English-speaking Parents Research Articles

Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years

Mobile devices are often used to keep young children occupied or calm, but it is not known whether this practice influences child development. To examine the longitudinal, bidirectional associations between the parent-reported frequency of using mobile devices to calm young children and children's executive functioning (EF) and emotional reactivity, testing moderation by child sex and temperament. This prospective cohort study included a community-based convenience sample of English-speaking parents of typically developing children aged 3 to 5 years. The study duration was from August 2018 to January 2020, with baseline (T1), 3-month follow-up (T2), and 6-month follow-up (T3) waves. Parent-reported frequency of use of mobile devices to calm children when upset (5-point Likert scale). At each wave, the child's EF was assessed with the Behavior Rating Inventory of Executive Function-Preschool Version Global Executive Composite and emotional reactivity with the Child Behavior Checklist Emotional Reactivity subscale. Structural equation models were built to examine cross-lagged associations of the use of devices for calming, EF, and emotional reactivity, testing for moderation by child sex or temperament (Child Behavior Questionnaire-Very Short Form surgency score, median split). Of 422 eligible parents with data at T1, 375 (88.9%) provided data at T2 and 366 (86.7%) at T3. At baseline, the mean (SD) age of the 422 children was 3.8 (0.5) years, the number of boys in the sample was 224 (53.1%), the number of individuals of non-Hispanic White race and ethnicity was 313 (74.2%), and among the parents, 254 (60.2%) had a college degree or higher. Among the boys, the use of devices to calm at T2 was associated with higher emotional reactivity at T3 (r [standardized regression coefficient] = 0.20; 95% CI, 0.10-0.30), while higher emotional reactivity at T2 had a nonsignificant association with increased device use for calming at T3 (r = 0.10; 95% CI, -0.01 to 0.21). Among children with high temperamental surgency, the use of devices to calm at T2 was associated with increased emotional reactivity at T3 (r = 0.11; 95% CI, 0.01-0.22), while higher emotional reactivity at T2 was associated with increased device use for calming at T3 (r = 0.13; 95% CI, 0.02-0.24). The findings of this study suggest that the frequent use of mobile devices for calming young children may displace their opportunities for learning emotion-regulation strategies over time; therefore, pediatric health care professionals may wish to encourage alternate calming approaches.

Educando a Nuestros Hijos: Examining Latinx Parental Stress Factors and Parental Engagement in Head Start Preschools

This study sought to understand Latinx parental stress factors as they relate to three types of parental engagement (PE; foundational education, school participation, and supplemental education) in preschool. Stress was examined in the form of global stress and acculturative stress (English competence pressure and pressure to acculturate). Spanish- and English-speaking Latinx parents (N = 189) of children enrolled in Head Start completed self-report surveys. Hierarchical linear regression results demonstrated that global stress significantly predicted foundational education and supplemental education, but not school participation behaviors. English competence pressure did not significantly predict any type of PE and pressure to acculturate only significantly predicted supplemental education behaviors. Findings have implications for developing family-school partnerships with Latinx parents of preschool children.

Acceptability to and Engagement With a Virtual Sickle Cell Trait Education Program (SCTaware): Single-Center Prospective Study.

Public health programs are tasked with educating the community on health topics, but it is unclear whether these programs are acceptable to learners. Currently, these programs are delivered via a variety of platforms including in-person, virtually, and over the telephone. Sickle cell trait (SCT) education for parents of children with this trait is one of many education programs provided by the Ohio Department of Health. The novel SCTaware videoconference education program was developed by a research team after central Ohio's standard program transitioned from in-person to telephone-only education during the COVID-19 pandemic. Our objectives were to investigate the acceptability of the format and engagement with the SCTaware education and assess parental worry about having a child with SCT before and after receiving SCTaware. This was a single-center, prospective study of English-speaking parents of children <3 years of age identified to have hemoglobin S trait by newborn screening. Parents who previously received SCT education by telephone, were able to be contacted, and had access to an electronic device capable of videoconferencing were eligible to complete surveys after receiving the virtual SCTaware education program. The SCTaware educator also completed a survey to assess participant engagement. Data were summarized descriptively and a McNemar test was used to compare parental worry before and after receiving SCTaware. In total, 55 participants completed follow-up surveys after receiving standard SCT telephone education and then completing SCTaware. Most (n=51) participants reported that the SCTaware content and visuals were very easy to understand (n=47) and facilitated conversation with the educator (n=42). All of them said the visuals were respectful and trustworthy, helped them understand content better, and that their questions were addressed. Nearly two-thirds (62%, n=34) reported that the pictures appeared very personal and applied to them. The educator noted most participants (n=45) were engaged and asked questions despite having to manage distractions during their education sessions. Many participants (n=33) reported some level of worry following telephone-only education; this was significantly reduced after receiving SCTaware (P<.001). Our results suggest that SCTaware is acceptable and engaging to parents. While telephone education may make SCT education more accessible, these findings suggest that many parents experience significant worry about their child with SCT after these sessions. A study to evaluate SCTaware's effectiveness at closing parents' SCT knowledge gaps is ongoing.

Parenting Culture(s): Ideal-Parent Beliefs Across 37 Countries

What is it to be “an ideal parent”? Does the answer differ across countries and social classes? To answer these questions in a way that minimizes bias and ethnocentrism, we used open-ended questions to explore ideal-parent beliefs among 8,357 mothers and 3,517 fathers from 37 countries. Leximancer Semantic Network Analysis was utilized to first determine parenting culture zones (i.e., countries with shared ideal-parent beliefs) and then extract the predominant themes and concepts in each culture zone. The results yielded specific types of ideal-parent beliefs in five parenting culture zones: being “responsible and children/family-focused” for Asian parents, being “responsible and proper demeanor-focused” for African parents, and being “loving and responsible” for Hispanic-Italian parents. Although the most important themes and concepts were the same in the final two zones—being “loving and patient,” there were subtle differences: English-speaking, European Union, and Russian parents emphasized “being caring,” while French-speaking parents valued “listening” or being “present.” Ideal-parent beliefs also differed by education levels within culture zones, but no general pattern was discerned across culture zones. These findings suggest that the country in which parents were born cannot fully explain their differences in ideal-parent beliefs and that differences arising from social class or education level cannot be dismissed. Future research should consider how these differences affect the validity of the measurements in question and how they can be incorporated into parenting intervention research within and across cultures.

Latina Mothers' Cultural Experiences, Beliefs, and Attitudes May Influence Children's Math Learning.

Drawing from a qualitative approach and through individual pláticas (processes of co-constructing knowledge through dialogue) as a linguistic and cultural framework, this work explored informal contextual factors valued by Spanish-speaking Latina mothers of children, three to five years of age and enrolled in a nonprofit California preschool. Results revealed that Latina mothers have cultural forms of knowledge which impact their children's educational experiences and engage in direct and indirect numeracy environments. While personal math experiences and home practices differed, Latina mothers experience and navigate their children's learning based on sociocultural aspects, influencing how they support their children's math learning. This study drew from sociocultural learning theories that value learning embedded within meaningful learning experiences. Patterns of family learning have several implications for educational practice, especially for Latine families whose parent participation is typically not as visible as White American English-speaking parents.

A paediatric English linguistics intervention on spoken language for English-speaking parents of deaf children having hearing problems

Background: This research aimed to find internet information about hearing loss, hearing technology, and spoken language acquisition for Pakistani English-speaking families of deaf or hard-of-hearing children (DHH). Methods: The existence or lack of parent education material on various websites was investigated using an exploratory, descriptive methodology. The research looked at the many Internet resources available. Results: Many websites with information for parents of DHH children acquiring spoken communication were found to be international. Each website was examined in fifteen different content categories. These websites featured English content. According to the present research findings, internet resources for Pakistani English-speaking parents with DHH students struggling with spoken dialect are typically less and less and not deeply involved. Conclusion: A Paediatric English Linguistics Mediation on Spoken Language for Parents of Deaf Children with Hearing Problems in Pakistani English internet alternatives for Pakistani English-speaking parents of DHH children who are having difficulty with spoken dialect are becoming fewer and more uninvolved.

Sociodemographic differences in opioid use and recovery following ambulatory pediatric urologic procedures.

Our aim was to examine associations between sociodemographic factors and postoperative opioid use and recovery among pediatric patients undergoing outpatient urologic procedures. We retrospectively evaluated 831 patients undergoing ambulatory urologic procedures from 2013 to 2017 at an urban pediatric hospital. Patients were evaluated for days of opioid use and days until return to baseline behavior. Differences in outcomes by race/ethnicity, primary language, median neighborhood household income, and health insurance type were analyzed using negative binomial regression models. Overall, patients reported a median of 1.0day (IQR: 2.0) of postoperative opioid use and 3.0 days (IQR: 6.0) of recovery time. After controlling for covariates, patients with non-English speaking parents took opioids for 26.5% (95% CI: 11.4-41.7%) longer and had 27.8% (95% CI: 8.1-51.0%) longer recovery time than patients with English-speaking parents. Hispanic patients took opioids for 27.5% (95% CI: 0.1-54.9%) longer than White patients. Patients with public insurance used opioids for 47.6% (95% CI: 5.0-107.4%) longer than privately insured patients. Non-English speaking, Hispanic, and publicly insured patients had a longer duration of postoperative opioid use than primarily English-speaking, White, and privately insured patients, respectively. Identifying these disparities is important for designing equitable postoperative care pathways.

Barriers and Facilitators to the Implementation of Family-Centered Technology in Complex Care: Feasibility Study.

BackgroundCare coordination is challenging but crucial for children with medical complexity (CMC). Technology-based solutions are increasingly prevalent but little is known about how to successfully deploy them in the care of CMC.ObjectiveThe aim of this study was to assess the feasibility and acceptability of GoalKeeper (GK), an internet-based system for eliciting and monitoring family-centered goals for CMC, and to identify barriers and facilitators to implementation.MethodsWe used the Consolidated Framework for Implementation Research (CFIR) to explore the barriers and facilitators to the implementation of GK as part of a clinical trial of GK in ambulatory clinics at a children’s hospital (NCT03620071). The study was conducted in 3 phases: preimplementation, implementation (trial), and postimplementation. For the trial, we recruited providers at participating clinics and English-speaking parents of CMC<12 years of age with home internet access. All participants used GK during an initial clinic visit and for 3 months after. We conducted preimplementation focus groups and postimplementation semistructured exit interviews using the CFIR interview guide. Participant exit surveys assessed GK feasibility and acceptability on a 5-point Likert scale. For each interview, 3 independent coders used content analysis and serial coding reviews based on the CFIR qualitative analytic plan and assigned quantitative ratings to each CFIR construct (–2 strong barrier to +2 strong facilitator).ResultsPreimplementation focus groups included 2 parents (1 male participant and 1 female participant) and 3 providers (1 in complex care, 1 in clinical informatics, and 1 in neurology). From focus groups, we developed 3 implementation strategies: education (parents: 5-minute demo; providers: 30-minute tutorial and 5-minute video on use in a clinic visit; both: instructional manual), tech support (in-person, virtual), and automated email reminders for parents. For implementation (April 1, 2019, to December 21, 2020), we enrolled 11 providers (7 female participants, 5 in complex care) and 35 parents (mean age 38.3, SD 7.8 years; n=28, 80% female; n=17, 49% Caucasian; n=16, 46% Hispanic; and n=30, 86% at least some college). One parent-provider pair did not use GK in the clinic visit, and few used GK after the visit. In 18 parent and 9 provider exit interviews, the key facilitators were shared goal setting, GK’s internet accessibility and email reminders (parents), and GK’s ability to set long-term goals and use at the end of visits (providers). A key barrier was GK’s lack of integration into the electronic health record or patient portal. Most parents (13/19) and providers (6/9) would recommend GK to their peers.ConclusionsFamily-centered technologies like GK are feasible and acceptable for the care of CMC, but sustained use depends on integration into electronic health records.Trial RegistrationClinicalTrials.gov NCT03620071; https://clinicaltrials.gov/ct2/show/NCT03620071

'Much more convenient, just as effective': Experiences of starting continuous glucose monitoring remotely following Type 1 diabetes diagnosis.

Initiating continuous glucose monitoring (CGM) shortly after Type 1 diabetes diagnosis has glycaemic and quality of life benefits for youth with Type 1 diabetes and their families. The SARS-CoV-2 pandemic led to a rapid shift to virtual delivery of CGM initiation visits. We aimed to understand parents' experiences receiving virtual care to initiate CGM within 30 days of diagnosis. We held focus groups and interviews using a semi-structured interview guide with parents of youth who initiated CGM over telehealth within 30 days of diagnosis during the SARS-CoV-2 pandemic. Questions aimed to explore experiences of starting CGM virtually. Groups and interviews were audio-recorded, transcribed and analysed using thematic analysis. Participants were 16 English-speaking parents (age 43 ± 6 years; 63% female) of 15 youth (age 9 ± 4 years; 47% female; 47% non-Hispanic White, 20% Hispanic, 13% Asian, 7% Black, 13% other). They described multiple benefits of the virtual visit including convenient access to high-quality care; integrating Type 1 diabetes care into daily life; and being in the comfort of home. A minority experienced challenges with virtual care delivery; most preferred the virtual format. Participants expressed that clinics should offer a choice of virtual or in-person to families initiating CGM in the future. Most parents appreciated receiving CGM initiation education via telehealth and felt it should be an option offered to all families. Further efforts can continue to enhance CGM initiation teaching virtually to address identified barriers.

‘Maybe if you talk to her about it’: intensive mothering expectations and heritage language maintenance

AbstractMaintaining heritage languages is frequently desired by migrants to continue cultural and social connections to family and identity. However, in imagined monolingual nations such as Australia, efforts to transmit minority languages are seen as a private matter and largely unsupported. Transmission of culture and language is also frequently seen as women’s work (Heller, Monica &amp; Laurette Lévy. 1992. Mixed marriage: Life on the linguistic frontier.Multilingua11(1). 32). This article seeks to explore how linguistically intermarried heterosexual couples orient to the task of heritage language maintenance along gender lines. It draws on a qualitative interview-based study into 22 couples living in Sydney. For the English-speaking background parents in the study, pressure to raise bilingual children arising out of a discourse ofintensive mothering(Hays, Sharon. 1996.The cultural contradictions of motherhood. New Haven: Yale University Press) was experienced in more negative ways by mothers than fathers. The analysis points to the effects of the non-migrant partner’s first language and their gender on heritage language efforts in linguistically intermarried families, and their impact on the (dis)continuation of linguistic diversity.

Remote and Hybrid Schooling During COVID-19: Associations with Child Behavior and Sleep.

The purpose of this study was to assess the prevalence of child behavior, academic and sleep concerns, and parent stress and depression symptoms during COVID-19; to test associations of parent-child well-being with child school format; and to examine effect moderation by child race/ethnicity and material hardship. A total of 305 English-speaking parents of elementary school-age children completed online surveys regarding demographics, child school format, behavior, learning-related experiences, sleep, and parent stress and depression symptoms. Multivariable linear and logistic regression analyses examined associations of school format with child and parent outcomes. Children were aged 5.00 to 10.99 years, with 27.8% underrepresented minority race/ethnicity. Per parental report, 27.7% attended school in-person, 12.8% hybrid, and 59.5% remote. In multivariable models, compared with children receiving in-person instruction, children receiving remote instruction exhibited more hyperactivity (β 0.94 [95% confidence interval, 0.18-1.70]), peer problems (β 0.71 [0.17-1.25]), and total behavioral difficulties (β 2.82 [1.11-4.53]); were less likely to show academic motivation (odds ratio [OR] 0.47 [0.26-0.85]) and social engagement (OR 0.13 [0.06-0.25]); were more likely to show schoolwork defiance (OR 2.91 [1.56-5.40]); and had a later sleep midpoint (β 0.37 [0.18-0.56]) and higher odds of cosleeping (OR 1.89 [1.06-3.37]). Associations of remote learning with behavior difficulties were stronger for children without material hardships. Children receiving remote and hybrid instruction were reported to have more difficulties compared with children receiving in-person instruction. Children with material hardships showed more behavior challenges overall but less associated with school format. Therefore, planning for a return to in-person learning should also include consideration of family supports.

Parents’ Perspectives about Special Education Needs during COVID-19: Differences between Spanish and English-Speaking Parents

ABSTRACT The purpose of this study was to explore parents’ perspectives about the special education process during the COVID-19 pandemic. The sample consisted of Spanish-speaking and English-speaking parents (N = 102) of children receiving special education services. Results indicated that language (English or Spanish), but not household income or parental education, was significantly associated with whether or not a child was receiving special education services during COVID-19, such that English-speaking parents were more likely to report that their child was receiving services relative to Spanish-speaking parents. The same predictors along with consideration of culture were used to examine the level of challenge children experience with online special education services. Language and consideration of one’s culture were significantly associated with the level of challenge children experienced when receiving online special education services, in which Spanish-speaking parents and parents who perceived that the IEP team rarely considered their child’s culture reported having more difficulty. Qualitative responses suggested that most parents were worried about their children regressing in academic gains. Preliminary results emphasize the need for understanding the perspectives of parents in navigating special education services to enhance equity in service access.

How do parents refer to their children while playing? A cross-linguistic comparison of parental input to Bulgarian- and English-speaking children with ASD.

Instances of person-reference, in the form of personal pronouns, names, or terms of endearment, are frequently used in child-directed speech. Examining this aspect of parental input is especially relevant to children with autism, who experience difficulties with person-reference. In this study, we compared the person-reference during parent-child interactions of Bulgarian (N=37) and English-speaking (N=37) parents of children with autism, who were matched on the language ability of their child. English-speaking parents used significantly more personal pronouns to refer to their children, while Bulgarian-speaking parents used the child's name more along with kinship terms. Furthermore, Bulgarian-speaking parents used significantly more different ways to refer to their child. These group differences were interpreted in the context of structural differences in the pronominal systems of Bulgarian and English, and in terms of culturally different discourse practices.

Impact of Challenging Behavior Online Modules on Korean Parents of Children With Developmental Disabilities: A Randomized Controlled Trial

Challenging behavior exhibited by young children with neurodevelopmental disabilities is known to negatively affect their optimal development and families’ quality of life. Although some support exists for English-speaking parents of children with autism who live in high-resource countries, it is scarce for others. Such disparity may also be heightened during the coronavirus disease 2019 (COVID-19) pandemic with its various societal restrictions. To mitigate the treatment gap, we developed and adapted a series of online training modules on behavioral principles and examined its effectiveness with 88 South Korean parents using a randomized controlled trial. We found significant interaction effects on increasing parents’ knowledge of behavioral principles, increasing positive parenting practices, and decreasing parental stress. Qualitative social validity data also indicated that parents were highly satisfied with the goals, procedures, and outcomes and that the program positively affected their parenting styles.

Identifying the Factors Influencing Patients' Telehealth Visit Satisfaction: Survey Validation Through a Structural Equation Modeling Approach.

Introduction: The COVID-19 pandemic accelerated the adoption of telehealth as an alternative to in-person hospital visits. To understand the factors impacting the quality of telehealth services, there is a need for validated survey instruments and conceptual frameworks. The objective of this study is to validate a telehealth patient satisfaction survey by structural equation modeling (SEM) and determine the relationship between the factors in the proposed telehealth patient satisfaction model (TPSM). Methods: We conducted a cross-sectional survey of pediatric patients and families receiving care from a comprehensive pediatric hospital in the Midwest between September 2020 and January 2021. In total, 2,039 usable responses were collected. We used an SEM approach by performing confirmatory factor analysis with Diagonally Weighted Least Squares modeling and Partial Least Squares-Path Modeling to establish the structural validity and examined the relationships among the constructs of "Admission Process" (AP), "Perceived Quality of Service" (PQS), and "Telehealth Satisfaction" (TS). Results: Participants were predominantly White (75%) and English-speaking (95%) parents (85%) of patients (mean age of patients was 10.2 years old). The survey responses were collected from patients visiting 43 department specialties, whereas 50% were behavioral and occupational therapy patients. The structural model showed that the admission process (AP) had a strong positive impact on perceived quality of service (PQS) (p = 0.67, t = 36.1, p < 0.001). The PQS had a strong positive impact on telehealth satisfaction (TS) (p = 0.66, t = 31.8, p < 0.001). The AP had a low positive direct impact on TS (p = 0.16, t = 7.46, p < 0.05). Overall, AP and PQS explained 61% variances (R2) of TS. Conclusions: We validated a newly proposed TS assessment model by using SEM. The TPSM will inform researchers to better understand the influencing factors in TS and help health care systems to improve telehealth patient satisfaction through a validated model.

Active auditory learning in infants born preterm

In this volume of The Journal, Richard et al report a study demonstrating auditory learning of sounds in a foreign language by infants born preterm during their hospitalization in the neonatal intensive care unit (NICU). By sucking on a specialized pacifier, infants of English-speaking parents were able to actively elicit lullabies and speech in French or Mandarin Chinese. After 20 of these sessions, infants hearing either language showed differential electrophysiologic responses to speech sounds in these languages with no effects on their responses to English language speech sounds.

A health literate approach to address health disparities: a virtual program for parents of children with sickle cell trait

ABSTRACT Background Approximately 8% of African Americans born annually have sickle cell trait (SCT), a public health concern that may contribute to health disparities if individuals with SCT do not know it and lack access to understandable information about reproductive implications. Pre-pandemic, Ohio offered in-person SCT education for parents of SCT-affected children but many did not attend. Those with limited health literacy (HL) were less likely to achieve high knowledge. We used a HL-focused evaluation of this education to develop a virtual program (SCTaware) to communicate clear, actionable information and promote knowledge retention. Methods Seven English-speaking parents, three with limited HL, were recruited in 2019 for in-person session videotaping and SCT knowledge assessments. Clinicians, HL experts, educators, genetic counselors, and parent stakeholders reviewed sessions, assessments, and accompanying visuals. Results Evaluators: observed parents asked few questions; noted undefined technical terms, closed questions, key concept omission, and limited explanation of visuals scoring low for understandability, actionability, and clarity; and developed SCTaware for individual videoconference delivery (knowledge objectives; plain language guide; HL-informed communication strategies; new visuals scoring highly for understandability, actionability, and clarity; narrated post-education version; standardized educator training). Conclusions Using a HL-focused evaluation, our diverse team created a promising virtual SCT education program addressing a common issue affecting populations at risk for disparities. Given virtual education will likely continue post-pandemic and limited HL is common, this approach may replicable for other public health education programs, especially those transitioning to virtual formats, to convey clear, actionable information and promote health equity.

Ask the parents: Testing the acceptability and usability of a hypospadias decision aid

In previous work, we engaged key stakeholders to create a web-based decision aid (DA) prototype to facilitate shared decision making about hypospadias. The study's objective was to use a human-centered design approach to assess the DA's acceptability and usability and revise it prior to pilot testing. We recruited English-speaking parents (≥18 years old) of sons with hypospadias (≤5 years) for a two-phase process of semi-structured phone/video interviews to obtain feedback about our DA prototype. DA webpages included: "Hypospadias," "Surgery Basics," "No Surgery," "Family Stories," "Help Me Decide," and "FAQs." In both phases, participants viewed the DA using the "think aloud" technique and completed several validated scales to evaluate its acceptability and usability. In phase 1, we collected feedback about the "Homepage" organization, values clarification methods (VCM), and webpage content. In phase 2, participants searched the DA for answers to hypospadias-related questions, provided feedback on testimonial videos and VCM, and shared their preferences about data visualizations. All interviews were audio recorded. After each phase, transcripts were qualitatively analyzed to identify key areas for revision. Revisions were made between phase 1 and 2 to improve the DA's acceptability and usability. We interviewed 20 participants (10/phase): median age 33.7 years, 60% female, 80% White. Mean score on the Preparation for Decision Making Scale: 86.8 (out of 100). We revised: 1) VCM, focusing on pros/cons of surgery and question prompts, 2) "Homepage," adding webpage descriptions (Extended Summary Figure), 3) menu organization, 4) "Surgery Day" webpage, adding general anesthesia risk information, and 5) "Hypospadias" webpage, adding an icon bar graph to help participants visualize statistics. Participants thought the testimonial videos were relatable and the VCMs would prepare them for their visit with their child's urologist. Ours is the first parent-centered DA developed and pre-tested for hypospadias. Using validated usability and acceptability scales, participants highly rated the DA in helping them arrive at a decision about surgery. Study limitations include the sample's lack of diversity (i.e., educated, health literate) and participants already decided about their son's hypospadias management before enrolling. To learn more about the DA's usability and acceptability, we plan to pilot test it in a clinical setting. Participants found our DA informative in understanding hypospadias. There was a high perceived level of preparation for hypospadias decision making. Participatory research methods, such as "think aloud," may be helpful when testing DAs as they privilege the patient's experience.

The COVID-19 Pandemic Contributed to Disparities in Housing-Cost Burden Among WIC-Participating Households in the Most Populous County in California.

Affordable housing is necessary for the health and well-being of children and families. The coronavirus disease 2019 (COVID-19) pandemic affected the ability of low-income families to pay for housing. The aim of this study is to evaluate associations between household characteristics of participants of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and housing-cost burden during the pandemic. WIC is a federally-funded nutrition assistance program for low-income mothers, infants, and children up to the age of 5. Data were from a 2020 survey of a random sample of WIC households (n = 5815) in Los Angeles County. Ordinal logistic regression determined the odds of being housing-cost burdened by parent respondent’s race/ethnicity, household composition, employment, residence, and housing cost. Logistic regression determined if the pandemic contributed to the housing-cost burden. A total of 61% of households reported housing-cost burden, with two-thirds attributing the burden to the pandemic. Spanish-speaking Hispanic parents and white parents reported a higher prevalence of pandemic-related burden, while Asian, Black, and English-speaking Hispanic parents reported a higher prevalence of burden unrelated to the pandemic. Single-parent households, those experiencing residential instability, and those with high housing costs had higher odds of burden. Spanish-speaking Hispanic parents, white parents, homeowners, and those with high housing costs were more likely to attribute the burden to the pandemic. To ensure that existing inequities are not exacerbated, it is vital that housing assistance be available to low-income households that were disproportionately affected by the pandemic.

Abstract PO-016: A latent class analysis of communication patterns between Hispanic and non-Hispanic childhood cancer survivors, parents, and medical providers

Abstract Introduction: The triad of communication between childhood cancer survivors (CCS), their parents, and their medical providers may motivate CCS healthcare engagement but has not been examined. This may be particularly important for Hispanic/Latino populations, who are more likely to trust and receive health information from hospital providers and are less likely to remain engaged in survivorship care compared to non-Hispanic white persons. Methods: We analyzed data from the Project Forward pilot study, a population-based study that evaluated follow-up care among 160 CCS-parent dyads (CCS mean age=20 years, 7 years from diagnosis, and 29% of parents identified as Spanish-speaking Hispanic). Nine indicators representing multiple dimensions of communication were used in latent class analysis to identify distinct classes of communication. These indicators were selected from the parent and CCS survey and asked about communication between CCS, parents, and medical providers. The association between resulting classes and various covariates (e.g., parent ethnicity/language, CCS demographic, clinical characteristics) was examined using multinomial logistic regression. Results: Three classes of the triad of communication were identified: (1) high healthcare-focused communication (37.5%); (2) high comprehensive communication (15.6%); and (3) overall low communication (46.9%). The high healthcare-focused communication class was characterized by patterns of high probability for communication about future health care needs among CCS, parents, and medical providers. The high comprehensive communication class was characterized by a high probability of communication about future healthcare needs and a high probability for parent-CCS communication about different cancer facets. The overall low communication class was characterized by a low probability of endorsing any communication items. Greater time since diagnosis was marginally significantly associated with reduced odds of the dyad's membership in class 2 [OR=0.798, 95% CI=0.635, 1.002, p-value=0.0520], compared to class 3 (low communication). Additionally, dyads with English-speaking non-Hispanic parents were less likely to be in class 2 [OR=0.361, 95% CI=0.130, 1.005, p-value=0.0511], compared to class 3. After adjusting for all covariates simultaneously, greater time since diagnosis was associated with reduced odds of membership in class 2 (vs class 3). Dyads with Spanish-speaking Hispanic parents were more likely to be in classes 1 and 2 (vs. class 3). Discussion: Our results support the need to enhance communication among CCS, parents, and medical providers generally to improve knowledge and understanding about the long-term effects of cancer, treatment, and outcomes. Our study suggests that dyads, where parents were Spanish-speaking Hispanics tended to engage in high communication. Examining language preference provides an important contextual understanding as it supports the notion that Hispanic/Latino cultural values may play a favorable role in high levels of communication. Citation Format: Carol Y. Ochoa, Junhan Cho, Kimberly A. Miller, Lourdes Baezconde-Garbanati, Randall Y. Chan, Albert J. Farias, Joel E. Milam. A latent class analysis of communication patterns between Hispanic and non-Hispanic childhood cancer survivors, parents, and medical providers [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-016.