Child Care Research Articles

Exploratory Study on Various Types of Leisure Activities of Indian Mothers of Children with Autism Spectrum Disorder- A Qualitative Analysis

The purpose of this study was to identify the important components of leisure and to comprehensively assess various leisure time activities, that entail the overall well-being of mothers of children with autism spectrum disorder (ASD) with indispensable demanding care of children with autism. A cross-sectional design with interpretivism and an inductive approach on a sample of 61 mothers of children with ASD, in India was used to explore various leisure time activities. Mothers engaging in the leisure of individual choice for self-replenishment, social connectedness, and happiness in life despite the demanding care of the child with autism were identified. The face, content, and construct validity are maintained in its preliminary stage. This study aimed to explore various leisure activities in the lives of mothers of children with ASD. The 7 categories of Leisure activities (LA) are Entertainment activities, Outings, Social events, Sports and physical exercises, Homemaking and other fruitful involvements, Arts, and intellectuals, Resting and relaxation, as diversionary activities to energize, divert, and relax as fun and free-time identified in the context of Indian mothers.

A balancing act: successfully managing senior leadership roles and motherhood

ABSTRACT This paper presents the findings of a self-study exploring the experiences of women leaders, and the intersections of leadership work with roles as mothers. Drawing on narratives of women from across experiences of leading to support women in the workplace, to women who juggle leadership work and mothering, and women whose mothering involves caring for children with Special Educational Needs and Disabilities, we address the dearth in scholarship addressing these positionings and implications for women in leadership. Using self-study as a qualitative approach to bring together three current school leaders and an ex – principal, this study uses autobiographical experiences and shared reflections on blogs and materials accessed through our professional networks to contribute robust and rich analysis of personal narratives on the challenges and opportunities afforded to women in the state school context in England. We apply a conceptual framework of micro-meso barriers to consider the relationship between self and organisation level interactions. Findings contribute strategies from the personal to the organisational, with implications for the ways in which coaching, flexible working and an equitable approach to decision making can be utilised by schools to support and engage women without a sense of compromised leadership practice or motherhood priorities.

Time Unmasked: Illuminating the Hidden Dimensions of Economic Stratification during COVID-19 in the United States

This paper delves into the nuanced impact of the COVID-19 pandemic on time use activities in the United States, particularly examining gender and parental status differences. Drawing on data from the 2018–2022 American Time Use Survey, the study analyzes trends in six distinct time use categories: unpaid care work, leisure, employed activities, personal care, childcare, and household activities. The research sheds light on the evolving dynamics within households during the pandemic, emphasizing the potential implications for economic stratification and societal well-being. The COVID-19 pandemic completely disrupted established time use patterns, forcing a reconsideration of ‘traditional’ gender roles and caregiving responsibilities in certain countries. While early studies hinted at a temporary shift toward more equitable distribution of household activities, particularly childcare, this paper scrutinizes these trends over a more extended period. Despite the short-lived increases in fathers’ involvement in childcare during the pandemic, the study finds that the caregiving burden remained disproportionately on mothers and women. Notably, the analysis reveals persistent gender disparities in unpaid care work, with women and mothers spending a disproportionate amount of time on household activities, housework, and caring for children. This unequal distribution of caregiving responsibilities limits a women’s ability to engage in paid work activities, contributing to economic stratification and constraining their financial resources. While some activities demonstrated slight reductions in gender gaps, the overall picture suggests that the pandemic may not bring about lasting changes in how time is allocated within households.

Parenting Patterns of Career Women in Instilling Islamic Religious Values in Children (Case Study of Communities in Griya Hangtuah Permai Housing, Pinang Kencana Kelurahan Tanjung Pinang Timur)

This research uses a descriptive qualitative approach to understand the reality that occurs, researchers want to show the parenting patterns used by mothers who perform two roles between a career outside the home and taking care of children in this case, which is seen how the mother educates in instilling Islamic religious values in children and is also assisted by a review of relevant literature. Data collection techniques carried out using interviews with relevant informants, interviews aim to get in-depth information. Based on the results of interviews in parenting career mothers teach Islamic religious values with a strategy of persuading and advising children according to what parents want to teach children and children must obey their parents' orders, this description of democratic parenting although different ways of implementing it still packs it in the important points of democratic parenting.

Integrated care for children and young people with special health and care needs: a systematic review

ContextThere is a dearth of high-quality evidence on integrated, coordinated and cost-effective care for children with special health and care needs (CSHCN).ObjectiveTo assess the effectiveness of integrated/coordinated care models for...

DESAFIOS E RESILIÊNCIA: UMA ANÁLISE DAS DIFICULDADES ENFRENTADAS POR MÃES DE FILHOS NO ESPECTRO AUTISTA

The diagnosis of Autism Spectrum Disorder presents some challenges and singularities, the limitations in its development entail a series of demands and significant changes in the family's routine and child care. The objective of this article is to understand the difficulties and experiences faced by mothers with children diagnosed with Autism Spectrum Disorder (ASD). The expected results will be significant in highlighting the challenges faced by mothers of children with Autism Spectrum Disorder (ASD), including the emotional impact of the diagnosis, the need to access specialized resources, the burden of care and difficulties in social interaction. Based on the studies analyzed, we hoped to understand this complex and significant issue faced by mothers of children with ASD in the care process. Research will play a relevant role in the development of policies and support programs that can protect the feminine essence and promote quality of life for families in society.

Survey of GP registrars' training experience and confidence in managing children and adolescents with mental health conditions in primary care.

The aim of thisstudy is to assess General Practitioner (GP) trainees' training experience, and confidence in assessing and managing children and adolescents with common mental health conditions in primary care in Ireland. An online anonymous questionnaire was distributed to third and fourth year GP registrars enrolled in the Irish College of General Practitioners training schemes. The online questionnaire evaluated participants' training experiences and confidence levels in key areas of child and adolescent mental health in primary care. Sixty participants completed the survey out of 406, yielding a response rate of 14.8%. The majority (88%) reported no formal training or experience working in Child and Adolescent Mental Healthcare Services (CAMHS) during their GP training scheme. Responses indicated that many participants rated their competency, skills, and knowledge in essential areas of Child and Adolescent Mental Health as needing improvement. Similarly, their awareness of referral pathways and specialty services was below expectations, with poor perceived access to services. A large proportion (91.7%) expressed a definite need for further training in child and adolescent mental health disorders. The results highlight the need for enhanced training and support for GP trainees in the field of Child and Adolescent Mental Health, ensuring their ability to effectively and confidently address these common issues in primary care.

Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial

BackgroundEarly intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People’s Health Partnership (CYPHP) model of care uses...

Acute Adrenal Insufficiency in Childhood: Etiopathogenesis, Clinical Picture, and Intensive Care

Introduction. Acute adrenal insufficiency (AAI) is a severe endocrinopathy whose victims include children and adolescents and which can be life-threatening despite its low incidence. Analysis of issues associated with intensive care of children with this pathology is of vital interest for pediatric anesthesiology and critical care medicine. The aim of this work was to assess current views on the etiopathogenesis, clinical pathology and intensive treatment of pediatric AAI.Materials and methods. The topic was researched by analyzing publications found in the Cochrane Library, PubMed and Medscape using the following search terms: “acute adrenal insufficiency, children and adolescents, intensive therapy, fluid management”, with 65 published sources chosen.Results and discussion. In AAI, caused by a sharp deficiency of cortisol (and mineralocorticoids), which triggers an inflammatory reaction, electrolyte imbalance and hemodynamic disorders. AAI presents with dehydration, nausea and vomiting, feelings of pain, hypotension, tachycardia, seizures and impaired consciousness up to coma. Laboratory tests in children often reveal hyperkalemia, hyponatremia, hypoglycemia and hypercalcemia. Intensive management of AAI in the ICU relies on parenteral corticosteroids (preferably intravenous hydrocortisone). Two or three days later, when the child is stable, they are switched to oral hormones. Meanwhile, fluid management is performed over 2 to 3 days to increase the circulating blood volume and relieve dehydration with crystalloid fluids.Conclusion. A clearer understanding of the etiopathogenesis, clinical manifestations and diagnostic features of AAI, along with knowledge of emergency care algorithms, will improve the quality of intensive therapy of pediatric patients with this condition.

Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.

In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines (Guidelines) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines, including several updates since the first version was released in 2013.The evidence base for the care of children in this environment is lacking, and medical care delivered in the high-threat environment is inconsistent and often not optimized for the care of infants and children. The Guidelines are supported from the existing literature base where possible, and where it is not, by consensus as to the current best practices as determined by iterative deliberations among the diverse and experienced group of stakeholders who are members of C-TECC. The Guidelines provide patient assessment and management information specific to the care of children in the following 3 dynamic phases of the high-threat environment: Direct Threat, Indirect Threat, and Evacuation. The phases represent a continuum of risk to the patient and the responder ranging from extreme (such as ongoing gunfire) to minimal (during movement toward definitive medical care).The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.

Gastrointestinal, Behaviour and Anxiety Outcomes in Autistic Children Following an Open Label, Randomised Pilot Study of Synbiotics vs Synbiotics and Gut-Directed Hypnotherapy.

Alterations of the microbiome-gut-brain (MGB) axis have been associated with autism spectrum disorder (ASD) and disorders of gut-brain interaction (DGBI). DGBI are highly prevalent in autistic children and are associated with worsening behaviour and anxiety. Treatments such as probiotics, prebiotics and gut-directed hypnotherapy (GDH) have shown efficacy in improving gut symptoms in children. The primary objective of the study was to compare changes in gastrointestinal (GI) scores following a 12-week intervention of synbiotics (prebiotic + probiotic) +/- GDH with a follow-up at 24 weeks. Secondary objectives included changes in behavioural and anxiety symptoms, while changes in gut microbiome composition were assessed as an exploratory objective. Children diagnosed with ASD aged 5.00-10.99 years (n = 40) were recruited and randomised (1:1) to a 12-week intervention of either synbiotics (SYN group) or synbiotics + GDH (COM group). Both the SYN and COM group experienced significant reductions in total GI scores post-intervention and at follow-up (p < 0.001), with no superiority of the COM treatment over the SYN treatment. The COM group showed beneficial reductions in anxiety scores (p = 0.002) and irritability behaviours (p < 0.001) which were not present in the SYN group. At follow-up, only those in the COM group maintained significant reductions in GI pain scores (p < 0.001). There were significant changes in gut microbiota such as increases in Bifidobacterium animalis and Dialister in both groups over time. In conclusion,synbiotics with or without GDH may help support standard care for autistic children who suffer comorbid DGBI. The trial was prospectively registered at clinicialtrials.gov on 16 November 2020 (NCTO4639141).

Legal Involvement in Pediatric Cancer Treatment Refusal: A Qualitative Study.

To characterize the spectrum of legal options considered in cases of treatment refusal, nonadherence, and abandonment (TRNA); clinicians' thought processes regarding legal intervention; and perceived consequences of legal involvement. We conducted in-depth, semistructured interviews with 30 pediatric oncologists between May and September of 2019 regarding experiences with TRNA. The interview guide covered types of conflicts encountered; factors and strategies considered in response; effects of TRNA cases, personally and professionally; the role of ethical frameworks and legal requirements; and resources needed to manage TRNA cases. Interviews were transcribed and coded iteratively using thematic analysis. Participants represented a range of institutional sizes, geographic locations, and years in practice. Twenty-five of 30 interviewees discussed legal consideration with regard to TRNA. Most participants first engaged the legal system through child protective service agencies. They considered patient age, treatment efficacy, quality of life (burden of treatment), and prognosis; family resources and social context; and preservation of therapeutic relationships and possible consequences of reporting. Experiences and outcomes of legal involvement varied. Clinicians struggle with the tension between obligations to report medical neglect and fears that reporting may result in more harm than benefit to the child in question. We urgently need more dialog between health care professionals and child protective services and legal professionals. Stakeholders from both groups would benefit from a greater understanding of the other's thought processes; clarity regarding the relevant facts; and mutual progress toward creative, evidence-based solutions to working out these complex challenges.

Interfacility Transfer of Children With Time-Sensitive Surgical Conditions, 2002-2017

Surgical care for children in the United States has become increasingly regionalized among fewer centers over time. The degree to which regionalization may be associated with access to urgent surgical care for time-sensitive conditions is not clear. To investigate whether transfers and travel distance have increased for 4 surgical conditions, and whether changes in transfers and travel distance have been more pronounced for rural vs urban children. This retrospective cross-sectional study analyzed data from 9 State Inpatient Databases from 2002 to 2017. Participants included children aged younger than 18 years undergoing urgent or emergent procedures for malrotation with volvulus, esophageal foreign body, and ovarian and testicular torsion. Residential and hospital zip codes were categorized as rural or urban. Hospitals were categorized as pediatric hospitals, adult hospitals with pediatric services, and adult hospitals without pediatric services. Primary outcomes were transfer for care and travel distance between patients' home residences and the hospitals where care was provided. Transfer and travel distance were analyzed using multivariable regression models. Among the 5865 children younger than 18 years undergoing procedures for malrotation with volvulus, esophageal foreign body, ovarian torsion, or testicular torsion, 461 (7.9%) resided in a rural area; 1097 (20.5%) were Hispanic, 1334 (24.9%) were non-Hispanic Black, and 2255 (42.0%) were non-Hispanic White; 2763 (47.1%) were covered by private insurance and 2535 (43.2%) were covered by Medicaid; and the median (IQR) age was 9 (2-14) years. Most care was provided at adult hospitals (73.4% with and 16.9% without pediatric services); the number of hospitals providing this care decreased from 493 to 292 hospitals (2002 vs 2017). Transfer was associated with rural residence (adjusted odds ratio [aRR], 2.3 [95% CI, 1.8-3.0]; P < .001) and increased over time (2017 vs 2002: aOR, 2.8 [95% CI, 2.0-3.8]; P < .001). Similarly, travel distance was associated with rural residence (adjusted risk ratio [aRR], 4.4 [95% CI, 3.9-4.8]; P < .001) and increased over time (2017 vs 2002: aRR, 1.3 [95% CI, 1.2-1.4]; P < .001). Rural children were more frequently transferred (2017 vs 2002) for esophageal foreign body (48.0% [12 of 25] vs 7.3% [4 of 55]; P < .001), ovarian torsion (26.7% [4 of 15] vs 0% [0 of 18]; P = .01), and testicular torsion (18.2% [2 of 11] vs 0% [0 of 16]; P = .04). Travel distance for rural children increased the most for torsions, from a median (IQR) of 19.1 (2.3-35.4) to 43.0 (21.6-98.8) miles (P = .03) for ovarian torsion and from 7.3 (0.4-23.7) to 44.5 (33.1-48.8) miles (P < .001) for testicular torsion. In this cross-sectional study of children with time-sensitive surgical conditions, the number of hospitals providing urgent surgical care to children decreased over time. Transfers of care, especially among rural children, and travel distance, especially for those with ovarian and testicular torsion, increased over time.

Utilizing the CFIR framework for mapping the facilitators and barriers of implementing teachers led school mental health programs - a scoping review.

Ample evidence has been generated regarding the effectiveness of school-based mental health interventions as part of the continuum of care for children and capacity building of teachers to deal with the emotional and behavioral challenges of students. The increasing trend of utilization of teachers as the natural support system of children and the huge financial impact of public health interventions highlights the need to review all available evidence regarding multilevel factors that facilitate or pose a challenge to the provision of School Mental Health Programs (SMHP) using teachers as providers. The current review aims to map extracted evidence under the Consolidated Framework for Implementation Research (CFIR) domains to support future implementation research on school-based mental health services. The scoping review included experimental, qualitative studies, and systematic reviews involving teacher-led mental health programs conducted in the school setting to improve the socio-emotional well-being of children and adolescents irrespective of time and geographical limitations. All (published and unpublished) evidence in English from Pubmed, Cochrane database of systematic reviews and clinical trials, Scopus, and Science Direct was searched using keywords and Boolean combinations and extracted using study designs, place of study, year of publication, sample size, and target population. A qualitative analysis of implementation facilitators and barriers cited by the studies was carried out and mapped on CFIR. This review identified barriers and facilitators of implementation across school-based mental health Programs in 29 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation, and the characteristics of individuals involved in implementation. These included the availability of structural characteristics, positive school culture, organizational readiness, committed leadership, and beliefs of the providers. Findings highlight the need for early assessment of contextual factors acting as barriers and facilitators and careful execution following realistic planning and stakeholders' engagement to ensure the success of SMHP.

Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval

Objective: To explore the choice of embryo transfer schemes for patients with low oocyte retrieval (≤ 3 oocytes). Methods: A retrospective analysis was conducted on patients with oocyte yields ≤ 3 undergoing in vitro fertilization and embryo transfer (IVF-ET) and frozen embryo transfer (FET) at the Maternity &amp; Child Care Center of Qinhuangdao Reproductive Medicine Department from January 2018 to December 2022. The data included 202 fresh cycles, with 104 cycles in Group-A and 98 cycles in Group-B. Additionally, 87 cycles involved the transfer of frozen embryos from fresh cycles that could not be transplanted for various reasons, with 31 cycles in Group-C and 56 cycles in Group-D. General patient information, embryo transfer details, and clinical pregnancy outcomes in both fresh and frozen cycles were statistically analyzed. Results: No significant differences were observed between Groups A and C in age, anti-Müllerian hormone (AMH), basal follicle-stimulating hormone (bFSH), body mass index (BMI), duration of infertility, the proportion of patients with diminished ovarian reserve (DOR), oocyte retrieval count, usable embryo count, or the number of transplanted embryos (all p&gt; 0.05). Advanced age was a risk factor for a decreased pregnancy rate, and FET significantly increased the pregnancy rate (p&lt; 0.05, respectively). Conclusion: For patients under 35 years old with low oocyte retrieval, it is recommended to freeze all embryos when available and then proceed with FET. For patients aged 35 and above, without reducing the pregnancy rate, fresh embryo transfer is recommended to minimize treatment cycle frequency and economic expenses. doi: https://doi.org/10.12669/pjms.40.10.9269 How to cite this: Shi H, Song Q, Liu J, Li C, Liu R. Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval. Pak J Med Sci. 2024;40(10):2251-2255. doi: https://doi.org/10.12669/pjms.40.10.9269 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The effect of baby touch on premature infants

Objective: Premature infants require special attention during nursing. This study aimed to explore the effects of baby touch on the growth, immunity, sleep and communication in premature infants. Methods: This was a retrospective study. A total of 64 premature infants with a gestational age of 30-36 weeks were selected at Maternity &amp; Child Care Center of Qinhuangdao from June 2022 to May 2023, and randomly divided into experimental group and control group. The control group received routine comprehensive nursing care for newborns, while the experimental group was additionally treated with touch intervention using the international standard touch method. The effects of the three months touch on the growth and development, immunological function, sleep quality, and emotional communication of the premature infants were observed. Results: No statistically significant differences were found in gender, gestational age, birth weight, birth length, or head circumference at birth between the two groups (p&gt; 0.05). In the third month, the increases in body weight, body length and head circumference were significantly more obvious, the immunological function indicators including CD3+, CD4+, CD8+, IgG, IgA and IgM were all significantly higher, the sleep time and sleep quality were both significantly superior, and the interaction time and intimacy with parents were significantly superior in the experimental group compared with the control group, with statistically significant differences (p&lt; 0.05). Conclusion: Baby touch can promote growth and development, strengthen immunological function, improve sleep quality and enhance the emotional communication abilities of premature infants, and help them better adapt to the environment and grow. doi: https://doi.org/10.12669/pjms.40.10.9275 How to cite this: Du Q, Zhu H, Guo M, Yang Q, Yang H, Ma Y. The effect of baby touch on premature infants. Pak J Med Sci. 2024;40(10):2256-2260. doi: https://doi.org/10.12669/pjms.40.10.9275 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Child care for young children with disabilities.

More than half (56%) of Canadian children aged 0 to 5 years are in non-parental child care, but data on child care attendance among children with disabilities is limited. This study examines child care participation among young children with disabilities in Canada, with a focus on different disability types. Analyses were conducted on 1,189 children aged 0 to 5 years identified with disabilities from Statistics Canada's 2023 Survey on Early Learning and Child Care Arrangements - Children with Long-term Conditions and Disabilities. Rates of child care participation, difficulties finding child care, difficulties within child care, and whether parents reported that their child had ever been denied a child care space because of their condition were examined. Logistic regression models tested for differences in the main child care arrangement and difficulty finding child care based on the child's disability while controlling for sociodemographic variables. Among children aged 0 to 5 years with disabilities, 45% attended a daycare centre, preschool, centre de la petite enfance, or before or after school care as their main child care arrangement; 17% attended another type of child care, such as a family child care home or care by a relative; and 38% did not regularly attend non-parental child care. The parents of nearly half of children with disabilities reported difficulty finding a child care arrangement, particularly for children with emotional conditions. Close to 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a child care space because of their condition. These findings highlight the need for information to support inclusive policies, practices, and resources for children with disabilities within the Canada-wide early learning and child care system.

Pediatric pulmonology 2023 year in review: Asthma.

Caring for children with asthma continues to be an essential responsibility of the pediatric pulmonologist. In this Pediatric Pulmonology Year in Review, we summarize the significant publications focused on pediatric asthma that have been published over the last year. Articles were selected from Pediatric Pulmonology and other relevant medical journals that historically publish in the field of pediatrics, and more specifically, pediatric asthma. Our aim was to highlight publications that may impact or change clinical practice. Once articles were collected, specific themes were chosen to best orient the reader to particular interests. In this review, we will discuss new findings that assist in the diagnosis and evaluation of pediatric asthma, highlight risk factors and social determinants that impact successful care, and discuss new interventions and treatment modalities for acute exacerbations and maintenance control. We hope this review can provide new insights and guidance for implementation into clinical practice within the field of pediatric asthma.

Health Promotion and Physical Wellness in Pediatric Physical Therapy.

A health promotion and physical wellness (HPPW) life course approach for pediatric physical therapy (PT) is recommended to improve children's health outcomes across the lifespan. A life course approach describes how a child's individual responses to environmental factors influence health outcomes. Using HPPW strategies, pediatric physical therapists can identify health risks and promote positive outcomes. Outcome measures and intervention recommendations are outlined to assist therapists in integrating HPPW strategies to ensure a longitudinal plan of care and optimal health outcomes for children. A child's health trajectory begins in the prenatal period and is influenced by individual and environmental factors. Pediatric PT uses child- and family-centered approaches and environmental assessments to design plans of care that address child and family HPPW goals. Incorporating HPPW strategies into pediatric PT facilitates positive health and physical wellness across a child's lifespan.See the video abstract for insights from the authors. Supplemental digital content available at https://www.dropbox.com/scl/fi/3g468hj1rpxrrivbeses0/HPPW-Video-Abstract_1080.mp4?rlkey=4p1i8z1gynroz064zpx3alijz&st=8u0gqemz&dl=0.

The Unique Impacts of COVID-19 on Low-Income and Diverse Canadian Women's Mental Health Profiles: A Latent Transition Analysis.

There is evidence of an overall decline in women's mental health, particularly those with young children, in the wake of the COVID-19 pandemic. However, research has also found heterogeneity in women's mental health responses. This longitudinal study sampled low-income women with young children by recruiting from the government's child care financial subsidy waitlist. To examine heterogeneity in women's mental health responses to COVID-19, a latent transition analysis was employed to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19 and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health changes after the onset of COVID-19. Mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between race, parenting practices, child temperament, and child mental health were significantly related to mothers' mental health profiles. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income women with young children.