Strengthening Family-School Partnerships: Perspectives on Parent-Educator Communication in Pre-K Programs

Universal Prekindergarten, Fertility, and Maternal Health: A Difference-in-Regression-Discontinuities Design with Extrapolations

Purpose – This study aims to investigate the strategies employed by kindergarten teachers and parents in preparing children's school readiness in the Batang Angkola District, considering the local context and related social dynamics. Design/methods/approach – Utilizing a qualitative descriptive method, the research combines a descriptive approach to outline existing phenomena with a qualitative approach to explore the meanings and interpretations of the strategies used. Data were collected through direct interviews with several kindergarten teachers and parent representatives in kindergartens and surrounding areas in the Batang Angkola District. Additionally, secondary data related to supporting theories on children's school readiness were utilized. Findings – The findings reveal that both kindergarten teachers and parents are not fully prepared for children's school readiness. This is evidenced by the non-alignment of teachers' educational backgrounds with early childhood education and the parents' primary focus on academic readiness, often neglecting other critical aspects such as social and emotional development. Furthermore, the strategies implemented by kindergarten teachers and parents fail to holistically address the needs of children during the transition process. Research implications/limitations – The study is limited to the Batang Angkola District and may not be generalizable to other regions. These findings highlight areas in educational practices that require improvement and suggest the need for further research to develop more effective strategies for holistic school readiness preparation. Practical implications – The insights gained from this study provide guidance for the development of more holistic and integrated school readiness preparation programs that can better support children during their transition to school. These programs should aim to balance academic learning with social, emotional, and physical development to ensure well-rounded preparedness. Originality/value – This research sheds light on the specific challenges faced by kindergarten teachers and parents in the Batang Angkola District, emphasizing the importance of a holistic approach to school readiness that includes academic, social, and emotional aspects. By addressing these challenges, the study contributes to the broader understanding of effective strategies for early childhood education in similar contexts. Paper type Case study

Objectives: Although depression is a significant public health issue, many individuals experiencing depressive symptoms are not effectively linked to treatment by their primary care provider, with underserved populations have disproportionately lower rates of engagement in depression care. Shared decision making (SDM) is an evidence-based health communication framework that can improve collaboration and optimize treatment for patients, but there is much unknown about how to translate SDM into primary care depression treatment among underserved communities. This study seeks to explore patients' experiences of SDM, and articulate communication and decision-making preferences among an underserved patient population receiving depression treatment in an urban, safety net primary care clinic.Methods: Twenty-seven patients with a depressive disorder completed a brief, quantitative survey and an in-depth semi-structured interview. Surveys measured patient demographics and their subjective experience of SDM. Qualitative interview probed for patients' communication preferences, including ideal decision-making processes around depression care. Interviews were transcribed verbatim and analyzed using thematic analysis. Univariate statistics report quantitative findings.Results: Overall qualitative and quantitative findings indicate high levels of SDM. Stigma related to depression negatively affected patients' initial attitude toward seeking treatment, and underscored the importance of patient-provider rapport. In terms of communication and decision-making preferences, patients preferred collaboration with doctors during the information sharing process, but desired control over the final, decisional outcome. Trust between patients and providers emerged as a critical precondition to effective SDM. Respondents highlighted several provider behaviors that helped facilitated such an optimal environment for SDM to occur.Conclusion: Underserved patients with depression preferred taking an active role in their depression care, but looked for providers as partner in this process. Due to the stigma of depression, effective SDM first requires primary care providers to ensure that they have created a safe and trusting environment where patients are able to discuss their depression openly.

It is well established that children’s school readiness is associated with their later academic achievement, but less is known about whether school readiness is also associated with other measures of school success, such as students’ social and emotional wellbeing. While some previous research has shown a link between early social and emotional development and student wellbeing, results are mixed and the strength of these relationships vary depending on whether data is based on child, teachers or parents ratings and which specific student wellbeing outcomes are measured. The present study explored the association between teacher-rated school readiness (Mage = 5.6 years) across five developmental domains (physical, social, emotional, language and cognitive, and communication and general knowledge) and four aspects of student wellbeing (life satisfaction, optimism, sadness and worries) in Grade 6 (Mage = 11.9 years) in a sample of 3906 Australian children. After adjustment for background child and family-level factors, children’s early physical, social and emotional development were associated with all four wellbeing outcomes in Grade 6, but early language and cognitive skills and communication and general knowledge skills were only associated with internalising behaviours (sadness and worries). Mechanisms through which these different aspects of development might influence later wellbeing are discussed, as well as ways that schools and governments can support students’ social and emotional wellbeing.

Parents and public officials are increasingly concerned about the school readiness of young children. In response, in recent years, state governments have boosted their support for pre-K programs. Several states, including Oklahoma, have opted for universal pre-K, making it available, on a voluntary basis, to all 4-year-olds. At the same time, the federal government, through the No Child Left Behind Act, has imposed new testing requirements on public schools to determine whether students as a whole and particular subgroups of students are making good academic progress. These trends have heightened interest in the effectiveness of pre-K programs.

Persisting socioeconomic gaps in school readiness have inspired research examining aspects of the pre-K experience that could reduce these gaps. A strategy that deserves consideration is the socioeconomic diversity of classrooms. In this literature review, we use ecological theory as a framework to present outcomes of socioeconomic diversity in U.S. pre-K settings on children’s cognitive, language, and social-emotional skills, with language benefits being the most pronounced. We also evaluate parent, teacher, and peer contributions to children’s school readiness in socioeconomically diverse pre-K settings. Research shows that children from all income backgrounds benefit in socioeconomically diverse learning environments – in academic preparedness and in other ways that prepare them for success in a diverse workforce and society. Evidence suggests that children from low-income families benefit most, which may reduce income-based gaps in school readiness. We conclude with recommendations for further research and discuss policy implications of increased socioeconomic diversity within pre-K programs.

For more than 30 years, pediatrics has embraced early child development and school performance at older ages as an integral part of clinical practice. This growing focus on child development and school performance outcomes was informed in part by the changing epidemiology of children’s health, the related reframing of the scope of pediatric practice under the construct of “new morbidities,” and the influential 1987 report from the Task Force on Pediatric Education.1,2 Child development has become a certified subspecialty, and residency programs have specified training requirements. Despite significant progress, even more needs to be done not only to identify children with developmental disabilities and institute appropriate and timely interventions, but also to promote optimal development and enhance the school readiness of all children.3 Our current understanding of the importance of early childhood is converging with our national policy agenda to improve educational opportunities and outcomes for all children. The convergence of these 2 trends is taking place under the banner of school readiness, referring both to a child’s capacity to learn, grow, and achieve and also creating an organizing principle and outcome for major statewide early childhood initiatives throughout the United States. As a result, pediatricians will increasingly be called on to direct more of their clinical expertise in service of this important societal goal, and are likely to find themselves, as many other early childhood professionals and teachers are, increasingly involved in the “school readiness business.” Underlying these observable changes in social policy are tectonic shifts in our understanding of the importance of early childhood and the role of school readiness in promoting not only academic achievement but longer term health outcomes. Whereas before 1990 the term school readiness was used to evaluate and some would say to label children who were not “mature enough” …

To explore surgeons' perspectives on and priorities for communicating about non-curative operations for patients with advanced cancers, which aim to improve longevity or quality of life without possibility of cure. Describing the potential benefits of non-curative surgery is important so that treatment decisions are based on an accurate understanding of what surgery can achieve. However, surgeons' perspectives on and practices for communicating non-curative operative intent with patients are not known. This qualitative study involved semi-structured interviews with cancer surgeons who were recruited throughout the U.S. through purposive and snowball sampling. Interviews included discussions around two case scenarios describing non-curative operations. We explored participants' perspectives and communication preferences through the scenarios. Thematic analysis was completed using an inductive approach. We interviewed 18 surgeons from 16 institutions with varying years of practice. Surgeons framed the overarching goal of non-curative surgery as preventing disease progression, with the more specific goals of living longer and living better. Additionally, participants underscored the prognostic uncertainty about the disease trajectory of advanced cancer, compounded by limited evidence to guide decisions about non-curative surgery. This uncertainty informs surgeons' communication priorities to 1) clarify treatment intent and 2) disclose their uncertainty, ultimately aiming to establish alignment with their patients. This study delineated an existing paradigm for discussing the goals of non-curative surgery for advanced cancer, and also highlighted the role that prognostic uncertainty plays in cancer surgeons' communication practices.

BackgroundPeople with intellectual disability (ID) expressed dissatisfaction with doctor-patient communication and mentioned certain preferences for this communication (our research). Since many people with ID in the Netherlands have recently moved from residential care facilities to supported accommodations in the community, medical care for them was transferred from ID physicians (IDPs) to general practitioners (GPs) in the vicinity of the new accommodation. We addressed the following research question: 'What are the similarities and differences between the communication preferences of people with ID and the professional criteria for doctor-patient communication by GPs?'MethodsA focus group meeting and interviews were used to identify the preferences of 12 persons with ID for good communication with their GP; these were compared with communication criteria used to assess trainee GPs, as described in the MAAS-Global manual.ResultsEight preferences for doctor-patient communication were formulated by the people with ID. Six of them matched the criteria used for GPs. Improvements are required as regards the time available for consultation, demonstrating physical examinations before applying them and triadic communication.ConclusionsPeople with ID hold strong views on communication with their doctors during consultations. GPs, people with ID and their support workers can further fine-tune their communication skills.

Children in immigrant families account for nearly one-in-four children in the U.S. They are the fastest growing population of children, and they are leading the nation’s racial and ethnic transformation. As a consequence, baby-boomers will depend heavily for economic support during retirement on race-ethnic minorities, many of whom grew up in immigrant families. Because the current circumstances and future prospects of children in immigrant families are important not only to these children themselves, but to all Americans, this report uses data from Census 2000 to portray the lives of children with immigrant parents and highlights policy and program initiatives that will foster the future success of these children. This report begins by discussing the diverse origins and destinations of children in immigrant families. It then highlights substantial evidence that children in immigrant families have deep roots in the U.S. refl ected in their own citizenship, as well as their parents’ citizenship and length of residence in this country, their own and their parents’ English fl uency, and their family commitment to homeownership. Based on a new alternative to the offi cial poverty measure, the report continues by discussing economic challenges confronted by many immigrant families. It also portrays additional immigrant strengths and challenges associated with family composition, parental education and employment, and access for children of immigrants to early education and the later years of schooling. Looking toward fostering a successful future for these children, the report identifi es promising policy and programmatic initiatives for language and literacy training, and for assuring access to education, health, and other essential services, and it identifi es immigrant-related questions that should be asked in all research studies involving children and families.

The Making Pre-K Count and High 5s studies represent a recent application of a phased two-stage, multi-level design, which was used to examine the effects of two aligned math programs implemented in early childhood settings. The purpose of this paper is to describe the challenges encountered in implementing this two-stage design and to describe approaches to resolving them. We then present a set of sensitivity analyses the study team used to examine the robustness of the findings. During the pre-K year, pre-K centers were randomly assigned either to receive an evidence-based early math curriculum and associated professional development (Making Pre-K Count) or to a pre-K-as-usual control condition. In the kindergarten year, students who had been in Making Pre-K Count program classrooms in pre-K were then individually randomly assigned within schools to small-group supplemental math clubs that were designed to sustain the gains from the pre-K program, or to a business-as-usual kindergarten experience. Making Pre-K Count took place in 69 pre-K sites, comprising 173 classrooms across New York City. High 5s took place in the 24 sites that were part of the public school treatment arm of the Making Pre-K Count study and included 613 students. The study focuses on the effect of the Making Pre-K Count and High 5s programs on children's math skills at the end of kindergarten as measured by two instruments, the Research-Based Early Math Assessment-Kindergarten (REMA-K) and the Woodcock-Johnson Applied Problems test. The multi-armed design, while logistically and analytically challenging, balanced multiple considerations of power, the number of research questions that could be answered, and efficiency of resources. Robustness checks suggest that the design created groups that were both meaningfully and statistically equivalent. Decisions to use a phased multi-armed design should consider both its strengths and weaknesses. While the design allows for a more flexible, expansive research study, it also introduces complexities that need to be addressed both logistically and analytically.

Effective communication in pediatric palliative cancer care is an important aspect of practice to enhance patient- and family-centered care, and to optimize decision-making. However, little is known about communication preferences practices from the perspectives of children, caregivers and their health care professionals (HCPs) in the Middle Eastern region. Furthermore, involving children in research is crucial but limited. This study aimed to describe the communication and information-sharing preferences and practices of children with advanced cancer, their caregivers, and health care professionals in Jordan. A qualitative cross-sectional study was conducted using semi-structured face to face interviews with three groups of stakeholders (children, caregivers and HCPs). Purposive sampling recruited a diverse sample from inpatient and outpatient settings at a tertiary cancer center in Jordan. Procedures were in line with the Consolidated criteria for reporting qualitative research (COREQ) reporting guidelines. Verbatim transcripts were thematically analyzed. Fifty-two stakeholders participated: 43 Jordanian and 9 refugees (25 children, 15 caregivers and 12 HCPs). Four major themes emerged: 1) Hiding information between the three stakeholders which includes parents who hide the information from their sick children and ask the HCPs to do so to protect the child from distressful emotions and children who hide their suffering from their parents to protect them from being sad; 2) Communication and sharing of clinical versus non-clinical information; 3) Preferred communication styles such as use of a companionate approach by acknowledging patients and caregivers' suffering, building a trustful relationship, proactive information sharing, considering child age and medical status, parents as facilitators in communication, and patients' and caregivers' health literacy; 4) Communication and information sharing with refugees where they had dialect issues, which hindered effective communication. Some refugees had unrealistically high expectations regarding their child's care and prognosis, which posed challenges to communication with staff. The novel findings of this study should inform better child-centered practices and better engage them in their care decisions. This study has demonstrated children's ability to engage in primary research and to express preferences, and parents' ability to share views on this sensitive topic.

BackgroundTrans and gender-diverse individuals experience adverse health outcomes that might be due, in addition to other factors, to stigma and discrimination in the health care sector. At the same time, the concept of person-centred care acknowledges the role of patient-physician communication in health care outcomes. This study aims to explore patient-physician communication preferences in trans and gender-diverse individuals.MethodA qualitative interview study was conducted, including N = 10 participants between February and March 2022. Participants were interviewed using a semi-structured interview guideline, based on previous knowledge in person-centred care and sample specific communication. Participants were asked about their experiences and wishes in patient-physician centeredness. Analyses were conducting using a qualitative content analysis strategy.ResultsMean age was 29.3 years; n = 6 participants identified themselves within the binary gender concept, while n = 4 identified themselves with a non-binary gender. Communication preferences for patient-physician communication were categorised into four themes: general communication aspects (e.g. active listening); the role of gender during appointments (e.g. appropriate/inappropriate addressing); gender-neutral language (e.g. experiences use of gender neutral language by physicians); own communication style (e.g. early outing and justification). Furthermore, possible contextual factors of patient-physician communication where found (e.g. trusting relationship).ConclusionAdding knowledge to communication preferences of trans and gender-diverse individuals, this study was able to identify preferences that are specific to the sample as well as preferences that differ from the cis-gendered population. However, it remains unclear how the patient-physician communication preferences affects health care utilization and outcomes.Trial registrationGerman Clinical Trial Register (DRKS00026249).

The Latino School Readiness Gap: Engaging Families in Design Thinking for Primary Care Interventions.

Within the United States, there are a variety of early education models and curricula aimed at promoting young children's pre-academic, social, and behavioral skills. This study, using data from the Miami School Readiness Project (MSRP; Winsler et al., 2008, 2012), examined the school readiness gains of low-income Latino (n = 7,045) and Black children (n = 6,700) enrolled in two different types of Title-1 public school pre-K programs: those in programs using the Montessori curricula and those in more conventional programs using the High/Scope curricula with a literacy supplement. Parents and teachers reported on children's socio-emotional and behavioral skills with the Devereux Early Childhood Assessment (DECA), while children's pre-academic skills (cognitive, motor, and language) were assessed directly with the Learning Accomplishment Profile Diagnostic (LAP-D) at the beginning and end of their four-year-old pre-K year. All children, regardless of curricula, demonstrated gains across pre-academic, socio-emotional, and behavioral skills throughout the pre-K year; however, all children did not benefit equally from Montessori programs. Latino children in Montessori programs began the year at most risk in pre-academic and behavioral skills, yet exhibited the greatest gains across these domains and ended the year scoring above national averages. Conversely, Black children exhibited healthy gains in Montessori, but demonstrated slightly greater gains when attending more conventional pre-K programs. Findings have implications for tailoring early childhood education programs for Latino and Black children from low-income communities.