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As government-funded universal programs for new parents continue to expand, it is critical to investigate their short- and longer-term effects. The level of knowledge, especially on the effect of group-based interventions, is sparse. This study is the second report from a large trial of a widely implemented universal group-based parenting program in Denmark and includes outcomes on child socio-emotional problems and use of health services. A sample of 1701 unborn children from families representative within the area, were randomized to intervention or care as usual beginning November 2014. From these families, 1268 mothers and 999 partners (mean age 29.4 and 31.19, respectively; 6% migration background) filled in the Ages and Stages Questionnaire. Intention-to-treat-analyses showed fewer socio-emotional problems in the intervention group (between-group difference - 2.34, 95% CI [0.40, 4.30], d = - 0.13) as reported by mothers, but not partners, when children were 10 months old. This finding was transitory (no longer significant at 19 months). No effects were found on health care utilization. The previous report from this trial showed no effects on measures of parenting. In total, these findings serve the purpose of adjusting future expectations to the size and type of effect to be gained from a universal parent program in a resourceful setting. We conclude that even if the Family Startup Program (DK: Familieiværksætterne) 2 was liked, well implemented, and well attended by the parents, the positive effect on children's socio-emotional problems, was too modest to be the argument that can carry the weight of policy going forward. PUBLIC SIGNIFICANCE STATEMENT: This study examined the effects of the Family Startup Program (DK: Familieiværksætterne), a universal, group-based program to support parents during the transition to parenthood. Results showed a modest transitory preventive effect on children's socio-emotional problems and no effects on health care utilization. These findings adjust down previous expectations to the size and type of effects to be gained from universal group-based parent support in a well-resourced setting., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Interactional processes between child and parents, in particular harsh and coercive parenting practices, have been established as important factors maintaining and shaping the developmental trajectory of disruptive child behavior. The Incredible Years Parent Training (IYPT) is a well-established evidence-based program targeting negative parent-child interactions in families with children exhibiting high levels of disruptive behaviors. There are, however, few studies investigating the effectiveness of the IYPT when implemented in established practice settings independently from research environments. Also, very little evidence exists for the program's effectiveness for school-aged children. The IYPT was administered to consecutive groups of parents (N = 842) across 19 Danish community sites during the period from 2012 to 2019. Pre and post data were collected using the Eyberg Child Behavior Inventory (ECBI). By means of a benchmark approach, the effectiveness of the intervention was compared with that of two European effectiveness randomized controlled trials. Large effect sizes were seen from pre to post for both parent-reported number of problematic disruptive child behaviors (ECBI Problem subscale; d = 1.51, p = 0.000, 95% CI [9.06-10.01]) and frequency of these behaviors (ECBI Intensity subscale; d = 1.15, p = 0.000, 95% CI [29.33-32.73]). Treatment effects found in this study are comparable to or larger than those found in previous effectiveness studies and show the IYPT to be an effective intervention when implemented across a range of different community settings in a large community sample of children across an age span of 2 to 12 years., (© 2023 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Empirically supported couple interventions often transfer from the US to several other parts of the world yet we have little data on their final reach. This study investigated relationship help-seeking in a random population sample of 1,371 individuals living with a partner in Denmark, a European high income - high divorce country. Only a small fraction of respondents had ever sought couple education (3%) or counseling/therapy (7%) with their partner. Among respondents experiencing a severe relationship crisis, individual types of help-seeking were the most prevalent. Both women (38.9%) and men (27.8%) with a recent relationship crisis sought information online, and mostly women (19.4%) also sought individual therapy. Findings can inform strategies for increasing the reach of couples in new cultural contexts., (© 2018 American Association for Marriage and Family Therapy.)

Objectives: The aims were to describe first-time mothers' confidence, mood and stress 2 and 6 months postpartum and to investigate the extent to which the tools measuring maternal confidence and maternal mood used alone or together at 2 months postpartum predict first-time maternal confidence, mood and stress 6 months postpartum., Design: A cohort including 513 first-time mothers' self-reported questionnaires concerning three scales: The Karitane Parenting Confidence Scale (KPCS), the Edinburgh Postnatal Depression Scale (EPDS), and the Parental Stress Scale (PSS) collected 2 and 6 months postpartum. Descriptive statistic, simple and multiple linear regression analysis were used., Results: First-time mothers' with confidence scores below the clinical cut-off (KPCS <40) fell significantly from 25% to 14% (p < 0.001), symptoms of depression above the clinical cut-off (EPDS ≥ 8) fell significantly from 16% to 12% (p < 0.001), and parental stress as a mother fell significantly from a mean of 32.88 to 30.98 (p < 0.001). The KPCS assessed at 2 months postpartum was the strongest predictor for both maternal confidence (R 2  = 0.38) and parental stress (R 2  = 0.26) 6 months postpartum., Conclusion: The results support the assumption that parenthood is a complicated period for first-time mothers characterised by low confidence, symptoms of depression and high stress which improve over time for the majority of mothers. The KPCS at 2 months postpartum was the strongest predictor of the measures used. Further research is needed to identify parents who are struggling, especially for health professionals' whose role is to support parents in their parenthood the first period after birth., (Copyright © 2018 The Authors. Published by Elsevier India Pvt Ltd. All rights reserved.)

Background: Supporting early mother-infant relationships to ensure infants' future health has been recommended. The aim of this study was to investigate whether video feedback using the Marte Meo method promotes a healthy early relationship between infants and vulnerable first-time mothers. Video feedback or usual care was delivered by health visitors during home visits in Danish municipalities., Methods: This quasi-experimental study included pre- and post-tests of 278 vulnerable families. Mothers were allocated to an intervention group (n = 69), a comparison group (n = 209) and an exactly matched video subsample from the comparison group (n = 63). Data consisted of self-reported questionnaires and video recordings of mother-infant interactions. Outcomes were mother-infant dyadic synchrony (CARE-Index), maternal confidence (KPCS), parental stress (PSS), maternal mood (EPDS) and infant socialemotional behaviours (ASQ:SE). The data were analysed using descriptive and linear multiple regression analysis., Results: The levels of dyadic synchrony in the intervention group had significantly improved (p < 0.001) at follow-up with a mean score of 9.51 (95%CI;8.93-10.09) compared with 7.62 (95%CI;7.03-8.21). The intervention group also showed a higher level of maternal sensitivity with a mean score of 9.55 (95%CI;8.96-10.14) compared with 7.83 (95%CI;7.19-8.46) in the matched video subsample (p < 0.001). With respect to infant cooperation, similar improvements were found with a mean score of 9.43 (95% CI;8.88-9.99) in the intervention group compared with 7.73 (95%CI;7.13-8.33) in the matched video subsample from the comparison group (p < 0.001). Furthermore, mothers in the intervention group reported significantly lower levels of parental stress with a mean score of 32.04 (95%CI;30.13-33.94) compared with 35.29 (95%CI;34.07-36.52) in the comparison group (p = 0.03), as well as higher levels of maternal confidence with a mean score of 41.10 (95%CI;40.22-41.98) compared with 40.10 (95%CI;39.65-40.56) in the comparison group (p = 0.04). No significant differences were found in EPDS and ASQ:SE., Conclusion: The findings support the assumption that video feedback using the Marte Meo method early after birth may strengthen the relationship between infants and vulnerable firsttime mothers as well as improve maternal psychosocial functioning. Further research applying random assignment is needed to strengthen these conclusions; further research is also needed to assess any long term effects of the video feedback intervention using the Marte Meo method., Trial Registration: This study was registered on 24 January 2013 in ClinicalTrials.gov with the identifier: NCT01799447 .

Health visitors need competences to promote healthy early parent-infant relationships. The aims of this study were to explore whether there are differences between groups of health visitors with and without additional parenting program education in terms of their knowledge of infant-parent interaction and their observation and assessment skills of such interactions. The cross-sectional study included 36 health visitors' certified Marte Meo therapists and 85 health visitors without additional parenting program education. Health visitors' observation skills were measured assessing five video-recorded mother-infant interactions. A questionnaire was used to measure their intention, self-efficacy, and knowledge. More certified Marte Meo therapists than health visitors without additional parenting program education reported a significantly higher mean level of knowledge of the early relationship, 6.42 (95% CI; 6.18-6.66) versus 5.05 (95% CI; 4.86-6.10), p = .04; and more certified Marte Meo therapists than health visitors without additional parenting program education reported a higher mean level of knowledge of infant self-regulation, 2.44 (95% CI; 2.18-2.71) versus 1.83 (95% CI; 1.62-2.03), p < .001. In the latter group, 54% (95% CI; 0.43-0.64) reported a significantly higher need for further education versus 22% (95% CI; 0.11-0.39), p = .001. Compared to health visitors without any parenting program education, health visitors certified as Marte Meo therapists reported a significantly higher frequency of correct assessment of mothers' sensitivity in two of five video-recordings, with 77.78% (95% CI; 0.61-0.87) compared to 45.88% (95% CI; 0.35-0.57) in Video 3, p = .001, and 69.44% (95% CI; 0.52-0.82) compared to 49.41% (95% CI; 0.39-0.60) in Video 4, p = .04, respectively. The results of the present study support the use of video-based education of health visitors to increase their knowledge of and skills in assessing parent-infant interactions. Randomized controlled trials are needed to determine whether the improved level of health visitors' knowledge and observation skills may be assigned to participation in the Marte Meo education program., (© 2017 Michigan Association for Infant Mental Health.)

The primary aim of the current meta-analysis was to investigate the overall effect of a relationship checkup (RC), a couple-oriented assessment, and feedback intervention. Systematic literature searches revealed 12 eligible randomized trials published between 1995 and 2015. Results showed significant overall pre-post effect of an RC on marital functioning (Hedge's g = 0.20) and individual mental health (g = 0.44). The between-group controlled effect size was significant at postassessment (g = 0.23) and up to six-month follow-up (g = 0.23). Characteristics of the RC format, therapist-guided versus self-directed, or the study samples, distressed versus healthy, did not moderate the overall effect of the RC. Thus, our results suggest an RC to improve couples' marital functioning up to six-month follow-up, while the effect on individual mental health and repeated delivery of a RC awaits further research., (© 2016 American Association for Marriage and Family Therapy.)

Objective: This study examined the effectiveness of the Marriage Checkup (MC), adapted for independent practice., Method: A total of 233 couples were recruited from 2 metropolitan areas of Denmark and randomized to the MC adapted for independent practice (MC-P, n = 116) or a waitlist condition (WL, n = 117). Self-report measures of relationship health were obtained online at 3 (WL) or 6 (MC-P) time points across 54 weeks. MC-P couples received 2 checkups (Week 7 and 51). WL couples received tickets to a movie night (Week 10). Data were analyzed using multilevel growth models., Results: Following the first checkup, small intervention effects were found on 3 of 4 outcome measures. Between the checkups, the effects on 2 of 3 measures first leveled off then reappeared. Following the second checkup, intervention effects in the small to medium range were found on all 4 measures including the Brief Marital Satisfaction Inventory (Cohen's d = 0.48), the Couple Satisfaction Index (d = 0.20), the Responsiveness and Attention Scale (d = 0.43), and the Intimate Safety Questionnaire (d = 0.21)., Conclusions: Couples receiving 2 annual checkups across 54 weeks experienced small to medium effects on relationship health when compared to controls. These are the first and preliminary results on a model for conducting regular relationship health checkups in a real-world therapeutic setting. Future studies are needed to investigate the comparative and long-term effects of this approach. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Background: Inadequate parenting is an important public health problem with possible severe and long-term consequences related to child development. We have solid theoretical and political arguments in favor of efforts enhancing the quality of the early family environment in the population at large. However, little is known about effect of universal approaches to parenting support during the transition to parenthood. This protocol describes an experimental evaluation of group based parenting support, the Family Startup Program (FSP), currently implemented large scale in Denmark., Methods/design: Participants will be approximately 2500 pregnant women and partners. Inclusion criteria are parental age above 18 and the mother expecting first child. Families are recruited when attending routine pregnancy scans provided as a part of the publicly available prenatal care program at Aarhus University Hospital, Skejby. Families are randomized within four geographically defined strata to one of two conditions a) participation in FSP or b) Treatment As Usual (TAU). FSP aims to prepare new families for their roles as parents and enhance parental access to informal sources of support, i.e. social network and community resources. The program consists of twelve group sessions, with nine families in each group, continuing from pregnancy until the child is 15 months old. TAU is the publicly available pre- and postnatal care available to families in both conditions. Analyses will employ survey data, administrative data from health visitors, and administrative register based data from Statistics Denmark. All data sources will be linked via the unique Danish Civil Registration Register (CPR) identifier. Data will be obtained at four time points, during pregnancy, when the child is nine months, 18 months and seven years. The primary study outcome is measured by the Parenting Sense of Competence scale (PSOC) J Clin Child Psychol 18:167-75, 1989. Other outcomes include parenting and couple relationship quality, utility of primary sector service and child physical health, socio-emotional and cognitive development., Discussion: The protocol describes an ambitious experimental evaluation of a universal group-based parenting support program; an evaluation that has not yet been made either in Denmark or internationally., Trial Registration: ClinicalTrials.gov ID: NCT02294968. Registered November 14 2014.

This study examined the effectiveness of an evidence-based parent training program in a real-world Scandinavian setting. Parents of 36 young children with or at risk of Attention Deficit Hyperactive Disorder (ADHD) self-referred to participate in the Incredible Years(®) Parent Training Program (IYPT) through a Danish early intervention clinic. Using a benchmarking approach, we compared self-report data with data from a recent efficacy study. Eight out of nine outcome measures showed comparable or higher magnitude of effect from pretest to posttest. Effects were maintained or improved across six months. The methodology of this study exemplifies a rigorous but feasible approach to assessing effectiveness when evidence-based US protocols are transferred into the existing Scandinavian service delivery. Findings suggest that IYPT can be implemented successfully as an easy-access early intervention to families of children with or at risk of ADHD., (© 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)