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Background The quality of the home learning environment has a significant influence on children’s language and communication skills during the early years with children from disadvantaged families disproportionately affected. This paper describes the protocol and participant baseline characteristics of a community-based effectiveness study. It evaluates the effects of ‘smalltalk’, a brief group parenting intervention (with or without home coaching) on the quality of the early childhood home learning environment. Methods/design The study comprises two cluster randomised controlled superiority trials (one for infants and one for toddlers) designed and conducted in parallel. In 20 local government areas (LGAs) in Victoria, Australia, six locations (clusters) were randomised to one of three conditions: standard care (control); smalltalk group-only program; or smalltalk plus (group program plus home coaching). Programs were delivered to parents experiencing socioeconomic disadvantage through two existing age-based services, the maternal and child health service (infant program, ages 6–12 months), and facilitated playgroups (toddler program, ages 12–36 months). Outcomes were assessed by parent report and direct observation at baseline (0 weeks), post-intervention (12 weeks) and follow-up (32 weeks). Primary outcomes were parent verbal responsivity and home activities with child at 32 weeks. Secondary outcomes included parenting confidence, parent wellbeing and children’s communication, socio-emotional and general development skills. Analyses will use intention-to-treat random effects (“multilevel”) models to account for clustering. Recruitment and baseline data Across the 20 LGAs, 986 parents of infants and 1200 parents of toddlers enrolled and completed baseline measures. Eighty four percent of families demonstrated one or more of the targeted risk factors for poor child development (low income; receives government benefits; single, socially isolated or young parent; culturally or linguistically diverse background). Discussion This study will provide unique data on the effectiveness of a brief group parenting intervention for enhancing the early home learning environment of young children from disadvantaged families. It will also provide evidence of the extent to which additional one-on-one support is required to achieve change and whether there are greater benefits when delivered in the 1st year of life or later. The program has been designed for scale-up across existing early childhood services if proven effective. Trial registration 8 September 2011; ACTRN12611000965909.

Summary Background & aims Child growth impairments are rampant in sub-Saharan Africa. To combat this important health problem, long-term follow-up studies are needed to examine possible benefits and sustainability of various interventions designed to correct inadequate child growth. Our aim was to perform a follow-up study of children aged 60–72 months whose mothers participated in a two-armed cluster-randomized education intervention trial lasting 6 months in rural Uganda when their children were 6–8 months old with data collection at 20–24 and at 36 months. The education focused on nutrition, hygiene, and child stimulation. Methods We measured growth using anthropometry converted to z-scores according to WHO guidelines. We also included assessments of body composition using bioimpedance. We used multilevel mixed effect linear regression models with maximum likelihood method, unstructured variance-covariance structure, and the cluster as a random effect component to compare data from the intervention (receiving the education and routine health care) with the control group (receiving only routine health care). Results Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of the children in the intervention and control group, respectively, were available for the current follow-up study. We found no significant differences in any anthropometrical z-score between the two study groups at child age of 60–72 months, except that children in the intervention group had lower (P = 0.006) weight-for-height z-score than the controls. There were no significant differences in the trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child age of 60–72 months. Neither did we detect any significant difference between the intervention and control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60–72 months. Separate gender analyses had no significant impact on any of the growth or body composition findings. Conclusion In this long-term study of children participating in a randomized maternal education trial, we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity or body composition. Trial registration Clinical Trials (clinical trials.gov) ClinicalTrials.gov ID NCT 02098031.

Children with autism spectrum disorder often display deficits in daily living skills. Behavior analysts can use telehealth, such as videoconferencing technology, to deliver interventions to families of these children. Given the COVID-19 pandemic and the common barriers to accessing behavioral interventions, it is imperative to evaluate the effectiveness and practicality of delivering behavioral interventions via telehealth. This study evaluated the efficacy of a parent-implemented intervention with coaching via telehealth to improve daily living skills. Children ranging in age from 5 to 9 years participated in the study with 1 or 2 of their parents serving as the primary implementer(s). Parents implemented the intervention with fidelity and the intervention yielded increases in independent daily living skill completion for all 4 participants.

Objective To explore fathers' pregnancy and early infancy experiences in supporting his infant, partner, and himself, using information collected from fathers, mothers, and mother-father dyads in a low-income, urban community. Background Father involvement is associated with positive child health outcomes and parental well-being. However, little information exists about low-income parents' perceived needs for father involvement during pregnancy and infancy. Methods This was an exploratory qualitative study of parents in low-income communities of Baltimore, Maryland. Participants were conveniently sampled via partnerships with community organizations. Eighty percent of parents were African American. Four focus groups were conducted with fathers (n = 8), 4 with mothers (n = 9), and 4 interviews with father-mother dyads (n = 8). Sessions were audio-recorded, transcribed, and analyzed using iterative, inductive open coding performed independently by two team members (interrater agreement 86%). Frequency tables were generated for identified categories for content analysis and theme development. Results Five themes were identified: perspectives on the father role, supporting partners, negotiating co-parenting, parenting logistics, and learning parenting skills. Participants expressed the importance of fathers to “be there” and barriers to being involved (e.g., finances, lack of role models). Fathers discussed needing to learn how to manage partner conflicts, while mothers discussed fathers' need for greater empathy. Dyads discussed the importance of co-parenting strategies (e.g., effective communication, sharing responsibilities). Logistics included direct infant care, finances, and community resources. Fathers discussed learning by trial and error rather than informational resources and relying on healthcare professionals for pregnancy information and female relatives for infant care. Conclusion Participants discussed various needs of fathers to be effective partners and parents, and lacking informational resources tailored specifically for fathers. Research is needed to explore the best ways to tailor and disseminate information to fathers, especially prenatally. Implications Study findings have significant implications for improving the ways in which maternity care, community-based programs, and pediatric providers support father involvement.

Child maltreatment is a global phenomenon that affects the lives of millions of children. Worldwide, as many as one in three to six children encounter physical, sexual, or emotional abuse from their caregivers. Children who experience abuse often show alterations in stress reactivity. Although this alteration may reflect a physiological survival response, it can nevertheless be harmful in the long run-increasing children's disruptive behavior and jeopardizing their development in multiple domains. But can we undo this process in at-risk children? Based on several lines of pioneering research, we hypothesize that we indeed can. Specifically, we hypothesize that highly dysfunctional parenting leads to an epigenetic pattern in children's glucocorticoid genes that contributes to stress dysregulation and disruptive behavior. However, we also hypothesize that it is possible to "flip the methylation switch" by improving parenting with known-effective parenting interventions in at-risk families. We predict that improved parenting will change methylation in genes in the glucocorticoid pathway, leading to improved stress reactivity and decreased disruptive behavior in children. Future research testing this theory may transform developmental and intervention science, demonstrating how parents can get under their children's skins-and how this mechanism can be reversed.

Background Poor eye contact and joint attention are early signs of autism spectrum disorder (ASD) and important prerequisites for developing other socio-communicative skills. Teaching parents evidence-based techniques to improve these skills can impact the overall functioning of children with ASD. We aimed to analyse the impact of conducting a group parent-training intervention with video modelling to improve the intelligent quotient (IQ), social and communication functioning and to minimise symptoms in children with ASD and intellectual disability (ID). Methods Study design: A multicentre, single-blinded, randomised clinical pilot trial of parent training using video modelling was conducted. Sample Sixty-seven parents of children with ASD, aged between 3 and 6 years and with IQs between 50 and 70, were randomised: 34 to the intervention group and 33 to the control group. Intervention program: The intervention group received parent training over 22 sessions, and the control group received the standard community treatment. Instruments Pre-evaluation and post-evaluation (week 28), the following were used: Autism Diagnostic Interview, Vineland Adaptive Behaviour Scale I, Snijders-Oomen Nonverbal Intelligence Test, Autism Behaviour Checklist and Hamilton Depression Rating Scale. Data analysis Intention to treat and complier-average causal effect (CACE) were used to estimate the effects of the intervention. Results There was a statistically significant improvement in the Vineland standardized communication scores in CACE (Cohen's d = 0.260). There was a non-statistically significant decrease in autism symptomatology (Autism Behaviour Checklist total scores) and a significant increase in the non-verbal IQ in the intervention group. After the false discovery rate correction was applied, IQ remained statistically significant under both paradigms. The effect size for this adjusted outcome under the intention-to-treat paradigm was close to 0.4, and when considering adherence (CACE), the effect sizes were more robust (IQ's Cohen's d = 0.433). Conclusions Parent training delivered by video modelling can be a useful technique for improving the care given to children with ASD and ID, particularly in countries that lack specialists.

Although behavioral therapy is an effective approach to reduce tics in children and adults, there is an insufficient availability and accessibility of behavioral therapy in the community.The goal of the study was to test the clinical efficacy of home-based, parent-provided behavioral therapy in children with Tourette syndrome aged seven to 13 years.An instructional habit reversal training-based video and guide was developed for use by parents. Eligible families, in this 10-week study, were enrolled in either a home-based therapy (DVD) group (received disk and written instructions) or an in-person therapist group (had scheduled visits with the therapist). Outcome scales included the Yale Global Tic Severity Scale, both the total Tic Severity Score and total Global Severity Score, and the parent report of Clinical Global Impressions of Improvement.Forty-four children (mean age = 10.21 ± 1.69 years) were enrolled into either the DVD (n = 33) or in-person therapist (n = 11) groups. Eighteen completed the study-eight in the DVD and 10 in the in-person therapist group. Outcome measures showed significant reductions in Yale Global Tic Severity Scale change ratios: mean improvement on the Tic Severity Score was DVD 32.4% (P 0.001) and in-person therapist 26.6% (P = 0.01); and for the Global Severity Score, DVD 33.7% (P 0.001) and in-person therapist 26.7% (P 0.001).Home-based, parent-administered habit reversal training behavioral therapy is efficacious for reducing tics in children. Telephone contacts early in the DVD treatment course might reduce the number of dropouts.

Young children with attention deficit hyperactivity disorder (ADHD) cope with functional difficulties attributed to executive dysfunction. This study evaluates the feasibility of the Parental Occupational Executive Training (POET) intervention. Parents of 71 children (4–7 years) with ADHD attended 8 to 10 weekly, personally tailored intervention sessions with an occupational therapist. Quantitative and qualitative measures were used to examine feasibility in four indices: parental attendance, adherence, and acceptance, and therapist fidelity. Parental attendance and home-strategy use during daily activities rates were high. Parents identified the occupational performance coaching model’s principles as supporting their ability to implement the intervention. Therapists demonstrated high fidelity to the POET’s theoretical bases. The POET is a feasible intervention with high parental attendance (98.61%), parental adherence (80.56%–94.44%), and therapist fidelity (100.00%). It can be implemented within child development centers and occupational therapy clinics and leads to parents’ increased adherence.

Legacy for Children™ (Legacy) is an evidence-based program focused on promoting sensitive, responsive parenting for socioeconomically disadvantaged families. Legacy has recently been culturally and linguistically adapted for Spanish-monolingual Latino families and is being piloted in partnership with an early childhood education program. We conducted a mixed methods study to identify barriers and facilitators to engagement, using program monitoring data sources from both participant and group leader perspectives. We conducted qualitative analyses of open-ended data to identify distinct barriers (e.g., employment challenges, health-related challenges and appointments) and facilitators (e.g., other mothers in group, interest in program topics) to engagement that emerged across English and Spanish language curriculum versions; curriculum-specific barriers and facilitators were also documented. We interpret these findings in light of quantitative data on measures of engagement, showing that participants in the Spanish curriculum evidenced comparable levels of parent-group leader relationship quality relative to the English group, and higher levels of parent's group support/connectedness and overall satisfaction. These results offer promising considerations for optimizing families' engagement in parenting programs in the context of early care and education settings.Legado para los Niños™ (Legado) es un programa basado en la evidencia que se centra en promover una crianza sensible y susceptible para familias con desventajas socioeconómicas. Recientemente, Legado se ha adaptado cultural y lingüísticamente para familias Latinas en las que sólo se habla español, y está siendo puesto en práctica experimental en asociación con un programa de educación en la temprana niñez. Llevamos a cabo un estudio con una variedad mixta de métodos para identificar obstáculos y promotores para ser incluidos usando recursos de información de la supervisión del programa provenientes de las perspectivas tanto de participantes como de líderes de grupo. Realizamos análisis cuantitativos de información no limitada de antemano para identificar diferentes obstáculos (v.g. dificultades de empleo, dificultades y citas relacionadas con la salud) y promotores (v.g. otras madres en el grupo, interés en los temas del programa) para ser incluidos los cuales surgieron a lo largo de las versiones curriculares del inglés y del español; también se documentaron los obstáculos y promotores relacionados con el currículo específico. Interpretamos estos resultados a la luz de la información cuantitativa sobre medidas de participación, mostrando que los participantes en el currículo en español demostraron comparables niveles de calidad de la relación progenitor-líder de grupo en relación con el grupo de inglés, y más altos niveles de apoyo del grupo a los progenitores y satisfacción en general. Estos resultados ofrecen consideraciones prometedoras para lograr una óptima participación de las familias en programas de crianza en el contexto de escenarios de cuidado y educación tempranos.Le programme Legacy for ChildrenTeilnahme von Eltern an einem originalen und einem kulturell adaptierten, evidenzbasierten Elternprogramm: "Vermächtnis für Kinder“ „Vermächtnis für Kinder“ (Legacy) ist ein evidenzbasiertes Programm zur Förderung sensibler, responsiver Erziehung für sozioökonomisch benachteiligte Familien. Legacy wurde vor kurzem kulturell und sprachlich für einsprachig-spanische Latino-Familien angepasst und wird in Zusammenarbeit mit einem frühkindlichen Bildungsprogramm pilotiert. Wir haben eine gemischte Methodenstudie durchgeführt, um Barrieren und vereinfachende Faktoren für eine Teilnahme zu identifizieren. Dafür haben wir zur Programmüberwachung Datenquellen sowohl aus Sicht der Teilnehmenden als auch der Gruppenleitenden verwendet. Wir haben qualitative Analysen offener Daten durchgeführt, um bestimmte Barrieren (z. B. berufliche Schwierigkeiten, gesundheitliche Probleme und Terminierung) und vereinfachende Faktoren (z. B. andere Mütter in der Gruppe, Interesse an Programmthemen) für eine Teilnahme zu identifizieren, die sich in der englischen und der spanischen Version des Curriculums abzeichneten. Curriculumsspezifische Barrieren und vereinfachende Faktoren wurden ebenfalls dokumentiert. Wir interpretieren diese Ergebnisse angesichts quantitativer Daten zur Teilnahme und zeigen, dass die Teilnehmenden am spanischen Curriculum im Vergleich zur englischen Gruppe eine vergleichbare Qualität der Beziehung zwischen Eltern und Gruppenleitenden sowie eine höhere Unterstützung / Verbundenheit und allgemeine Zufriedenheit unter den Eltern aufweisen. Diese Ergebnisse bieten vielversprechende Überlegungen zur Optimierung der Beteiligung von Familien an Erziehungsprogrammen im Kontext von Frühförderung und Bildung.オリジナルで、文化的に改変されたエビデンスに基づく子育てプログラム−レガ シー・フォー・チルドレンTM−に対する親の関与度 レガシー・フォー・チルドレンTM(Legacy)は、 社会経済的に恵まれない家族の ための繊細で応答的な子育てを促進することに焦点を置いたエビデンスに基づく プログラムである。Legacyは最近、スペイン語だけを使用するラテンアメリカ系 の家族のために、文化的言語的に改変され、幼児教育プログラムと共に試験的に 実施された。我々は、参加者とグループリーダーのそれぞれの視点からの、プロ グラムをモニタリングしたデータソースを使って、関与度に関しての障壁要素と 促進要素を同定するために混合研究法を使った。英語版とスペイン語版のカリキ ュラムにまたがって表れた関与度に関する明確な障壁要素 (例:雇用の課題、健 康の課題と予約に関する課題) と促進要素 (例:グループの中の他の母親達、プ ログラムのテーマに対する興味) を同定するために、自由回答のデータの定性分 析を行った。それぞれのカリキュラムに特有の障壁要素と促進要素も記録された。 これらの結果を、関与度を測定した定量データに照らして解釈した。その結果、 スペイン語のカリキュラムへの参加者は、英語のグループと比較して、親とグル ープリーダーの関係性の質は同等レベルであり、親のグループのサポート／つな がりと全体的な満足度はより高いレベルであることが証明されたことを示した。 これらの結果は、幼児教育・保育の設定の文脈において子育てプログラムにおけ る家族の関与度を最適化するための有望な考慮事項を提供している。.“儿童传承”是一项循证项目, 致力于推动社会经济上处于弱势的家庭开展体贴的、积极的育儿方式。该项目最近在文化和语言上适合了西班牙语单语的拉丁裔家庭, 并且正在与一个幼儿教育计划合作进行试点。我们进行了一项混合方法研究, 从参与者和小组负责人的角度, 利用项目监控数据源, 确定参与的障碍和促进因素。我们对开放式数据进行了定性分析, 以确定英语和西班牙语课程版本中明显的参与障碍 (例如, 就业挑战, 与健康相关的挑战和任命) 和促进 (例如, 小组中的其他母亲, 对项目主题感兴趣) 因素;课程特定的障碍和促进因素也被记录在案。我们根据参与度的量化数据来解释这些发现。结果表明, 西班牙语课程的参与者在育儿小组的领导关系质量方面与英语组的参与者水平相当, 并且其育儿的小组支持、沟通以及整体满意度更高。这些结果为儿童早期看护和教育机构优化家庭参与育儿计划提供了可能的参考。.مشاركة الوالدين في برنامج أصلي معدل ثقافيا قائم على الأدلة (برنامج إرث للأطفال: Legacy) برنامج إرث للأطفال (Legacy) هو برنامج قائم علي الادله يرتكز علي تعزيز الرعاية الوالدية الحساسة وسريعة الاستجابة عند العائلات المحرومة اجتماعيا. وقد تم مؤخرا تطويع برنامج (Legacy) ثقافيا ولغويا للأسر الاسبانيه اللاتينية أحاديه اللغة ويجري تجريبه بالشراكة مع برنامج تعليمي للطفولة المبكرة. وقد أجرينا دراسة مختلطة المنهج لتحديد العوائق والعوامل الميسرة للمشاركة ، وذلك باستخدام مصادر بيانات رصد البرامج من منظور كل من المشاركين وقادة المجموعات. وأجرينا تحليلات وصفية للبيانات لتحديد العوائق البارزة (مثل تحديات العمالة ، والتحديات الصحية ومشاكل المواعيد) والعوامل الميسرة (مثل الأمهات الأخريات في المجموعات ، والاهتمام بمواضيع البرنامج) للمشاركة التي برزت من خلال الإصدارات الإنجليزية والأسبانية للمنهج. وتم أيضا توثيق العوائق والعوامل الميسرة الخاصة بالمناهج. ونحن نفسر هذه النتائج في ضوء البيانات الكمية المتعلقة بمقاييس المشاركة ، والتي تبين ان المشاركين في المنهج الاسباني اثبتوا مستويات مماثله من جوده علاقة الآباء بقائد المجموعة بالمقارنة مع المجموعة الانجليزيه ، ومستويات اعلي من دعم/ترابط مجموعة الآباء والرضا العام. وتقدم هذه النتائج اعتبارات واعدة لتحسين مشاركه الأسر في برامج الرعاية الوالدية في سياق الرعاية المبكرة وسياقات التعليم.

Background Children with intellectual disabilities are likely to present with challenging behaviour. Parent mediated interventions have shown utility in influencing child behaviour, although there is a paucity of UK research into challenging behaviour interventions in this population. NICE guidelines favour Stepping Stones Triple P (SSTP) as a challenging behaviour intervention and this trial aims to evaluate its clinical and cost effectiveness in preschool children with moderate to severe intellectual disabilities. Methods This trial launched in 2017 at four sites across England, with the aim of recruiting 258 participants (aged 30–59 months). The Intervention Group receive nine weeks of SSTP parenting therapy (six group sessions and three individualised face to face or telephone sessions) in addition to Treatment as Usual, whilst the Treatment as Usual only group receive other available services in each location. Both study groups undergo the study measurements at baseline and at four and twelve months. Outcome measures include parent reports and structured observations of behaviour. Service use and health related quality of life data will also be collected to carry out a cost effectiveness and utility evaluation. Discussion Findings from this study will inform policy regarding interventions for challenging behaviour in young children with moderate to severe intellectual disabilities. Trial registration number Clinicaltrials.gov, NCT03086876. Registered 22nd March 2017, https://clinicaltrials.gov/ct2/show/NCT03086876.

Poor nutritional status or stunting still becomes a public health problem in Indonesia, with prevalence of 37.2% in 2013. Some research results show that stunted children have lower cognitive development than normal children. This study aims to assess whether there is an effect of giving multiple-nutrient biscuits and psychosocial parenting education on height and development of children under the age of three (toddlers). This study used quasi experimental design. The treatment was given for 2 mo to 28 stunted children who were divided into 3 groups, namely: (1) multiple-nutrient biscuits (2) psychosocial parenting education (3) multiple-nutrient biscuits and psychosocial parenting education. Multiple-nutrients biscuit was given 12 pieces a day for 2 mo. Meanwhile, psychosocial parenting education was given direcly by psychologist in the form of lectures, brainstorming and role play. In order to identify the effect of treatment on children's height and development, the data obtained was analyzed using paired t-test, while the analysis of differences between treatment groups was carried out using analysis of variance (ANOVA). The results showed that giving psychosocial parenting education significantly increased height, children's nutritional status based on height by age index, and improved cognitive development among toddlers. Giving multiple-nutrient biscuits and psychosocial parenting education significantly increased height and cognitive development among toddlers. In order to overcome children's growth and development problem, nutrition interventions need to be carried out along with the provision of education about maternal parenting to children.

Autism, also known as pervasive developmental disorder or autism spectrum disorder, is a group of clinical syndromes of developmental delay or impairment. Social impairment, verbal communication impairment, and behavioral impairment are the three conditions for the diagnosis of autism spectrum disorder, according to the American Psychiatric Association’s Diagnostic and Statistical Manual. According to relevant statistics, about 1 in 100 children is now diagnosed with autism, and their rehabilitation treatment is also valued by people from all walks of life. In the rehabilitation training of autistic children, it is found that the rehabilitation training of autistic children should pay attention to the role of parents and family environment. It is crucial that parents receive systematic training and act as partners in the development of the intervention plan. Research shows that a specific structured education and skills training program for parents of children with autism can be beneficial in improving behavioral problems, functional communication, and symptoms of autism in children with autism. To this end, this paper has completed the following work: Secondly, a portion of the systematic training of CA parents is discussed, followed by an explanation of the structure and principles of BPNN. Finally, the BPNN is utilized to create a model for assessing the impact of systematic parent instruction on CA. The experimental findings suggest that the proposed BPNN outperforms the competition.

INTRODUCTION Child-Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group training designed to teach positive parenting skills. Parent engagement in such programs is a common implementation barrier. Our objectives were to (1) examine the impact of a peer mentor on attendance and stigma and (2) replicate a previous study by measuring PriCARE's impact on child behavior and parenting practices. METHOD Parents of 2- to -6-year-old children without specific behavior problems were randomized to mentored PriCARE (n = 50), PriCARE (n = 50), or control (n = 50). Stigma was measured at 10 weeks. Child behavior and parenting practices were measured at baseline and 10 weeks using the Eyberg Child Behavior Inventory (ECBI) and Parenting Scale (PS). Analysis of variance models were used to examine differences across groups. RESULTS There was no significant difference in attendance between mentored PriCARE and PriCARE arms (mean 3.80 vs 3.36 sessions, p = 0.35). Parents randomized to the mentor reported lower stigma (3.75 vs 5.04, p = 0.02). Decreases in the mean ECBI scores between 0 and 10 weeks were greater in the PriCARE arms (n = 100) compared with the control arm (n = 50), reflecting larger improvements in behavior [intensity: -7 (-2 to -13) vs 4 (-3 to 12) to p = 0.014; problem: -3 (-1 to -4) vs 1 (-1 to 3) to p = 0.007]. Scores on all PS subscales reflected greater improvements in parenting behaviors in PriCARE arms compared with control (all p < 0.04). CONCLUSION Adapting PriCARE with a peer mentor may decrease stigma but does not improve program attendance. PriCARE shows promise in improving behavior in preschool-aged children and increasing positive parenting practices.

Feeding concerns are common in the first 2 years of life and typically reflect maternal perceptions occurring within the larger context of the parent-child relationship. We aimed to determine whether (1) maternal depressive systems predicted perceived picky eating, mediated by maternal negative perceptions; (2) receipt of the Video Interaction Project (VIP) parenting intervention impacted perceived picky eating through this pathway; and (3) perceived picky eating was associated with child growth or subsequent dietary patterns.We performed a partial longitudinal analysis of 187 low-income, predominantly Hispanic mother-child dyads enrolled in a randomized controlled trial of the VIP. Mother-infant dyads were enrolled postpartum in an urban public hospital. Participants randomized to the VIP met with an interventionist on days of well-child visits; sessions were designed to facilitate interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interaction; the curriculum did not contain feeding-specific elements. We used structural equation modeling to determine direct, indirect, and total effects of maternal depressive symptoms, maternal negative perceptions, and the VIP on perceived picky eating. We then tested associations between perceived picky eating and (1) child growth, using multivariable linear regression and multilevel modeling; and (2) subsequent child dietary consumption, using multivariable multinomial logistic regression.Maternal depressive symptoms had significant total effects on negative maternal perceptions (β = 0.32, p0.001) and perceived picky eating (β = 0.21, p0.01) after controlling for potential confounders. This effect was partially mediated by maternal negative perceptions (indirect effect: β = 0.06, p = 0.04). When used in the model as the predictor, the VIP had a significant total effect on perceived picky eating (β = -0.16, p = 0.02), which was partially mediated by maternal depressive symptoms and negative perceptions (indirect effect: β = -0.05, p = 0.02). Perceived picky eating was not associated with child diet at age 2 years or adiposity from 6 months to 3 years.Maternal concerns about picky eating may reflect deeper depressive symptoms and negative perceptions of her child's behavior. Interventions designed to facilitate positive parenting in general may lessen feeding-specific concerns, such as picky eating. Although reassurance about growth and nutritional outcomes for children perceived as picky eaters is appropriate, clinicians should also consider probing for underlying symptoms of depression that could lead to eating concerns.

OBJECTIVE To evaluate differences in how mothers and fathers perceive and respond to their adolescents' chronic pain before and after The Comfort Ability Program (CAP), a 1-day cognitive-behavioral intervention, and to compare outcomes between mother-father dyads and mothers who attended the intervention alone. METHODS Parents completed the Pain Catastrophizing Scale (PCS) and Helping for Health Inventory (HHI) at baseline (preintervention) and at 1 week, 1 month, and 3 months after intervention. Confirmatory factor analyses evaluated construct validity and invariances of the scales. Paired t tests compared scores between mothers and fathers. Unpaired t tests compared mother-father dyads (n = 33) and mothers who attended the intervention alone (n = 73). RESULTS PCS baseline showed significant construct instability between maternal and paternal interpretations. However, 1 week after intervention, construct stability improved between parents. On the PCS and HHI, in which lower scores represent more adaptive parenting behaviors, fathers scored significantly lower than mothers at baseline (PCS: 22.6 [7.7] vs 28.0 [11.4], p value = 0.033; HHI: 16.0 [8.1] vs 20.6 [9.6], p value = 0.029). At 3 months after intervention, PCS scores for both mothers and fathers significantly decreased from baseline (mothers: p value = 0.009; fathers: p value = 0.052) and converged (mothers: 18.6 [11.2] vs fathers: 18.3 [13.2]; p value = 0.786). Mother and father HHI scores were significantly lower at 3 months than baseline (mothers: 13.2 [9.5], p value = 0.005; fathers: 15.0 [12.7], p value = 0.017), although improvement of construct stability between parents was less evident. CONCLUSION Findings suggest that mothers and fathers may differentially perceive and respond to their adolescents' pain and that CAP parent-training intervention may help align their thinking. The results further demonstrate that both parents make adaptive changes after intervention, reinforcing the value of including both parents in pediatric treatment for chronic pain.

INTRODUCTION: Obesity affects 15.7% of U.S. preschoolers, with higher rates among low-income and Spanish-speaking populations. Food, physical activity, and sleep parenting practices, referred to collectively as obesity-related parenting practices, are linked with children’s risk of obesity and are a common target in family-based obesity interventions. Yet, there is no brief, validated measure of obesity-related parenting practices that is appropriate for use in intervention studies and for diverse audiences. This study tests the factorial validity of a brief measure of obesity-related parenting and measurement invariance of the English and Spanish versions of the scale, as well as among mothers and fathers. METHODS: Parents of children enrolled in Head Start (N=578; 500 mothers and 78 fathers) completed a brief survey of food (seven items), physical activity (five items), and sleep parenting (three items) in fall of 2017 and of 2018. Scale items were drawn from existing measures and the evidence base, initially drafted in English, and then translated to Spanish. One parent per family completed the scale independently in English (n=448) or Spanish (n=130). A confirmatory factor analysis framework was adopted to test a three-factor model for the total sample. Multi-group structural equation modeling was used to assess measurement invariance of the scale by the language of administration (English or Spanish) and among mothers and fathers separately. RESULTS: Results supported a three-factor model of obesity parenting with a single factor each for food, physical activity, and sleep parenting. There was statistically significant measurement invariance across all groups (p

IntroductionParenting programmes help to alleviate conduct problems in children, but ensuring that all parents feel supported to attend, complete and learn from these programmes has proven difficult. Parents can feel overwhelmed and struggle to change their parenting. This article aims to inform the future refinement of parenting programmes by examining parents’ narratives of how programmes motivated them to change and enabled them to put changes into practice.Method and resultsForty-two parents, most of whom had attended Incredible Years group sessions, were interviewed about their views and experiences of parenting programmes that focused on positive parenting practices. Analysis of interview transcripts drew on thematic approaches. Parents perceived that parenting programmes helped them to better understand their child and themselves and to let go of anxieties surrounding their child’s behaviour. Better understanding included greater awareness of emotions and of behaviours their child could and could not control. Parents believed this awareness helped them to change the ways that they interacted with their child, which, in turn, helped them and their child to feel calmer. With greater understanding and calmness parents believed they became more able to see for themselves the changes that they could make in their parenting and everyday lives, and to feel more confident in putting these into practice.DiscussionBy supporting parents to reflect on their own and their child’s situation, parents perceived that programmes enabled them to improve interactions with their children without getting stuck in self-blame or feeling overwhelmed. Parents of children whose behaviour remained challenging believed that programmes led to beneficial changes in the way they felt about their child’s behaviours. Enhanced support for reflection by parents could potentially help more families to benefit from parenting programmes.

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes pre- and post-following CM Facebook. A binary indicator was developed to measure whether the outcomes were improved (1 = Improved, 0 = Not improved). Multi-variable logistic regressions were applied to examine the relationship between whether the outcome was improved with reference to the baseline socio-demographics. No significant differences were detected between pre and post outcomes overall (p &gt, 0.05), except improvement in feeding healthy meals within the budget available (p &lt, 0.05). However, improvement in select outcomes was more significant in men and single-parent households. The CM Facebook page could be an important platform to influence low-income caregivers of young children.

Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents’ and pediatricians’ perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020), one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children’s healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice, and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents’ needs and pediatricians’ perceptions of those needs with regard to CoF information.

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants' and young children's cumulative physiological stress.Este estudio puso a prueba una práctica de intervención contemplativa secular con base en un grupo, el Entrenamiento Compasivo con Base Cognitiva (CBCT), con padres de niños pequeños. Nosotros reportamos sobre un estudio de efectividad preliminar controlado al azar. Maestros titulados administraron el CBCT por 20 horas a lo largo de 8-10 semanas en dos grupos de padres con infantes y niños pequeños. El grupo de intervención fue comparado con un grupo de control en lista de espera. Treinta y nueve padres y sus niños, que oscilaban en edad de 4 meses a 5 años, fueron evaluados antes y después de la intervención (n=25 grupo de intervención, n=14 grupo de control en lista de espera) en cuanto a la concentración de cortisol en el cabello. Los padres también completaron cuestionarios auto-administrados en ambos momentos temporales con respecto a información demográfica, síntomas físicos de estrés, estrés de crianza, auto-compasión, así como plena conciencia. Los niños de padres en el grupo CBCT experimentaron una significativa disminución de cortisol al momento de la evaluación posterior a la intervención, tal como se les comparó con el grupo de control. Sin embargo, el cortisol de los padres y las medidas de auto-reporte no cambiaron significativamente. El CBCT pudiera ser una nueva manera positiva de intervenir con padres para reducir el estrés fisiológico cumulativo de infantes y niños pequeños.Cette étude a testé une intervention de pratique contemplative séculaire et basée sur un groupe, la Formation de Compassion Cognitive (abrégé ici selon l'anglais CBCT), avec des parents de jeunes enfants. Cet article porte sur une étude d'efficacité préliminaire randomisée et contrôlée. Des formateurs certifiés ont procédé à une CBCT de 20 heures réparties sur 8-10 semaines chez deux cohortes de parents avec des nourrissons et des jeunes enfants. Le groupe d'intervention a été comparé à un groupe de contrôle en liste d'attente. Trente-neuf parents et leurs enfants, allant de 4 mois à 5 ans d’âge, ont été évalués avant et après l'intervention (n=25 intervention, n=14 contrôle de liste d'attente) sur la concentration de cortisol capillaire. Les parents ont également rempli des questionnaires auto-administrés aux deux temps d’évaluation, concernant des données démographiques, les symptômes physiques de stress, le stress de parentage, l'auto-compassion et la pleine conscience. Les enfants de parents du groupe CBCT ont fait preuve de baisses de niveau de cortisol importantes à l’évaluation post-intervention en comparaison au groupe de contrôle. Cependant le cortisol parental et les mesures auto-rapportées n'ont pas changé de manière importante. La CBCT peut être une nouvelle manière positive d'intervenir avec les parents afin de faire baisser le stress physiologique cumulatif des nourrissons et des jeunes enfants.Kognitiv-basiertes Mitgefühlstraining (CBCT) für Eltern reduziert Cortisol bei Säuglingen und Kleinkindern Die vorliegende Studie testet eine gruppenbasierte säkulare kontemplative Praxisintervention, das Kognitiv-basiertes Mitgefühlstraining (Cognitive-Based Compassion Training; CBCT), mit Eltern kleiner Kinder. Es handelt sich hierbei um eine randomisierte kontrollierte vorläufige Wirksamkeitsstudie. Zertifizierte Lehrkräfte führten das CBCT über einen Zeitraum von 20 Stunden in 8 bis 10 Wochen mit 2 Kohorten von Eltern mit Säuglingen und Kleinkindern aus. Die Interventionsgruppe wurde mit einer Wartelisten-Kontrollgruppe verglichen. 39 Eltern und ihre Kinder im Alter von 4 Monaten bis 5 Jahren wurden vor und nach der Intervention hinsichtlich der Cortisolkonzentration in ihren Haaren untersucht (n = 25 Interventionsgruppe, n = 14 Wartelistengruppe). Die Eltern füllten zu beiden Zeitpunkten zudem selbstverantwortlich Fragebögen zu demografischen Angaben, körperlichen Stresssymptomen, Erziehungsstress, Selbstmitgefühl und Achtsamkeit aus. Bei Kindern der Eltern in der CBCT-Gruppe war bei der Beurteilung nach der Intervention im Vergleich zur Kontrollgruppe ein signifikanter Rückgang des Cortisols zu verzeichnen. Die elterlichen Cortisolwerte und Selbstberichtsmaße änderten sich jedoch nicht signifikant. Das CBCT könnte eine positive neue Möglichkeit sein, bei Eltern einzugreifen, um den kumulativen physiologischen Stress von Säuglingen und Kleinkindern zu senken.両親に行った認知に基づく共感トレーニング (Cognitively-Based Compassion Training: CBCT) による乳児や幼児のコルチゾールの減少 本研究では、幼児を持つ両親に対しグループでの非宗教的な瞑想的実践介入 (group-based secular contemplative practice intervention)、認知に基づく共感トレーニング (Cognitively-Based Compassion Training: CBCT) を実施した。われわれが行った予備的な無作為化比較試験の効果研究について報告する。資格を持つ教員が乳児や幼児を持つ両親の二つのグループに対し、8～10 週間にわたって 20 時間の CBCT を行った。介入グループと非介入コントロールグループを比較した。 39 組の両親とその 4 か月 ～5 歳の年齢の子どもについて、介入前後 (介入グループ n = 25、非介入グループ n = 14) の時点で頭髪中のコルチゾールを評価した。両親には、介入前後の時点で統計上のデータ、ストレスによる身体症状、子育てのストレス、セルフ・コンパッション (self-compassion)、そしてマインドフルネス (mindfulness) に関する自記式質問紙を記入してもらった。介入後の評価時点において、CBCT (介入) グループの両親の子どもではコントロール (非介入) グループの子どもに比べ、コルチゾールが有意に減少していた。しかしながら、両親のコルチゾールや自記式評価尺度では、有意な変化は認められなかった。 CBCT は、乳児や幼児の累積的な身体的ストレスを軽減するために役立つ、新しい介入法になるかも知れない。.父母基於認知的同情訓練)CBCT(減少嬰兒和幼兒的皮質醇 本研究測試一個對幼兒父母長期沉思實踐干預小組, 即基於認知的同情訓練 (CBCT)。我們報告一項隨機對照組的初步療效研究。經過認證的教師在兩個同齡群嬰兒的父母中進行 8-10 週的 20 小時 CBCT 培訓。研究比較干預組與候補名單對照組。在干預前和干預後 (n = 25 干預組, n = 14 候補名單對照組), 對年齡在 4 個月至 5 歲之間的 39 位父母及其子女作出頭髮皮質醇的濃度評估。父母還在兩個時間點完成有關其特徵丶壓力的生理症狀丶育兒壓力丶自我同情和內觀的問卷。與對照組相比, CBCT 組父母的孩子在干預後皮質醇顯著下降。但是, 父母的皮質醇和自我報告並沒有明顯改變。 CBCT 可能是一種積極干預父母的新方法, 可以降低嬰兒和幼兒的累積生理壓力。.تدريب التعاطف القائم علي المعرفة (CBCT) للوالدين يقلل من الكورتيزول في الرضع والأطفال الصغار تتناول هذه الدراسة التدخل التاملي القائم علي المجموعة ، والتدريب علي التعاطف المعرفي (CBCT) ، مع آباء وأمهات الأطفال الصغار. وتقدم تقريرا عن دراسة مبدأية منضبطة تجريبيا للكفاءة الأولية. قام مدرسون مؤهلون ومعتمدون بإدارة تدريب العاطفة المعرفية CBCT لمده 20 ساعة خلال 8-10 أسابيع مع مجموعتين من الاباء والأمهات الذين لديهم رضع وأطفال الصغار. تمت مقارنه مجموعه التدخل بالمجموعة الضابطة في قائمه الانتظار. وتم تقييم مجموعة من 39 من الاباء والأمهات وأطفالهم ، الذين تراوحوا في العمر من 4 أشهر إلى 5 سنوات ، في مرحله ما قبل وبعد التدخل (n = 25 المجموعة التجريبية ، n = 14 المجموعة الضابطة) من حيث تركيز الكورتيزول في الشعر. واستكمل الاباء أيضا الاستبيانات التي تدار ذاتيا في كلا التوقيتين فيما يتعلق بالديموغرافيات ، والاعراض الجسدية للإجهاد ، وإجهاد الرعاية الولدية ، والتعاطف الذاتي ، واليقظة. وقد أظهر أطفال الاباء في مجموعه CBCT انخفاضات كبيره في الكورتيزول في تقييم ما بعد التدخل مقارنه بالمجموعة. ومع ذلك ، فإن الكورتيزول عند الوالدين ومقاييس التقرير الذاتي لم تتغير بشكل كبير. وبذلك قد يكون CBCT طريقه ايجابيه جديده للتدخل مع الاباء لخفض الإجهاد الفسيولوجي التراكمي للرضع والأطفال الصغار.

Contemporary parent-implemented early intervention programs for children with autism spectrum disorder usually incorporate a range of techniques with different theoretical underpinnings. While research suggests that parents often learn to implement interventions with an acceptable degree of overall fidelity, there is limited research into parent use of individual intervention techniques. This study included five mothers of young children with autism spectrum disorder who participated in a 12-week parent training program based on the Early Start Denver Model. Ten-minute play samples were coded for the mothers’ use of 18 specific Early Start Denver Model techniques before, during, and 1 month after the training program. The correlation between the mothers’ use of each Early Start Denver Model technique and their child’s level of engagement and expressive language was also calculated. Results suggest that all mothers increased the number of techniques that they were using from baseline to parent training. Some Early Start Denver Model techniques were moderately or strongly correlated with both child engagement and expressive language. There was considerable variation in outcomes across all mother–child dyads. These preliminary results have implications for how parents are trained/coached to implement interventions for young children with autism spectrum disorder. Lay abstract Parents of young children with autism are often taught to deliver interventions which involve several different types of strategies. Research suggests that parents can usually learn to deliver these interventions but not much is known about their use of each specific intervention strategy. This study included five mothers of young children with autism who participated in a 12-week parent training program based on the Early Start Denver Model. We measured their use of 18 different ESDM strategies before, during, and 1 month after the training program. We found that parents increased the number of strategies that they used during the training program. There were differences between mothers in terms of the ESDM strategies that they used the most during the training. We also found that some of the strategies were more closely related to children’s levels of engagement and language than others. This suggests that parent training should be adapted to suit each parent’s needs.

Residential substance misuse treatment programs for men typically do not integrate treatment for intimate partner violence (IPV) or parenting despite significant overlap between substance misuse, IPV and child maltreatment. A randomized trial compared two fatherhood focused interventions in 6-month residential substance misuse treatment programs. Fathers for Change (F4C) is an integrated intervention targeting IPV and child maltreatment. Dads ‘n’ Kids (DNK) is a psychoeducational intervention focused on child development and behavioral parenting skills. Sixty-two fathers were randomly assigned to F4C or DNK. They received 12 weeks of individual treatment while in the residential facility and were offered 4 aftercare sessions following discharge. They were assessed prior to treatment, at the time of residential discharge, following completion of the intervention booster sessions, and 3 months following intervention. Overall, both groups showed significant reductions in affect dysregulation, anger, and IPV. F4C fathers showed significantly greater decreases in affect dysregulation problems. There were no significant differences between groups on IPV but men who received F4C may have been less likely to use substances after leaving residential treatment. Integration of fatherhood focused interventions were possible and welcomed by residents at the facilities. F4C showed some benefit over DNK in terms of affect dysregulation symptoms and substance use relapse.

Facial disfigurement due to any congenital or acquired condition is a social disability that can impede communication, contribute to awkward social interactions, and cause individuals with differences to be isolated and rejected. Yet, few interventions have been developed to address the psychosocial consequences of living with a visible difference, despite research indicating that the more visible the disfigurement is to others, the greater the social implication and challenge for the affected individual. This article reviews the impact of the “What to Do When People Stare” social and communication workshop, including its theoretical basis (drawn from anthropological research and theory pertaining to disfigurement), the phenomenon of staring, and the experience of being the target of a stare. The review highlights feedback from 46 individuals with disfiguring conditions caused by burns, dermatological conditions, and craniofacial conditions who completed a Workshop Evaluation Survey. The instructor, who has a facial difference, reviewed the science of staring, the role and influence of the media and beauty in society, myths associated with disfigurement, social and communication skills, and asked specific questions to elicit feelings and beliefs about why people stare, and how it feels to be the object of a stare. After completing the workshop, 80% of participants reported that they felt better prepared to cope with staring, and 83% reported a better understanding about the motives of staring. The workshop demonstrates the need to increase awareness of visible differences and to teach individuals with visible differences and the general public appropriate social skills for engaging with one another. The workshop’s success to date highlights the need for similar programs addressing the psychosocial communicative dimensions related to staring. Collaborations with burn centers and other nonprofit organizations that treat and assist individuals with psychosocial issues related to visible difference could strengthen content and assessment data.

This study tested a web-based parenting course called FosterParentCollege.com (FPC) Culturally Competent Parenting (CCP) for transracial foster and adoptive parents. Research indicates that transracial children, whose parents practice culturally competent parenting, have positive outcomes. A mixed methods pretest posttest treatment and control group design were implemented to determine if there was a difference in parent scores on openness to cultural receptivity after completing the course in comparison to parents assigned the control group. Cultural receptivity is defined as the effort that parents are willing to put forth to learn about CCP. Additionally, parents who participated in the treatment course completed 2-month follow-up interviews on self-reported application of techniques. Results of the study showed that parents enrolled in the treatment course had significantly higher scores for openness to cultural receptivity after completing the course than before. Themes identified in follow-up interviews indicated parents' efforts to learn more about CCP.

Culturally adapted evidence-based parenting interventions constitute a key strategy to reduce widespread mental health disparities experienced by Latinx populations throughout the United States. Most recently, the relevance of culturally adapted parenting interventions has become more prominent as vulnerable Latinx populations are exposed to considerable contextual stressors resulting from an increasingly anti-immigration climate in the country. The current study was embedded within a larger NIMH-funded investigation, aimed at contrasting the differential impact of two culturally adapted versions of the evidence-based parenting intervention known as GenerationPMTO©. Specifically, a sample of low-income Mexican-origin immigrants was exposed either to a culturally adapted version of GenerationPMTO primarily focused on parent training components, or to an enhanced culturally adapted version in which parenting components were complemented by sessions focused on immigration-related challenges. The sample for the study consisted of 103 Mexican-origin immigrant families (190 individual parents). Descriptive analysis and generalized estimating equations (GEEs) indicated that exposure to the enhanced intervention, which included context- and culture-specific sessions, resulted in specific benefits for parents. However, the magnitude of the impact was not uniform for mothers and fathers and differed according to the type of immigration-related stress being examined (i.e., intrafamilial vs. extrafamilial stress). Overall, findings indicate the relevance of overtly addressing contextual (e.g., discrimination) and cultural challenges in culturally adapted interventions, as well as the need to increase precision according to the extent to which immigration-related stressors impact immigrant mothers and fathers in common and contrasting ways. Implications for family therapy practice and research are discussed.Las intervenciones basadas en evidencia, dirigidas a padres y adaptadas a la cultura son una estrategia clave para reducir las desigualdades en salud mental generalizadas que las poblaciones de latin@s experimentan en los Estados Unidos. Más recientemente, la relevancia de intervenciones dirigidas a padres adaptadas a la cultura ha adquirido más peso al estar las poblaciones de latin@s expuestas a factores estresantes contextuales considerables como resultado de un ambiente cada vez más contrario a la inmigración en el país. Este estudio fue incluido dentro de una investigación de mayor escala financiada por NIMH cuyo objetivo era contrastar el impacto diferencial de dos versiones adaptadas a la cultura de la intervención basada en evidencia y dirigida a padres conocida como GenerationPMTO在美国拉丁族裔人口中, 文化调适后的以实证为基础的家长干预是一个非常重要的可以减少较为广泛的心理健康方面不均衡差异的关键策略。最近, 美国国内日益兴起的反移民社会大环境给脆弱的拉丁裔人口造成了各种巨大的外界压力。这种情况下文化调适后的家长干预其相关作用越来越显著。NIMH资助的较大规模调查研究旨在针对实证为基础的家长干预即GenerationPMTO

BackgroundParent–child interaction is essential in the development of attentional control (AC) and executive functioning (EF). Educating parents in AC and EF development may help them to respond more adaptively to their child's developmental needs.AimThis study aimed to investigate whether parents can be educated to improve interactions with their child through a compact psycho‐educational programme that focuses on fostering the development of AC and EF.SampleParents and their children in a low‐risk sample of four‐ to eight‐year‐olds were randomly assigned to either the educational programme condition (N = 34) or the control condition (N = 36).MethodsParental supportive presence and intrusiveness were observed during home visits, and children's performance‐based AC and EF were assessed before and after the four‐session programme.ResultParents in the educational programme improved significantly in support ( = .19) and intrusiveness ( = .09) compared to controls. There was no short‐term programme mediation effect on child AC and EF through parental support and intrusiveness. This study showed, however, that parents who improved after the educational programme had children who improved on AC and EF.ConclusionParent–child interaction can be enhanced in a low‐risk sample of four‐ to eight‐year‐olds using a compact educational group programme within the school community. Future studies should aim at examining variations in programme responsiveness and assessing associations between parent–child interaction and AC and EF over time.

This overview of systematic reviews (SRs) aimed to identify dietary and lifestyle interventions in pregnant women that reduce the prevalence of overweight, obesity, and/or risk factors thereof, in their children. Following identification of eligible SRs, a matrix of all included studies identified overlap between SRs. The most recent, comprehensive, high-quality SRs were selected for further dissagregation. We developed a Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-based effectiveness matrix incorporating effect size and study quality to prioritise interventions as (1) beneficial or harmful, (2) possibly beneficial or possibly harmful, (3) no effect, (4) possibly no effect, or (5) uncertain effect. Of the 27 SRs identified, 16 SRs were excluded due to overlap. From 11 remaining SRs, five discrete interventions were ranked "beneficial" or "possibly beneficial" for reducing risk factors for childhood obesity: (1) balanced energy/protein supplements, (2) dietary counseling alone, (3) low glycemic index dietary advice, (4) diet and exercise counseling, (5) diet counseling and supervised exercise. High protein supplementation was ranked "harmful" as it increased the risk of small-for-gestational age (SGA) infants in normal-weight pregnant women. Evidence of the impact of pregnancy-related diet or lifestyle interventions, on childhood obesity was limited. Five dietary interventions, alone or in combination with exercise, showed beneficial effects on the risk factors for childhood obesity.

Evidence for the effect of preconception and periconceptional risk factors on childhood outcomes such as obesity and other non-communicable diseases (NCDs) in later life is growing. Issues such as maternal malnutrition need to be addressed before pregnancy, to prevent a transgenerational passage of risk of NCDs. The aim of this review was to evidence for preconception interventions to prevent obesity and other risk factors for NCDs in children. A search for systematic reviews of interventions in the preconception period published between 2006 and 2018 was conducted on academic databases. Fifteen reviews were included, two of the reviews also included pregnant women. None of the reviews directly reported on obesity or NCD outcomes in children. Results suggest that exercise- and diet-based interventions significantly reduced maternal weight postpartum, weight gain during pregnancy, and improved prevention and control of gestational diabetes. Balanced protein energy supplementation during and before pregnancy was associated with an increase in mean birth weight and reduction of low birth weight babies. There is a dearth of evidence for preconception programmes that follow up on childhood outcomes related to a risk of NCDs. Nevertheless, results suggest that women who received preconception interventions were more likely to have improved pregnancy-related and behavioural outcomes.

Background: Irritability, a common behavioral problem for school-aged children, is often first assessed by primary care providers, who manage about a third of mental health conditions in children. Until recent changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM), irritability was often associated with mood disorders, which may have led to increases in bipolar disorder diagnosis and prescription of mood stabilizing medication. Objective: Our aim was to explore differences between the approaches psychiatric and primary care providers use to assess irritability. Methods: A single trained interviewer conducted detailed interviews and collected demographic data from a homogeneous group of physicians that saturated with a sample size of 17 pediatric, family medicine, and psychiatric providers who evaluate and treat school-aged children. Qualitative and quantitative data were collected and analyzed. Results: In general, primary care providers chose to refer children with irritability to mental health specialists when medication management became complex, while the psychiatric providers chose behavior modification and parent education strategies rather than medications. The psychiatric group had a significantly higher caseload mix, prior experience with irritability, and more confidence in their assessment capabilities. There was lack of continuing medical education about irritability in all groups. Conclusion: This preliminary study highlights the importance of collaboration between primary care and subspecialties to promote accurate assessment and subsequent treatment of school-aged children with irritability, who can represent a safety concern for self and others. More research is needed to establish an efficient method of assessing and managing irritability in primary care and better utilization of specialists.

Background: Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. Method: A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent–child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. Results: Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. Conclusion: Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.

Aim The study assessed the outcome of a low-intensity parent training program for improving parent's language input to children with language delay. Method Nine parents and their children aged between 12 months to 24 months, exhibiting delay in language development, participated in a brief training program over three sessions. Training comprised of inputs on speech-language development, play development and speech-language stimulation strategies, supported by a manual. Effect of the training program on parent's language behaviour was evaluated through observations of parent-child interaction recorded before training and six-weeks and 10-weeks post training. Measures including, different functions served by verbalizations of parents and their nonverbal affective behaviours, were analysed. Results and Discussion Parents’ verbalizations increased significantly from baseline to the two follow-up sessions. Proportion of comments, suggestions and reflections on the child's productions increased with a concurrent decrease in the use of direct commands and questions, from baseline to post training at 10-weeks. Parents reported regular use of the manual during and after the training sessions. Post training, they identified play-based activities and provided opportunities for interactions in daily routines. Changes in the child's communication skills were also reported. Conclusion A low-intensity training program for parents, supported by a manual focusing on developmentally appropriate play and speech-language stimulation, resulted in increased verbal interaction and changes in language input to children.

Dissemination of pediatric basic life support skills, while recommended, is not done routinely for pregnant women and their partners within the maternity services. This study evaluates an e-learning program coupled with the use of a novel infant pillow mannequin to determine whether a low-cost intervention with potential for widespread application could enable training in the event of an infant choking and the provision of basic life support. A prospective cohort study with an uncontrolled pre- and posttest design was used following institutional ethical approval. A 4-week cycle of antenatal education classes in a regional Maternity Hospital in Ireland and a purposive sample of pregnant women and their partners attending the antenatal education classes were used. The following measures were assessed: (1) confidence in knowing what to do in the event of an infant choking; (2) confidence in performing infant cardiopulmonary resuscitation (CPR); (3) ability to perform the requisite skills; and (4) the perceived acceptability of the infant pillow mannequin as a means of practice. Twenty-four individuals completed a pre- and postprogram questionnaire. The e-learning program along with practice on the pillow mannequin significantly affected confidence (P < .001) in the actions to take in the event of an infant choking and in performing infant CPR. Forty-four participants used the pillow mannequin for practice and volunteered to have their skills assessed. More than 90% demonstrated correct positioning of the infant in the event of choking, correctly identified the correct ratio of chest compressions to breaths, and conducted chest compressions to the required depth. Three distinct categories of comment were identified: usefulness of the program; simplicity of the program/pillow mannequin; and accessibility for practice at home. A self-instructional e-learning program coupled with an infant pillow mannequin enables parents to learn the procedure in the event of an infant choking and to demonstrate basic life support. This low-cost intervention has the potential for widespread application within developed and developing countries.

This study investigated the effects with training and graphical icons on task performance for elderly novice users on automatic teller machines (ATMs). 124 elderly novice users who had no prior ATM experience participated in the training and test of ATM usage. Participants in the control group (n = 62) were training to use the traditional text-based ATM interface meanwhile those in the experimental group (n = 62) were training to use the alternative ATM interface with graphical icons. They were asked to learn how to perform three major tasks of ATMs. A test immediately following the training and a test one month after training was carried out. Task completion score was used for measuring user performance. The results showed although training could help elderly novice users succeed in learning to use ATMs, they still had a significant decline in user performance in the test one month later compared with the immediate test. Participants of the experimental group outperformed those of the control group in both the immediate test and one month test after training, especially in the latter. The finding suggested graphical icons could help to improve the learning and retention of ATM usage for elderly novice users, especially the latter, which would compensate for the drawback of training and reduce forgetting rate to some extent. Well-designed graphical icons could benefit elderly novice users much from learning phase to retention phase. The findings of this study can be applied to guide the design and development of ATMs or other public technology devices considering elderly novice users.

The goals of this study were to evaluate the gender-based effectiveness of the parental intervention of the Suspertu (“recovery” in English) prevention program for adolescents with risk behaviors in Spain. The sample included 229 parents (105 fathers and 124 mothers). One open-label trial with repeated measures was used. Parents received a family therapy and a group education. The intervention improved parents’ authoritative parenting style, decreasing the degree of parental stress and reducing parent’s psychopathological symptoms and maladjustment. Improvement in both groups (fathers and mothers) was mainly observed from pre- to post-intervention assessment. According to the results, prevention programs for adolescents with risk behaviors may be a suitable context both to teach parents to deal appropriately with their children’s risk behaviors, and to improve parent’s psychological state. The authors wish to thank the technical team of the Suspertu (Fundación Proyecto Hombre Navarra) program for assisting in the evaluation of the sample.

The current study examined the indirect effect of the use of behavioral parenting skills following the Infant Behavior Program, a brief, home-based adaptation of the child-directed interaction phase of parent–child interaction therapy, on infant language production. Participants were 60 infants (55% male, mean age 13.47 ± 1.31 months) and their caregivers, who were recruited at a large urban pediatric primary care clinic and were included if their scores exceeded the 75th percentile on a brief screener of early behavior problems. Families were randomly assigned to receive the infant behavior program or standard pediatric primary care. Results demonstrated a significant indirect effect of caregivers’ use of positive parenting skills (i.e., praise, reflections, and behavior descriptions) on the relation between group and infant total utterances at the 6-month follow-up, such that infants whose caregivers increased their use of positive parenting skills following the intervention showed greater increases in language production. These findings extend previous research examining parenting skills as a mechanism of change in infant language production, and highlight the potential for an early parenting intervention to target behavior and language simultaneously during a critical period in language development.

OBJECTIVE: In an effort to promote the health and developmental outcomes of children born into poverty, the Centers for Disease Control and Prevention (CDC) conceptualized and designed the Legacy for Children™ (Legacy) public health prevention model. This article examines the impact of Legacy on children’s cognitive and language development (intelligence quotient [IQ], achievement, language skills, and early reading skills) using both standardized assessments and parent-reported indictors through third grade. METHODS: Data were collected from 2001 to 2014 from 541 mother-child dyads who were recruited into the 2 concurrent randomized controlled trials of Legacy in Miami and Los Angels. Cognitive and/or language outcomes of children were assessed annually from age 2 to 5 years as well as during a follow-up visit in the third grade. RESULTS: Children experiencing Legacy at the Los Angeles site had significantly higher IQ and achievement scores at 2 and 6 years postintervention, equivalent to approximately one-third of an SD (4 IQ points). IQ results persisted over time, and the difference between intervention and comparison groups on achievement scores widened. There were no significant differences in cognitive outcomes in the Miami sample. There were no significant differences in language outcomes for either site. CONCLUSION: Legacy shows evidence of effectiveness as an intervention to prevent cognitive delays among children living in poverty. The mixed findings across sites may not only reflect the impact of heterogeneous risk profiles noted by other intervention research programs but also warrant additional study.

The incarceration of mothers affects 1.7 million minor children who are at high risk of behavioral problems, emotional trauma, and future incarceration. The jail setting removes women from society for brief periods of time providing an opportunity to offer essential interventions for those who will be returning to the community, and possibly their children, rather quickly. Utilizing a pre- and post-test quasi-experimental design, we measured the self-reported treatment effects for female inmates, housed in a county jail in the New York metropolitan area, who completed an evidence-based parenting program. Program participants reported reduced depression, increased parental knowledge, and increased communication with their families and fellow inmates. The results indicated that alternative ways of measuring program success are needed - particularly for populations who present with long histories of criminal justice involvement and drug use.

Objective To conduct a single-arm pilot study assessing the feasibility and acceptability of a 30-day parent-focused mindfulness and psychosocial support mobile app intervention for parents of children with chronic pain. Methods Thirty parents completed the intervention, which included a mindfulness curriculum, peer support videos, and written psychoeducational content. Twelve healthcare providers also assessed the app and provided feedback. Feasibility was assessed by server-side documented usage on ≥50% of the days in the intervention period and completion of ≥70% of the mindfulness content. Parent and provider acceptance were assessed by ≥70% of participants rating each acceptance test question as ≥5 on a 7-point Likert scale. Parents completed measures of solicitousness, stress, mindful parenting, and resilience prior to and following the intervention. Results Feasibility results were mixed: parents completed mindfulness content on an average of 11.2 days during the intervention period, slightly under the pre-established criterion. However, parents completed an average of 72.1% of the content, which met feasibility criterion. Acceptance criteria were met for the majority of parent acceptance test questions and all of the provider acceptance test questions. Exploratory analyses of the psychosocial measures revealed significant decreases in parental solicitous behavior and perceived stress, and a significant increase in mindful parenting. Conclusions The current study extends the emerging body of research on mindfulness-based interventions for parents of children with chronic illness and suggests that it may be acceptable to deliver this content through a mobile device. Future research is needed to assess the intervention’s efficacy compared to standard of care.

Background Peer-led support groups play an important role in supporting people with chronic diseases. They may be particularly important for people with rare diseases who typically do not have access to professional support options that focus on their disease-specific needs. Many peer-led support groups in rare diseases, however, are not sustained, and many patients do not have access to support groups. Training and education for peer support group leaders could address barriers to initiating and sustaining groups, but there is little evidence on the effectiveness of support group leader training programs. A previous systematic review evaluated the effects of training programs for peer leaders of support groups for people with medical illness on leader and support group outcomes, but it identified only one randomized controlled trial (RCT) that compared high- and low-resource training programs for cancer support group leaders. The trial did not find evidence that the high-resource program was more effective, but was limited by a small sample size and serious methodological limitations. To meet the needs of people living with the rare autoimmune connective tissue disease scleroderma, the Scleroderma Patient-centered Intervention Network has partnered with patient organizations to develop the Scleroderma Support group Leader EDucation Program, and a full-scale RCT to test the effectiveness of the program is planned. To verify the need for such a trial, we updated the previous systematic review. Updated evidence Review methods for the update were unchanged from the initial review. The updated database search yielded 1504 unique citations in addition to the 9757 assessed for eligibility in the previous review. All additional citations identified in the updated search were excluded at the title and abstract review stage. Conclusions Our systematic review update found that there is presently insufficient evidence on the effectiveness of training and support programs for peer leaders of disease-based support groups, highlighting the need for well-designed and rigorously conducted RCTs to examine the effects of training for peer leaders of support groups, especially in a rare disease context. The Scleroderma Patient-centered Intervention Network’s trial of the Scleroderma Support group Leader EDucation Program will serve as such a trial. Systematic review registration PROSPERO CRD42018096369 Electronic supplementary material The online version of this article (10.1186/s13643-019-0981-0) contains supplementary material, which is available to authorized users.

Low-income Latinas/os are exposed to widespread mental health disparities in the United States. Most recently, a resurgence of anti-immigration narratives has led vulnerable Latina/o immigrants to experience considerable contextual stressors with multiple deleterious consequences for their overall well-being, including significant disruptions to their parenting practices. Within this context of adversity and despite the multiple benefits associated with parent training (PT) prevention interventions, the availability of contextually and culturally relevant PT interventions remains limited in underserved Latina/o communities. This paper constitutes a contribution to this gap in knowledge by presenting a model of intervention delivery utilized in the dissemination of culturally adapted versions of the evidence-based intervention known as GenerationPMTO.Los latinos de bajos recursos están expuestos a amplias desigualdades relacionadas con la salud mental en los Estados Unidos. Recientemente, un resurgimiento de relatos antiinmigratorios han llevado a los inmigrantes latinos vulnerables a sufrir considerables factores desencadenantes de estrés contextual con varias consecuencias perjudiciales para su bienestar general, por ejemplo, interrupciones significativas a sus prácticas de crianza. Dentro de este contexto de adversidad, y a pesar de los múltiples beneficios asociados con las intervenciones preventivas de capacitación para padres, la disponibilidad de intervenciones de capacitación para padres contextualmente y culturalmente relevantes siguen siendo limitadas en las comunidades latinas marginadas. Este artículo constituye un aporte a este déficit de conocimiento mediante la presentación de un modelo de aplicación de intervenciones utilizado en la difusión de versiones culturalmente adaptadas de la intervención de base factual, conocida como GenerationPMTO.在美国,低收入拉美裔人群在心理健康状况方面的差距其影响涉及面很广。近来复苏的反移民形势让拉美裔移民经历了巨大的社会环境压力,也对他们的整体健康产生了多种有害的后果,包括对他们为人父母养育孩子方面的行为也有重大的破坏作用。尽管父母训练(PT)预防干预有很多好处,但是在这种比较不利的大环境下,面向社会福利照顾不到的拉美裔移民社群的人而采取的在具体情境和特定的文化下的相关父母干预措施还很少见。这篇论文旨在通过介绍GenerationPMTO这种实证为基础的模式来填补这方面知识的空白。这个模式在推广应用过程中已经根据所适用的文化做了调整。在以低收入拉美裔移民家庭父母作为研究对象的实证研究中,针对他们的文化作调适后发展出来的模式在应用过程中对他们发生的变化,都已经如实作了记录。全文由四部分组成。首先是边对主要理论阐释,边对模型进行综述;然后通过一个具体案例研究对模型的核心组成部分进行描述;最后是关于预防和医学干预的讨论。.

The goal of the present research was to test the efficacy of the Bringing Baby Home couple-focused psychoeducational program for promoting father involvement and related satisfaction. A randomized clinical trial design was used to randomly assign 136 pregnant couples to either an intervention or control group. Father involvement post-intervention was assessed through self-report of engagement in parenting tasks. Intent-to-treat analysis of covariance analyses indicated that fathers who participated in the Bringing Baby Home program reported significantly more involvement in parenting tasks, satisfaction with the division of parenting labor, and feeling appreciated by their wives. Both husbands and wives were also more satisfied with the division of labor when fathers were more involved in parenting. Results suggest that couple-focused psychoeducational programs can be successful for promoting father involvement.

The aim of this research was to examine the effectiveness of positive parenting program (Triple-P) on the mental health of mothers of children with intellectual disability (ID). This study was a quasi-experimental research with pretest, posttest design, and a control group. Thirty-six mothers of students with ID participated in this study and were divided into two groups (intervention group and control group). Each group consisted of 18 participants. The intervention group received a parent training program during 12 sessions, each session lasting for 80 min, while the control group did not receive any special training. Multivariate analysis of covariance test was applied to analyze the obtained data using SPSS software. The results of this study indicated that Triple-P had significant effect on the somatic symptoms, anxiety, depression, social dysfunction, and mental health of mothers of children with ID. As a result, this research emphasized that parenting skills training will improve the mental health of mothers of children with ID, and therefore, planning for Triple-P training is of particular importance.

BACKGROUND Children with developmental disabilities tend to develop challenging behaviours. Parenting programmes that focus on behaviour management may help parents address these difficult behaviours by increasing parenting self-efficacy. However, the literature on parenting self-efficacy is still limited due to measurement variability in conceptualization and operationalization of the construct, and heavy reliance on cross-sectional data. METHOD This study utilized hierarchical linear regression to examine the predictors of parenting self-efficacy in 284 mothers who attended a parenting programme in a hospital's Department of Child Development in Singapore. RESULTS Our model was able to explain 37% of variance in parenting self-efficacy. After controlling for general stress and specific parenting hassles, the programme was still found to be effective in improving mothers' parenting self-efficacy. CONCLUSIONS Results are discussed in terms of their implications for developing a model for parenting self-efficacy, and possible improvements to be made on the parenting programme.

The Resource Parent Curriculum (RPC) is a workshop designed to promote trauma-informed parenting among foster, adoptive, and kinship caregivers (i.e., resource parents). The ultimate goal of RPC is to improve placement stability and promote healing from traumatic stress in children who have been placed in out-of-home care. The current study examined data from multiple RPC implementation sites throughout the United States. This study used a pre- versus postworkshop design to assess resource parents' (n = 314) improvement on trauma-informed parenting, perceived self-efficacy for parenting a child who experienced trauma, tolerance of child misbehavior, and whether parent characteristics moderated the impact of RPC on these outcomes. A repeated measures multivariate analysis of variance (MANOVA) demonstrated improvement from pre- to postworkshop on trauma-informed parenting F(1, 259) = 11.96, p = .001, η2 = .044; parenting self-efficacy F(1, 259) = 17.41, p = .000, η2 = .063; and tolerance of child misbehavior F(1, 259) = 3.94, p = .048, η2 = .015, regardless of parent characteristics (e.g., age, gender race/ethnicity, and resource parent type). The results of the current study support prior work showing the effectiveness of RPC in improving resource parents' trauma-informed knowledge and attitudes and further demonstrates the effectiveness of RPC with a diverse range of resource parents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

This article advances knowledge about the effectiveness of applying a community-based efficacious parenting intervention in parallel with an efficacious preadolescent intervention in changing substance abuse norms among preadolescent Latino youth. The study employed a longitudinal, randomized control group design comparing three groups: (1) Parent intervention combined with a Youth intervention: Parent/Youth; (2) Parent intervention without a Youth intervention: Parent Only; and (3) Treatment as usual: Comparison. In the comparison group, parents participated in a standard parenting program delivered by the community partner, and the youth received the usual drug use prevention programming offered in their schools. Data from both parents and youth at the19 participating schools were collected at pre-test, immediate post-test (4 months after pre-test), and two follow-up (8 & 20 months after the pre-test). The total sample includes 532 families (parent-child dyads). The parent-child dyads consisted of one parent and one youth ages 12–14. The retention rates for both parents and preadolescent were high across the different waves of data collection (79%–96%). Regression results of youth substance use norms were calculated based on three permutations of data: (a) original data, with no imputation and no propensity score matching; (b) imputed data but no propensity score matching; and (c) imputed data plus propensity score matching. Compared to the Comparison group, the Parent/Youth condition was the most effective in changing youth's norms, closely followed by the Parent Only condition. These findings make a significant contribution in advancing knowledge on family/youth substance use prevention for Latinos in a community environment. Although the study took place in a specific urban center in the Southwest US, its findings can be generalized to other urban communities of similar characteristics across the country.