Changes In Parental Behavior Research Articles

Child Talks+: A New Intervention to Support Families Affected by Parental Mental Illness

Child Talks+ is a preventive intervention developed with the aim to assist mental health professionals in offering support to children of parents with mental health problems and/ or addiction problems. This brief report presents the intervention, which can be adopted by mental health workers, social workers and other healthcare professionals who are in contact with patients who are parents. Parents and their children are entitled to receive psychoeducation about the parents’ mental health problems. Interventions to provide knowledge and support will enable parents and children to have a mutual understanding of the situation in the family and possible changes in parental behavior. Common grounds can make it easier for the family to speak openly about mental health problems within the family. The intervention aims to enhance parenting communication skills. After completing the intervention, patients should feel more equipped to talk with the children about their mental health problems, as well as listen to the children’s needs and experiences.

Parental Control and Adolescent Delinquency Based on Parallel Process Latent Growth Curve Modeling.

Although ample evidence demonstrates parental influences on delinquent behavior in adolescent years, few studies have examined how change in adolescent delinquency and change in parental behavior are related to each other, particularly in late adolescence. This study utilized survey data collected over three high school years (N = 3074 Grade 10 students; mean age = 15.57, SD = 0.74 at Time 1) to examine how change trajectory of adolescent-reported delinquency is related to change trajectory of adolescent perceived parental behavioral and psychological control using parallel process growth curve modeling. Results revealed that adolescent delinquency level was negatively associated with both parents’ behavioral control and positively associated with parents’ psychological control at Time 1 (Grade 10). However, adolescent delinquency increased in parallel with decreased parental behavioral control, but not a change in psychological control. Initial paternal behavioral control positively predicted a linear increase slope of adolescent delinquency while initial adolescent delinquency level also positively predicted a linear decrease slope of paternal behavioral control. These results highlight the parallel development of parents’ behavioral control and children’s delinquent behavior and delineate the reciprocal influence between paternal behavioral control and adolescent children’s delinquency.

New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic

BackgroundViral infections may trigger type 1 diabetes (T1D), and recent reports suggest an increased incidence of paediatric T1D and/or diabetic ketoacidosis (DKA) during the COVID-19 pandemic.ObjectiveTo study whether the number...

Therapeutic alliance as a predictor of behavioral outcomes in a relationally focused, family-centered telehealth intervention.

This study evaluates therapeutic alliance as a mediator of the relationship between dosage and clinical outcomes for the Family Check-Up (FCU) Online, a telehealth adaptation of an evidence-based parenting intervention for parents of middle school youth. The sample consisted of N = 111 parents with children in middle school who received the FCU Online as part of an ongoing clinical trial. They were randomly assigned to receive telehealth coaching and participated in the intervention and follow-up assessment 12 months later. Data was collected using parent and child questionnaires as well as engagement data collected as part of the online intervention, using both parents and children as reporters of parent behavioral change. Using parent report measures, there was clear support for a mediation model, with parent report of alliance predicting parent self-report ratings of clinical progress (parent behavior change) at 12-month follow-up. However, for the child-report data, there was no clear relationship between dosage or therapeutic alliance with child reports of parenting. Clinical implications and future research directions are discussed.

Males and females of a polygamous songbird respond differently to mating opportunities

Parents are expected to make fine-tuned decisions by weighing the benefits of providing care to increase offspring survival against that of deserting to pursue future mating opportunities. A higher incentive for the rarer sex in the population indicates an impact of mating opportunities on parental care decisions. However, in a dynamic breeding system, deserting the offspring and searching for a new mate would influence mating opportunities for both sexes. Sex-specific costs and benefits are expected to influence males’ and females’ parenting strategies in different ways. Here, we investigated Chinese penduline tits, Remiz consobrinus, which exhibit flexible parental care strategies: uniparental care by the male or female, biparental care, and biparental desertion occur in the same population. We show that male penduline tits change their parental behavior over the breeding season; they desert clutches produced early in the season but care for the late season clutches. The change in male parenting behavior is consistent with the seasonal decline in mating opportunities. In contrast, parenting by females did not change over the breeding season, nor was it associated with seasonal variation in mate availability. Taken together, mating opportunities have different associations with parental behavior of male and female Chinese penduline tits. We recommend an inclusion of mating opportunities for both sexes simultaneously in order to understand one of the fundamental decisions in parental care evolution—care or desert. Divorce is a common feature of both human and nonhuman animal societies. Theoretical studies suggest that one of the drivers of divorce is enhanced mating opportunity, i.e., parents with higher mating opportunities are more likely to abandon their family than those with low mating opportunities. Here, we investigate the dynamics of parental behavior and mating opportunities in a wild population of a small songbird, the Chinese penduline tit Remiz consobrinus. This species exhibits one of the most diverse avian breeding systems wherein both uniparental (male or female) and biparental rearing can be seen in a single population. We show that male penduline tits abandon their offspring in response to enhanced mating opportunities while the female parental behavior remains unaffected. This implies the relationship between mating opportunities and parental care is more complex than currently acknowledged and requires further investigation.

Prevalence of antibiotic self-medication behavior and related factors among children aged 0 to 5 years

ABSTRACT Background: Self-medication behavior has great adverse effects on children. The aims of this study were to assess the prevalence of self-medication with antibiotics (SMA) among children aged 0–5 years and explore the related factors. Methods: A cross-sectional survey was conducted from 1 July 2019 to 31 July 2019 in Wuhan, Hubei Province (Central China). A structured questionnaire was used to collect data from 1188 parents of children aged 0–5 years on sociodemographic characteristics, SMA among children, antibiotic knowledge and health beliefs of SMA. Results: Of the 1188 participants, 14.32% had self-medicated their children with antibiotics in the past 6 months. The higher the degree of perceived threat (OR = 0.94, 95%CI: 0.89–1.00) and self-efficacy (OR = 0.94, 95%CI: 0.89–0.98), the less likely parents were to self-medicate their children. On the contrary, the higher the degree of perceived barriers, the more likely parents were to self-medicate their children with antibiotics (OR = 1.058, 95%CI: 1.01–1.11). Conclusions: Health beliefs of parents were significantly associated with SMA among children. In addition to extensive health education, the Chinese government should also improve the accessibility and quality of health services to reduce the barriers of parental behavior change.

Seasonal patterns in nest survival of a subtropical wading bird, the Hawaiian Stilt (Himantopus mexicanus knudseni).

Nest survival is influenced by where and when birds decide to breed. For ground-nesting species, nest-site characteristics, such as vegetation height and proximity to water, may impact the likelihood of nest flooding or depredation. Further, habitat characteristics, and thus nest survival, may fluctuate across the breeding season. The Hawaiian Stilt (‘Ae‘o; Himantopus mexicanus knudseni) is an endangered Hawaiian waterbird that nests in wetlands across the Hawaiian Islands. In this study, we used observational surveys and nest cameras to examine the impact of nest-site characteristics and day of nesting season on nest survival of the Hawaiian Stilt. Early nests had a higher chance of survival than late nests. For most of the nesting season, taller vegetation was correlated with increased nest survival, while shorter vegetation was correlated with increased nest survival late in the nesting season. Seasonal patterns in nest survival may be due to changes in parental behavior or predator activity. Nest depredation was responsible for 55% of confirmed nest failures and introduced mammals were the primary nest predators. Our study is the first to examine seasonality in nest survival of Hawaiian Stilts and suggests that, despite longer nesting seasons and year-round occupation of wetlands, late nesters in subtropical regions may have lower nest survival than early nesters, similar to trends observed in temperate regions.

Presidential Address, 2020-Using Technology to Deliver Services and Supports in Homes, Neighborhoods, and Communities: Evidence and Promise.

Presidential Address, 2020-Using Technology to Deliver Services and Supports in Homes, Neighborhoods, and Communities: Evidence and Promise.

Nicotine, Cotinine, and Tobacco-Specific Nitrosamines Measured in Children's Silicone Wristbands in Relation to Secondhand Smoke and E-cigarette Vapor Exposure.

Simple silicone wristbands (WB) hold promise for exposure assessment in children. We previously reported strong correlations between nicotine in WB worn by children and urinary cotinine (UC). Here, we investigated differences in WB chemical concentrations among children exposed to secondhand smoke from conventional cigarettes (CC) or secondhand vapor from electronic cigarettes (EC), and children living with nonusers of either product (NS). Children (n = 53) wore three WB and a passive nicotine air sampler for 7 days and one WB for 2 days, and gave a urine sample on day 7. Caregivers reported daily exposures during the 7-day period. We determined nicotine, cotinine, and tobacco-specific nitrosamines (TSNAs) concentrations in WB, nicotine in air samplers, and UC through isotope-dilution liquid chromatography with triple-quadrupole mass spectrometry. Nicotine and cotinine levels in WB in children differentiated between groups of children recruited into NS, EC exposed, and CC exposed groups in a similar manner to UC. WB levels were significantly higher in the CC group (WB nicotine median 233.8 ng/g silicone, UC median 3.6 ng/mL, n = 15) than the EC group (WB nicotine median: 28.9 ng/g, UC 0.5 ng/mL, n = 19), and both CC and EC group levels were higher than the NS group (WB nicotine median: 3.7 ng/g, UC 0.1 ng/mL, n = 19). TSNAs, including the known carcinogen NNK, were detected in 39% of WB. Silicone WB show promise for sensitive detection of exposure to tobacco-related contaminants from traditional and electronic cigarettes and have potential for tobacco control efforts. Silicone WB worn by children can absorb nicotine, cotinine, and tobacco-specific nitrosamines, and amounts of these compounds are closely related to the child's urinary cotinine. Levels of tobacco-specific compounds in the silicone WB can distinguish patterns of children's exposure to secondhand smoke and e-cigarette vapor. Silicone WB are simple to use and acceptable to children and, therefore, may be useful for tobacco control activities such as parental awareness and behavior change, and effects of smoke-free policy implementation.

COVID-19 Related Challenges and Advice from Parents of Children with Autism Spectrum Disorder

With the rise of the COVID-19 pandemic and shelter-in-place, families with children with autism spectrum disorder (ASD) face a unique set of challenges related to a diverse set of issues. A qualitative study was conducted in the form of semi-structured interviews from fifteen parents of children and adolescents from a non-public school for children with ASD. Questions covered the following topic areas: general COVID-19 experiences and concerns, changes in the child’s mood and behavior, changes in parent mood and behavior, and coping/advice. Quotes and descriptions from the participants were reviewed and grouped into thematic areas. Findings showed that parents of children with ASD are facing a wide range of challenges, including explaining COVID-19 and safety precautions to their child in a comprehensible way, assisting with e-learning, and guiding their child back into social situations and the community. As children with ASD have difficulties with transitions, parents stated the importance of creating structure in the home by creating schedules and boundaries, while allowing for flexibility as to not over enforce the rigidity children with autism often face. Advice on coping with the additional stressors were also shared. Parents recommended finding time for themselves to reset, utilizing support systems, and reflecting on daily pleasures as positive coping mechanisms. This study aimed to both develop an initial guide for families, teachers and clinicians caring for children with ASD and to create awareness in the community about the challenges presented by COVID-19 and shelter-in-place.

Adolescents as Agents of Parental Healthy Lifestyle Behavior Change: COPE Healthy Lifestyles TEEN Program.

Obesity is a leading health crisis around the world. An intervention strategy scarcely utilized for behavior change is that of a child as change agent. The purpose of this study was to describe the impact of teens reviewing newsletters from a healthy lifestyle intervention with their parents. Evaluation data from a randomized controlled trial, COPE Healthy Lifestyle TEEN Program, was analyzed. A descriptive study was conducted of parents' and teens' lifestyle behaviors as reported by parents. One hundred sixty-nine parents completed evaluations. Two thirds of parents reported changing a behavior as a result of the program. Nearly three quarters of parents reported behavior changes in their teens. Over 90% reported they would recommend this or a similar program. The obesity epidemic shows no signs of reversal, and hence multiple approaches to impact healthy lifestyles are urgent. Including children as a change agent is a potential target for interventions addressing obesity.

Open trial of the Parent Behavior Change Intervention (PBC-I): Study protocol.

Parents have profound impacts on adolescents' health behaviors. Yet parents receive minimal training in the elements of conversations that optimally inspire their children toward engaging in healthy behaviors. The current study examines a novel interpersonal target: parent-adolescent conversations about adolescent health behavior change. Derived from advances in the science of behavior change, the Parent Behavior Change Intervention (PBC-I) contains conversational elements (e.g., behavior change techniques, positive communication strategies) hypothesized to reduce parent-adolescent coercion and conflict and facilitate upward spirals of healthy behavior change in adolescents. The first phase of the study involves the development of the PBC-I in a small case series (N = 12 dyads). The second phase involves an open trial of the PBC-I (N = 36 dyads). Adolescents will receive six 50-min sessions of the Transdiagnostic Sleep and Circadian Intervention to improve sleep while their parents receive six50-min sessions of the PBC-I. Parent-adolescent dyads will be assessed before and after the intervention. The primary analysis will examine whether postintervention use of behavior change techniques and positive communication strategies by parents is higher than preintervention use and whether increased use by parents predicts more positive conversational behaviors, less parent-adolescent conflict, higher adolescent motivation for change, and improved adolescent sleep. This research provides an initial test of the hypothesis that improving the parent-adolescent conversation will improve adolescent sleep health behavior. While sleep-related health behaviors are the focus of this study, the research is designed to be relevant to a broad range of health behavior change in young people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Evaluating a Brief Behavioral Parenting Program for Parents of School-aged Children with ADHD

SYNOPSIS Objective. Typical parenting programs require considerable time inputs, which can be a significant barrier to program access. Here we assessed whether a brief behavioral parenting program, 1-2-3 Magic, would be effective in reducing disruptive behavior and ADHD symptoms in school-aged children with ADHD and dysfunctional parenting in their parents. Design. Fifty-seven parents of children aged 6–12 years were randomly allocated to the treatment group (n= 28) or waitlist-control group (n= 29). Treatment-group parents participated in the 1-2-3 Magic group program over three consecutive weeks. Treatment-group data were collected at pre-, post-intervention, and 6-month follow-up, and control-group data were collected at pre- and post-intervention, with child and parental behavior change assessed using the Eyberg Child Behavior Inventory, Parent Stress Index, and Conners. Results. Parents in the treatment-group reported less child disruptive behavior, reduced child ADHD symptom severity, and less dysfunctional parenting at post-intervention compared with controls. Post-intervention results indicated that the major intervention effects were maintained at the 6-month follow-up. Conclusions. Findings provide preliminary treatment efficacy for this brief behavioral parenting intervention for school-aged children with ADHD and their parents.

Empowering parents for human immunodeficiency virus prevention: Health and sex education at home.

BackgroundImproving health literacy amongst human immunodeficiency virus (HIV)-positive mothers could strengthen child and adolescent HIV prevention. The Amagugu intervention included health literacy materials to strengthen maternal communication and has demonstrated success in low-resource HIV-endemic settings.ObjectivesOur aims were to (1) evaluate whether Amagugu materials improved health literacy leading to changes in parental behaviour towards communicating on topics such as HIV, health behaviours and sex education, and (2) explore what additional information and materials mothers would find helpful.MethodThe Amagugu evaluation included 281 HIV-positive mothers and their HIV-uninfected children (6–10 years). Process evaluation data from exit interviews were analysed using content analysis and logistic regression techniques.ResultsOf 281 mothers, 276 (98.0%) requested more educational storybooks: 99 (35.2%) on moral development/future aspirations, 92 (32.7%) on general health, safety and health promotion, and 67 (23.8%) on HIV and disease management. Compared to baseline, mothers reported that the materials increased discussion on the risks of bullying from friends (150; 53.4%), teacher problems (142; 50.5%), physical abuse (147; 52.3%) and sexual abuse (126; 44.8%). Most mothers used the ‘HIV Body Map’ for health (274; 97.5%) and sex education (267; 95.0%). The use of a low-cost doll was reported to enhance mother–child communication by increasing mother–child play (264; 94.3%) and maternal attentiveness to the child’s feelings (262; 93.6%).ConclusionParent-led health education in the home seems feasible, acceptable and effective and should be capitalised on in HIV prevention strategies. Further testing in controlled studies is recommended.

Changing Exposure Perceptions: A Randomized Controlled Trial of an Intervention with Smoking Parents.

Children who live with smokers are at risk of poor health, and of becoming smokers themselves. Misperceptions of the nature of tobacco smoke exposure have been demonstrated among parents, resulting in continued smoking in their children’s environment. This study aimed to change parents’ perceptions of exposure by providing information on second- and third-hand exposure and personalised information on children’s exposure [NIH registry (NCT02867241)]. One hundred and fifty-nine families with a child < 8 years and at least one smoking parent were randomized into intervention (69), control (70), and enhanced control (20) groups. Reported exposure, parental smoking details, and a child hair sample were obtained at the start of the study and 6–8 months later. Parental perceptions of exposure (PPE) were assessed via a questionnaire. The intervention consisted of motivational interviews, feedback of home air quality and child’s hair nicotine level, and information brochures. PPE were significantly higher at the study end (94.6 ± 17.6) compared to study beginning (86.5 ± 19.3) in intervention and enhanced control groups (t(72) = −3.950; p < 0.001). PPE at study end were significantly higher in the intervention group compared to the regular control group (p = 0.020). There was no significant interaction between time and group. Parallel changes in parental smoking behaviour were found. Parental perceptions of exposure were increased significantly post intervention, indicating that they can be altered. By making parents more aware of exposure and the circumstances in which it occurs, we can help parents change their smoking behaviour and better protect their children.

Parent perceptions of routine growth monitoring: A scoping review.

Despite being a well-accepted part of paediatric care, little is known about the benefits or potential harms of routine growth monitoring (RGM) from a parent's perspective. To explore parental experiences with RGM. Literature searches were performed on Google Scholar, psycINFO, CINAHL, and PubMed. Included studies were published after 2000 and described parental comprehension, preferences, attitudes toward, and/or behaviour change related to RGM. Of 24 reviewed studies, four themes were identified: reliance on growth monitoring, understanding, influence on feeding and behaviour, and response to obesity-related classification. RGM was familiar but not strongly preferred to identify a child's weight status. Parental understanding of RGM was poor, particularly among parents with low socioeconomic status. A common belief was that heavier babies were healthier, while smaller babies should prompt concern. Parents may be anxious and change behaviour in response to RGM, such as by halting breastfeeding, supplementing, or restricting their child's diet. Parents frequently discounted RGM information when their child was identified as overweight, and expressed concerns about self-esteem and eating disorders. This scoping review identifies that although RGM is familiar and sometimes reassuring to parents, increased consideration should be given to potential harms from parental perspectives when conducting growth monitoring.

The Lengthening Transition to Adulthood: Financial Parenting and Recentering during the College-to-Career Transition

Using longitudinal data collected from a college cohort in the United States ( N = 922), we examined the associations between systemic and structural factors (gender, race/ethnicity, family SES, and first-generation college status), financial parenting (teaching, and modeling behavior), and emerging adults’ financial behavior. We conducted a series of one-way repeated measure ANOVA analyses (GLM) to assess patterns of average change in financial parenting and financial behavior in the first year in college, fourth year in college, and two years after college and found evidence suggestive of recentering—a gradual transfer of responsibility during emerging adulthood from parent-directed behavior to self-directed behavior; however, the decline in financial parenting was not offset by an improvement in emerging adults’ financial behavior. Despite similar patterns of change, family socioeconomic status (SES), first-generation college student status, and gender influenced both financial parenting and financial behaviors at each time point. We discuss the findings and the implications on the timing and length of the recentering process.

THE MANAGEMENT OF EDUCATION CENTER PROGRAMS FOR STREET CHILDREN EMPOWERMENT IN A NON-GOVERNMENTAL ORGANISATION (NGO)

This study aims at revealing (1) the implementation of education center programs in Non- Governmental Organizations (NGO) of Rumah Impian (2) the role of NGO in empowering street children through its education center programs by reviewing their management of planning, organizing, implementation, controlling, (3) the constraints faced by NGO in implementing education center programs and (4) the benefits for the street children after the implementation of its education center program. This research can be categorized as case study using a qualitative approach. The subjects of this study were the head and staff of Rumah Impian as well as the street children who participated in the program.The data collection was conducted by interview, observation and documentation. The analysis technique used the interactive analysis model of Miles &amp; Huberman. The validity of the data was through source triangulation by comparing the data of interview, observation and documentation. The results of this study showed that 1) the implementation of the education center program was conducted with fun learning-based teaching and skills development. 2) The role of Rumah Impian according to its participation level for handling street children can be categorized as education roles. 3) The constraints in implementing the program consists of funding, the parental perceptions for the benefits of education center programs, the limited number of assistants, experts for program evaluation and the limited space. 4) The benefits of the program were improving the knowledge and skills among the street children and risky adolescents and changes in positive parental behavior, which were initially antipathic to education center activities, are now turning to be very enthusiastic in suporting education center activities.

Does Level of Engagement in a Digital Parent Training Program Impact Improvements in Parenting and Child Outcomes?

Background Approximately 8% to 10% of children younger than 5 years of age experience emotional, behavioral, and social relationship problems. These children are more likely to exhibit poor social interactions, problematic parent–child relationships, and school related setbacks, thus reinforcing the need for early interventions such as parent training programs. The ezParent program is a tablet-based delivery adaptation of the group-based Chicago Parent Program, a program designed to address the needs of families raising young children in urban poverty. The growing interest in and adoption of mHealth has changed the way people receive and seek treatment and the way clinicians deliver care. Despite the usefulness of mHealth apps in helping people manage various aspects of health, people’s use of those technologies often lasts only for a short period of time. This suggests a need to delve more deeply into user behaviors. Objective The purpose of this study was to (1) classify levels of engagement by identifying individual usage of ezParent based on observed user activity (ie, “metadata”) and (2) examine whether levels of ezParent engagement is associated with changes in parenting and child behavior over time (ie, parenting stress, self-efficacy, warmth, follow through, punishment, child behavior problems and intensity). Methods This study used a single-group, pre- and posttest design with repeated measures follow-up. Survey measures were collected at baseline (T1), 12 weeks postbaseline (T2) and 24 weeks postbaseline (T3). The study included 92 parents with data collected from two pediatric primary care clinics based in two urban cities with a high proportion of low income and minority families: Chicago, Illinois (cohort 1) and Baltimore, Maryland (cohort 2). Engagement was conceptualized based on total number of modules completed, amount of time spent in the program, and number of skills saved by the parent. Each outcome variable was modeled using a separate mixed-effects model to determine the model of best fit and was analyzed across time and level of engagement. Results Overall, 78 parents logged in to the ezParent program. The data aggregation resulted in 41 parents categorized as high engagers (cohort 1 n=29; cohort 2 n=12) and 37 parents as low engagers (cohort 1 n=13; cohort 2 n=24). Significant differences were across all outcome variables: parenting stress (P&lt;.05), self-efficacy (P&lt;.05), warmth (P&lt;.05), punishment (P&lt;.05), follow-through (P&lt;.05), child behavior intensity (P&lt;.05), and child behavior problems (P&lt;.05). Although parenting outcomes improved, improvements were not significantly associated with levels of engagement. Conclusions This study provides insight into engagement of parents participating in a digitally delivered parent training program. Although level of engagement was not associated with improvements in parenting and child outcomes, we were able to systematically identify and test key usage metrics to ope rationalize engagement. This indicates that further study may help researchers identify other usage metrics more indicative of engagement. By exploring usage data, researchers, app developers, and clinicians can better understand how users engage with future tablet-based interventions.

Improving health, wellbeing and parenting skills in parents of children with special health care needs and medical complexity \u2013 a scoping review

BackgroundParenting children with special health care needs can be challenging particularly if children have complex conditions. Parents may struggle to manage their child’s health and their own emotions, contributing to poorer health outcomes for the family. Frequent healthcare contact presents opportunities to intervene, but current evidence review is limited. This review scopes and synthesizes interventions to improve health, wellbeing and parenting skills.MethodsUsing formal scoping review methodology MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, ERIC, ASSIA, HMIC and OpenGrey were searched to February 2017. Citations were double screened according to predetermined eligibility criteria. Data were extracted and synthesized on study design, population, measurement tools, and results.ResultsSixty-five studies from 10,154 citations were included spanning parenting programs, other parent behavior change interventions, peer support, support for hospital admission and discharge and others. Interventions for parents of children with a wide range of conditions were included. These targeted a broad selection of parent outcomes, delivered by a wide variety of professionals and lay workers. Most studies reported positive outcomes. No serious adverse events were noted but issues identified included group and peer relationship dynamics, timing of interventions in relation to the child’s disease trajectory, the possibility of expectations not fulfilled, and parent’s support needs following intervention. Children with medical complexity were not identified explicitly in any studies.ConclusionsThe range of interventions identified in this review confirms that parents have significant and diverse support needs, and are likely to benefit from a number of interventions targeting specific issues and outcomes across their child’s condition trajectory. There is much scope for these to be provided within existing multi-disciplinary teams during routine health care contacts. Careful tailoring is needed to ensure interventions are both feasible for delivery within routine care settings and relevant and accessible for parents of children across the complexity spectrum. Further review of the existing literature is needed to quantify the benefits for parents and assess the quality of the evidence. Further development of interventions to address issues that are relevant and meaningful to parents is needed to maximize intervention effectiveness in this context.