This study suggested that parents of a child with ABI use adaptive coping less than parents in the community but do not differ in the use of non-productive coping. Families need long-term targeted support to meet the challenges paediatric ABI presents and may benefit from interventions which actively seek to change parental coping strategies. [ABSTRACT FROM AUTHOR]

This study investigated parent-reported barriers and enablers to establishing sun safety practices with young children (0–4 years; N = 423) living in Australia. An online survey examined parent/child adherence to recommended sun safety practices and barriers and enablers to establishing sun safety practices. Adherence to different sun safety practices varied across age groups. Lack of child cooperation was the most commonly-endorsed barrier while child compliance was the most commonly-endorsed facilitator. Young children's lack of cooperation with sun safety practices represents a major obstacle for parents. In conclusion, the development and testing of family-based intervention approaches to reduce child resistance and promote cooperation is warranted. [ABSTRACT FROM AUTHOR]

Participation in high-quality early childhood education and care (ECEC) benefits children and society. Policy recognition of this manifests through government subsidy strategies to increase ECEC access in the years immediately preceding school. Yet despite this action, many children do not receive the recommended amount. This study utilizes a mixed-methods design to investigate ECEC participation barriers and facilitators in three Australian communities. Parents and service providers completed online questionnaires (45 parents, 63 providers) and semi-structured interviews (21 parents, 16 providers). Results showed that issues related to both direct (e.g., fees) and indirect (e.g., travel) costs are particularly important barriers for families, and are well-recognized by providers. A range of factors were also considered important for facilitating participation (e.g., effective promotion of the benefits linked to high-quality play-based learning in formal settings, professional training of staff). Findings demonstrated the ecological complexity of participation. Strategies to address barriers and harness facilitators are required across multiple levels. Highlights: Participation in high-quality early childhood education benefits children. Many children do not receive the recommended dose of early childhood education. Parents and providers see various participation costs as important barriers. Providers may underestimate barriers relating to maternal role beliefs. Promotion of child benefits and staff training may facilitate participation. [ABSTRACT FROM AUTHOR]

Background: Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. Method: The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. Results: More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child's mental health. Between-person baseline predictors of higher intention ratings were parent's prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child's education, lower social support and financial hardship. Conclusion: Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need. [ABSTRACT FROM AUTHOR]

Objectives: To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care. Methods: A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children's Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity. Results: The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities. Conclusions: Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care. What is known about the topic? Children with chronic medical conditions have high rates of unmet need for mental healthcare. Qualitative research has indicated features of mental health services that may be important to consider in service design to address these unmet needs. What does this paper add? A detailed understanding of parents' preferences for features of mental health services for children with chronic medical conditions, including their importance and prediction of uptake under different scenarios. What are the implications for practitioners? Parents preferred services with recommendation from specialists, mental health providers who understand the impact of chronic conditions, lower cost, and shorter wait time. Offering preferred mental health services is predicted to significantly reduce unmet needs and reduce inequalities in care. [ABSTRACT FROM AUTHOR]

Autism assistance dogs (AADs) increase safety for children with autism and their families. Autism assistance dogs can also decrease familial stress and the isolation which families may experience due to fear for their child's safety and judgement from others within the community. Currently there is a paucity of literature on parents' experiences of AADs. Therefore, this study aimed to develop a rich understanding of parents' experiences of owning an AAD. A mixed methods design was utilised, with a qualitative descriptive design and the use of occupational mapping. Eight families were recruited through an Australian AAD programme and participated in semi‐structured in‐depth interviews throughout 2017. The interviews were analysed thematically. Mobility in the community before and after introduction of the dog was measured using occupational mapping. Families plotted on Google Map printouts the places they frequented before and after placement of their dog. Five major themes emerged from the analysis of the interviews: freedom through restraint; expanding our world; a calming/sensory tool (AAD); "at the end of the day they're dogs"; and, friendship and personal growth. The occupational maps demonstrated a median increase of 8.5 more places and 20.50 km further travelled from home after having the dog for over a year. Families with an AAD experienced an expanded world for the child and their family. Families experienced freedom in the places they could go, decreased isolation due to the safety which the dog provides. Occupational mapping supported the qualitative data, showing increased mobility and decreased isolation of the family. The paradox of freedom through restraint is a new and key finding which requires further exploration. The results provide support for funding and increased awareness of AAD programmes. Future longitudinal comparative studies are needed to explore the long‐term impact of AADs on the child and family. [ABSTRACT FROM AUTHOR]