Parental Health Outcomes Research Articles

Mental Health Outcomes of Parents with Children Enrolled in the Competence-Based Curriculum in Public Day Primary Schools in Nairobi County, Kenya

Involvement in their children's education through the Competency-Based Curriculum (CBC) significantly impacts the mental health outcomes of parents, necessitating a deeper understanding of how these educational demands influence parental well-being. This study examines the mental health outcomes of parents with children enrolled in the CBC in primary schools in Nairobi County, Kenya. Utilizing Cognitive Behavioral Theory (CBT), the research employed a quantitative approach with a cross-sectional survey design targeting parents with children enrolled in the CBC in primary schools. A multi-stage sampling technique resulted in a sample size of 376 parents. Data were collected using structured questionnaires, including the Parenting Sense of Competence (PSOC) scale, Multidimensional Fatigue Inventory (MFI), Parental Stress Scale, and New General Self-Efficacy Scale. Statistical analysis using SPSS Version 25 involved descriptive methods. The findings revealed generally positive mental health outcomes, with high levels of parenting satisfaction and self-efficacy, alongside moderate levels of mental fatigue and stress. These results align with CBT, emphasizing the role of positive beliefs and effective coping strategies in maintaining mental health. The study concludes that while CBC aims to enhance learning, it also creates challenges for parents that impact their mental health.

Assessing the health impacts of parenthood on people with cystic fibrosis: the HOPeCF prospective cohort protocol

IntroductionPeople with cystic fibrosis (CF) are living longer and healthier lives with a growing number considering and pursuing parenthood. The decision of whether to become a parent is complex for...

Short-term effectiveness of music therapy songwriting for mental health outcomes of at-risk parents in the NICU: a study protocol of an international multicenter mixed-methods trial.

Preterm birth contributes to adverse mental health outcomes of parents dealing with a premature neonate. The main objective of this study is to determine whether music therapy (MT) songwriting during the infants' stay in the neonatal intensive care unit (NICU) is superior to standard care in reducing the risk of postpartum depression in high-risk parents of preterm children throughout the hospital treatment. The secondary objectives include assessment of effectiveness of MT in other aspects of mental health (anxiety level, perceived stress, mental wellbeing, coping, resilience). Furthermore, this trial will evaluate the medical and social factors that may be associated with the effects of MT songwriting. The study design is a sequential mixed method study with a dominant status QUAN to qual. The quantitative trial was designed as a parallel, multicenter, pragmatic, randomized controlled trial. The qualitative study is a descriptive phenomenological study that seeks to understand the lived experiences of participants exposed to songwriting. Participants are parents of premature infants hospitalized in NICU (106 families) in 5 hospitals, in Colombia and Poland. Intervention: 3 MT songwriting sessions per week across 3 weeks. Primary outcome: the risk of postnatal depression; secondary outcomes: anxiety level, mental wellbeing, resilience, stress, coping. The results will be analyzed quantitatively and qualitatively. This study will provide a report on the effectiveness of MT songwriting on mental health in at-risk parents of preterm infants.

Examining emotional and behavioural trajectories in siblings of children with life-limiting conditions

BackgroundHealthy siblings of children with life-limiting conditions often experience emotional and behavioural struggles over the course of the ill child’s condition(s). Resources to support these siblings are limited due to a lack of understanding about their needs. Therefore, this study was designed to characterize the emotional and behavioural trajectories among siblings of children with progressive, life-limiting genetic, metabolic, or neurological conditions over a 12-month observation period.MethodsSeventy siblings were recruited from a large-survey based study (Charting the Territory) that examined the bio-psychosocial health outcomes of parents and siblings. Linear mixed effect models were used to assess the association between siblings’ emotions and behaviour trajectories and selected demographic variables. Siblings’ emotions and behaviour were measured with Child Behaviour Checklist (CBCL).ResultsSiblings’ mean age was 11.2 years at baseline and Internalizing, Externalizing, and Total Behaviour Problems mean scores were within normal ranges across time. However, 7–25% of siblings had scores within the clinical range. Brothers had higher levels of Internalizing Problems than sisters, whereas sisters had higher levels of Externalizing Problems than brothers. When treatment was first sought for the ill child less than a year prior to study participation, siblings had higher levels of Internalizing and Externalizing Problems compared with siblings who participated more than one year after treatment was sought.ConclusionHealthy siblings experience emotional and behavioural problems early in the child’s disease trajectory. Although these problems improve with time, our findings show that brothers and sisters experience different types of challenges. Therefore, timely support for siblings is important as they navigate through the uncertainties and challenges.

Physical, Cognitive, Emotional, and Social Health Outcomes of Parents in the First Six Months after Childhood Critical Illness: A Prospective Single Centre Study.

Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge. Parents reported health outcomes at PICU discharge (baseline), and 1-, 3-, and 6-months post-discharge. We used the Pediatric Quality-of-Life Family Impact Module, Patient Health Questionnaire-4, and post-traumatic stress disorder (PTSD) Checklist for DSM-5. The group-based trajectory model was used to identify recovery patterns. We included 128 parents of children aged 1 month to 18 years, admitted to the PICU for ≥48 h. Three post-discharge composite health trajectory groups were classified: 54 mild (42%), 68 moderate (53%), and 6 severe (4%). Parents in the mild and moderate groups returned to baseline health within the first 3 months, but those in the severe group exhibited worse outcomes at 6-months. The mean (SD) PICU stay durations for mild, moderate, and severe groups were 9 (16), 7 (10), and 38 (61) days; days of mechanical ventilation were 4 (5), 4 (7), and 18 (25) days; and readmission rates were 12 (22%), 23 (34%), and 4 (66%), respectively. Identifying these trajectories enables novel, targeted interventions for at-risk parents, underscoring the significance of integrated PICU follow-up care.

Major cardiovascular events and death in parents of children with type 1 diabetes: a register-based matched cohort study in Sweden

Aims/hypothesisParenting a child with type 1 diabetes has been associated with stress-related symptoms. This study aimed to elucidate the potential impact on parental risk of major cardiovascular events (MCE) and death.MethodsIn this register-based study, we included the parents of 18,871 children, born 1987–2020 and diagnosed with type 1 diabetes in Sweden at <18 years. The median parental age at the child's diagnosis was 39.0 and 41.0 years for mothers and fathers, respectively. The cohort also encompassed 714,970 population-based matched parental control participants and 12,497 parental siblings. Cox proportional hazard regression models were employed to investigate the associations between having a child with type 1 diabetes and incident MCE and all-cause death, and, as secondary outcomes, acute coronary syndrome and ischaemic heart disease (IHD). We adjusted for potential confounders including parental type 1 diabetes and country of birth.ResultsDuring follow-up (median 12 years, range 0–35), we detected no associations between parenting a child with type 1 diabetes and MCE in mothers (adjusted HR [aHR] 1.02; 95% CI 0.90, 1.15) or in fathers (aHR 1.01; 95% CI 0.94, 1.08). We noted an increased hazard of IHD in exposed mothers (aHR 1.21; 95% CI 1.05, 1.41) with no corresponding signal in fathers (aHR 0.97; 95% CI 0.89, 1.05). Parental sibling analysis did not confirm the association in exposed mothers (aHR 1.01; 95% CI 0.73, 1.41). We further observed a slightly increased hazard of all-cause death in exposed fathers (aHR 1.09; 95% CI 1.01, 1.18), with a similar but non-significant estimate noted in exposed mothers (aHR 1.07; 95% CI 0.96, 1.20). The estimates from the sibling analyses of all-cause death in fathers and mothers were 1.12 (95% CI 0.90, 1.38) and 0.73 (95% CI 0.55, 0.96), respectively.Conclusions/interpretationHaving a child diagnosed with type 1 diabetes in Sweden was not associated with MCE, but possibly with all-cause mortality. Further studies are needed to disentangle potential underlying mechanisms, and to investigate parental health outcomes across the full lifespan.Graphical

The physical and psychosocial benefits of a family judo program for parents of children with Autism Spectrum Disorder: A pilot study

BackgroundParents of children with Autism Spectrum Disorder (ASD) tend to have high levels of stress and poor health habits. There is a lack of interventions that focus on improving health outcomes in parents of children with ASD. ObjectiveTo examine the physical and psychosocial effects of a family-based judo program on parents of children diagnosed with ASD. MethodsThis study utilized a pre-post single group design. Eighteen parent-child dyads participated in a 14-week judo program for families of children with ASD. Judo sessions were held once a week for 45 min. Parents wore wrist accelerometers to assess physical activity/sleep quality, and completed surveys regarding self-reported stress levels pre- and post-judo. Parents also completed open-ended questions regarding their experience in the program. Paired sample t-tests were conducted to examine changes in stress, physical activity, and sleep quality from pre-to post-program. ResultsBoth a decrease in parental stress (47.77 vs. 41.61, p < 0.01) and an increase in minutes per day of physical activity (35.49 vs 45.94, p = 0.002) were observed from baseline to post-program. Fourteen of the 18 parents (78 %) reported at least one psychosocial benefit (e.g. increased self-confidence) or physical health benefit (e.g. increased physical activity) from participation in the program. ConclusionsA family judo program may provide health benefits, such as reducing stress levels and increasing physical activity in parents of children with ASD. Further research involving larger sample sizes is necessary to better determine the effects of judo on both parents and their children with ASD.

Birth Spacing and Parents’ Physical and Mental Health: An Analysis Using Individual and Sibling Fixed Effects

An extensive literature has examined the relationship between birth spacing and subsequent health outcomes for parents, particularly for mothers. However, this research has drawn almost exclusively on observational research designs, and almost all studies have been limited to adjusting for observable factors that could confound the relationship between birth spacing and health outcomes. In this study, we use Norwegian register data to examine the relationship between birth spacing and the number of general practitioner consultations for mothers’ and fathers’ physical and mental health concerns immediately after childbirth (1–5 and 6–11 months after childbirth), in the medium term (5–6 years after childbearing), and in the long term (10–11 years after childbearing). To examine short-term health outcomes, we estimate individual fixed-effects models: we hold constant factors that could influence parents’ birth spacing behavior and their health, comparing health outcomes after different births to the same parent. We apply sibling fixed effects in our analysis of medium- and long-term outcomes, holding constant mothers’ and fathers’ family backgrounds. The results from our analyses that do not apply individual or sibling fixed effects are consistent with much of the previous literature: shorter and longer birth intervals are associated with worse health outcomes than birth intervals of approximately 2–3 years. Estimates from individual fixed-effects models suggest that particularly short intervals have a modest negative effect on maternal mental health in the short term, with more ambiguous evidence that particularly short or long intervals might modestly influence short-, medium-, and long-term physical health outcomes. Overall, these results are consistent with small to negligible effects of birth spacing behavior on (non-pregnancy-related) parental health outcomes.

Effectiveness of Nonpharmacological Interventions for Improving the Mental Health and Other Psychosocial Outcomes of Parents with Perinatal Loss: A Systematic Review and Meta‐Analysis

The objective of this study was to assess the effectiveness of nonpharmacological interventions in enhancing the mental health and psychosocial outcomes of parents who have experienced perinatal loss, in comparison to active/inactive control groups. It also sought to identify the characteristics and components of effective interventions in the included studies. A comprehensive search was conducted across seven databases from January 2008 to December 2023. The analysis included randomized controlled trials (RCTs) published in English journals and dissertations that reported at least one mental health outcome postintervention for parents with perinatal loss. Twenty‐one RCTs were included. The findings demonstrated significant improvements of nonpharmacological interventions in the grief, posttraumatic stress disorder, depression, anxiety, and perceived social support of parents with perinatal loss, with moderate‐to‐high certainty of evidence. Optimal characteristics of nonpharmacological interventions for parents with perinatal loss were identified to inform future studies, including the intervention approaches (cognitive‐based interventions), delivery modalities (face‐to‐face), and formats (individual‐based), and a recommended number of sessions of four or fewer. To validate these findings and explore the process of nonpharmacological interventions in improving health outcomes for parents with perinatal loss from diverse backgrounds, further rigorous RCTs with larger sample sizes and longer follow‐up periods are required.

Material Hardship, Protective Factors, Children’s Special Health Care Needs, and the Health of Mothers and Fathers

BackgroundParents of children with special health care needs (CSHCN) are at risk of poorer health outcomes. Material hardships also pose significant health risks to parents. Little is known about how protective factors may mitigate these risks and if effects are similar between mothers and fathers. MethodsThis was a cross-sectional survey study conducted using the US 2018/2019 National Survey of Children’s Health, including parents of children 0 to 17 with income <200% of the federal poverty level. Separately, for parents of children with and without special health care needs (N-CSHCN), weighted logistic regression measured associations between material hardship, protective factors (family resilience, neighborhood cohesion, and receipt of family-centered care), and 2 outcomes: mental and physical health of mothers and fathers. Interactions were assessed between special health care needs status, material hardship, and protective factors. ResultsSample consisted of parents of 16,777 children; 4440 were parents of CSHCN. Most outcomes showed similar associations for both mothers and fathers of CSHCN and N-CSHCN: material hardship was associated with poorer health outcomes, and family resilience and neighborhood cohesion associated with better parental health outcomes. Family-centered care was associated with better health of mothers but not fathers. Interaction testing showed that the protective effects of family resilience were lower among fathers of CSHCN experiencing material hardship. ConclusionsFamily resilience and neighborhood cohesion are associated with better health outcomes for all parents, though these effects may vary by experience of special health care needs, parent gender, and material hardship.

Improving Parental Stress and Child ASD Severity through the Japanese Parent Mentorship Program: A Research Protocol

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition which often begins in early childhood and can involve a spectrum of persistent challenges with social communication, restricted interests, and repetitive behaviours. Literature in western and non-western countries has demonstrated that parents of children with ASD experience elevated stress relative to parents of neurotypical children. Despite the health-related burdens presented by raising children with ASD, little clinical and research emphasis is placed on reducing parental stress. Furthermore, much of the limited work on parent-centered interventions been conducted in the U.S., and few similar interventions have been developed for the Japanese population. Methods: The Japanese Parent Mentorship Program (JPM) seeks to modify a pre-existing social support intervention (the Colorado Parent Mentorship Program developed for parents of ASD children in the U.S.) to Japanese parents by incorporating dialogue about the culturally relevant stressors, social acceptability, maternal burden, saving the face, and parent-child attachment. To test the efficacy of the JPM at reducing parental stress, a randomized control trial will be conducted with mothers of ASD children who were born and are living in Japan for a minimum of five years. Results: Enrolment into the JPM will be associated with decreased parental stress post-intervention. The social support provided in the JPM will also be a protective moderator on the relationship between parental stress and ASD severity by weakening the overall association between parental stress and ASD severity. Discussion: The JPM can improve health outcomes for parents and their children with ASD by decreasing parental stress and consequently, ASD severity, leading to numerous indirect and positive implications on their physical, emotional, and social well-being. As prompted by the JPM, cultural competence in ASD management, is associated with positive outcomes such as such as increased likelihood of treatment continuation, increased strength of perceived therapeutic alliance and increased perceived treatment benefit. Conclusion: This research contributes to a major gap in the cross-cultural literature about parental stress and ASD. This work can be used to inform intervention strategies in Japan and researchers can emulate this design towards a global shift of providing culturally competent interventions for all.

Assessing the impact of grief on quality of life, work productivity, and health outcomes for parents bereaved from SMA: A study protocol

BackgroundU.S. cost-effectiveness recommendations suggest that analyses should include all costs and effects relevant to the decision problem [1]. However, in many diseases, including spinal muscular atrophy (SMA), few studies have evaluated bereaved family outcomes after a child has died, neglecting potential impacts on their health-related quality of life (HRQoL), work productivity, and mental health. Additionally, grief-related outcomes are rarely included in economic evaluations. This manuscript outlines the protocol of a study that will estimate the HRQoL, work functioning, and mental health of bereaved parents of children with SMA type 1 to determine how outcomes vary based on parent’s sex and the time since a child’s death.MethodsThis study will involve two phases. In Phase 1, we will conduct a literature review to identify prior research that has measured how parental grief impacts HRQoL, work productivity, and mental health. We will also interview four bereaved parents of children with SMA type 1, stratified by parent sex and time since their child’s death, and analyze findings using a thematic analysis. In Phase 2, we will develop a survey draft based on Phase 1 findings. Parents bereaved from SMA type 1 will review our survey draft and we will revise the survey based on their feedback. We will send a cross-sectional survey to approximately 880 parents bereaved from SMA type 1. We will analyze findings from the survey to investigate whether the severity of grief symptoms is correlated with HRQoL, productivity, depression and anxiety symptom severity. We will also evaluate whether the mean scores of grief and each of the outcomes vary significantly when stratified by parent sex and the time since the child’s death.DiscussionOur results will provide preliminary information on how parental grief can impact HRQoL, productivity, and mental health outcomes over time. Increasing the availability of family outcomes data will potentially assist organizations performing health economic evaluations, such as the Institute of Clinical and Economic Review (ICER) in the U.S. This research will also help to inform the development of future economic guidelines on this topic.

A pilot study examining financial stress during COVID-19 and executive function in mental health in parents and children

Families have endured intense economic shock throughout the COVID-19 pandemic, which may be linked to reduced cognitive performance as well as mental health outcomes of parents and children. The present study investigated how COVID-19-related financial stress and parental job loss impact executive functions and mental health in both parents and adolescents. Participants in the study were 83 adolescent-parent dyads (Adolescent Age M = 13.01 years, SD = 2.27, Parent Age M = 43.26, SD = 5.07) who participated remotely between April 25th and June 1st 2021. Both parents and adolescents completed three measures of executive function and also reported on their mental health symptoms using the MHI-5 and RCADS-short, respectively. Parents also reported on financial stress and whether they or their partner had lost employment during the pandemic (37.8% lost employment). Parental job loss was correlated with greater financial stress (r =.342, p =.002). Financial stress was correlated with worse adolescent inhibitory control (r = -.232, p =.036), but better parent working memory (r =.261, p =.018). Greater financial stress was associated with more mental health symptoms (r =.288, p =.009) for parents, but not adolescents. These results suggest that financial stress may impact child executive function and parent mental health. Further research is needed, as the long-term repercussions of economic stress on mental health and executive functions may become more apparent as the pandemic progresses.

Effectiveness of Structured Care Coordination for Children With Medical Complexity

Children with medical complexity (CMC) have chronic conditions and high health needs and may experience fragmented care. To compare the effectiveness of a structured complex care program, Complex Care for Kids Ontario (CCKO), with usual care. This randomized clinical trial used a waitlist variation for randomizing patients from 12 complex care clinics in Ontario, Canada, over 2 years. The study was conducted from December 2016 to June 2021. Participants were identified based on complex care clinic referral and randomly allocated into an intervention group, seen at the next available clinic appointment, or a control group that was placed on a waitlist to receive the intervention after 12 months. Assignment of a nurse practitioner-pediatrician dyad partnering with families in a structured complex care clinic to provide intensive care coordination and comprehensive plans of care. Co-primary outcomes, assessed at baseline and at 6, 12, and 24 months postrandomization, were service delivery indicators from the Family Experiences With Coordination of Care that scored (1) coordination of care among health care professionals, (2) coordination of care between health care professionals and families, and (3) utility of care planning tools. Secondary outcomes included child and parent health outcomes and child health care system utilization and cost. Of 144 participants randomized, 141 had complete health administrative data, and 139 had complete baseline surveys. The median (IQR) age of the participants was 29 months (9-102); 83 (60%) were male. At 12 months, scores for utility of care planning tools improved in the intervention group compared with the waitlist group (adjusted odds ratio, 9.3; 95% CI, 3.9-21.9; P < .001), with no difference between groups for the other 2 co-primary outcomes. There were no group differences for secondary outcomes of child outcomes, parent outcomes, and health care system utilization and cost. At 24 months, when both groups were receiving the intervention, no primary outcome differences were observed. Total health care costs in the second year were lower for the intervention group (median, CAD$17 891; IQR, 6098-61 346; vs CAD$37 524; IQR, 9338-119 547 [US $13 415; IQR, 4572-45 998; vs US $28 136; IQR, 7002-89 637]; P = .01). The CCKO program improved the perceived utility of care planning tools but not other outcomes at 1 year. Extended evaluation periods may be helpful in assessing pediatric complex care interventions. ClinicalTrials.gov Identifier: NCT02928757.

Psychological flexibility as a predictor of mental health outcomes in parents of pre-school children during the COVID-19 pandemic: A two-year longitudinal study

In light of the adverse mental health impacts of the COVID-19 pandemic for parents of preschool-aged children, it is important to identify modifiable protective factors that can inform interventions for parents who continue to struggle. The present study examined prospective and concurrent associations of parental psychological flexibility (acceptance, defusion, and committed action) with measures of parental stress and depression symptoms in an international sample of parents of preschoolers assessed at three time points over the first two years of the COVID-19 pandemic: The start of the pandemic (T1) as well as the end of the first (T2) and second (T3) year of the pandemic. Consistent with hypotheses, the three measures of parent psychological flexibility (assessed at T2) prospectively predicted parenting stress levels one year later (T3) (p < .05). Defusion and Committed Action also prospectively predicted lower levels of depression symptoms one year later [p < .05]. Comparable concurrent analyses of data of parents who provided data at T1 and T2 (N = 79) are also presented with acceptance and defusion negatively associated with parental stress (p < .001) and defusion negatively associated with depression (p < .05). This study contributes longitudinal evidence for the value of psychological flexibility for parents and suggests that Acceptance and Commitment Therapy interventions may help to support parental mental health during sustained periods of stress such as the COVID-19 pandemic.

Mental health outcomes in parents of children with a cancer diagnosis in Sweden: A nationwide cohort study.

The diagnosis of paediatric cancer is a crisis for the parents who are the primary caregivers of the affected child. A comprehensive assessment of the longitudinal impact of childhood cancer on parental mental health and the potential sex differences between the parents is lacking. Thus, we aimed to explore the subsequent short- and long-term mental health outcomes among the parents of children with cancer and examine whether the outcomes vary between the mother and father. By combining several Swedish registers, parents of a child (ages 0-14 years) with a cancer diagnosis between Jan 1, 2006, and Dec 31, 2016 were identified. For each parent of children with cancer, up to five mothers or fathers of cancer-free children were randomly selected and matched, respectively. Hospital contacts for any mental health disorders between 5 years before and 7 years after the diagnosis of childhood cancer were retrieved. An interrupted time series negative binomial regression was performed to assess the short- and long-term impact of a childhood cancer diagnosis on the parents' subsequent mental health outcomes. 16,199 mothers (2852 with a child with cancer and 13,347 without) and 15,708 fathers (2769 with a child with cancer and 12,939 without) were included in this study. Compared with mothers of children without cancer, mothers of children with cancer had higher risks of mental health disorders in the first year after diagnosis (rate ratio [RR] and 95% Confidence Interval [CI], 1.17 (1.03-1.32)), and notably, the adverse impact became more severe over time (RR and 95% CI, 1.36 (1.07-1.74), in the seventh year). For fathers of children with cancer, the risk of mental health disorders was continuously higher compared to matched comparisons (RR and 95% CI, 1.31 (1.01-1.71)). Our findings suggested that parental mental health was affected continuously by a diagnosis of childhood cancer in their children. In particular, the mother's mental health was affected more severely. Customised psychological services or interventions are highly needed for the parents of children with cancer. Swedish Research Council, Allmänna Sjukhusets i Malmö Stiftelsen för bekämpande av cancer, Swedish Heart-Lung Foundation, ALF funding from Region Skåne and China Scholarship Council.

Impact of ethnicity on parental health outcomes and experiences after paediatric intensive care unit discharge: a mixed-methods systematic review.

The impact of ethnicity on parental health outcome after paediatric intensive care unit (PICU) discharge remains unclear. Thirteen medical and healthcare databases, unpublished studies and grey literature were searched up to November 5, 2021. We performed a mixed-method systematic review to understand the impact of ethnicity on parental outcomes after PICU discharge, including eight quantitative and eight qualitative studies. Among 1529 parents included, 1064 (72%) were White. Higher prevalence of post-traumatic stress disorder was seen in Black parents (17% White vs 36% Black, p = .03). Latino ethnicity was found to have protective effect against anxiety as compared to White parents (coefficient - 4.27, p < .001). A total of 91 findings were aggregated into 14 categories, and the five synthesized themes from the eight qualitative studies were long-term psychological impact after PICU, use of coping strategies, challenges of re-integration, changes in relationships and the utilization of formal support services and resources. Mixed-method synthesis found that parents of ethnic minority group were underrepresented (18%) and had higher attrition rates in a longitudinal study as compared to White parents following childhood critical illness. Conclusion: There are significant gaps in evidence related to the impact of ethnicity on long-term parental health outcomes after PICU discharge. Ethnic diversity and inclusiveness in long-term PICU research may aid understanding of the parental experiences and outcomes to close the gap in health disparity.

Association of Food Insecurity with Mental Health Outcomes in Parents and Children.

Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.

Associations between parental type 2 diabetes risk and offspring birthweight and placental weight: a survival analysis using the Walker cohort

Aims/hypothesisLow birthweight (BW) is associated with the development of type 2 diabetes. Genome-wide analyses have identified a strong genetic component to this association, with many BW-associated loci also involved in glucose metabolism. We hypothesised that offspring BW and placental weight (PW) are correlated with parental type 2 diabetes risk, reflecting the inheritance of diabetes risk alleles that also influence fetal growth.MethodsThe Walker cohort, a collection of birth records from Dundee, Scotland, from the 1950s and the 1960s was used to test this hypothesis by linking BW and PW measurements to parental health outcomes. Using data from SCI-Diabetes and the national death registry, we obtained health records for over 20,000 Walker parents. We performed Fine–Gray survival analyses of parental type 2 diabetes risk with competing risk of death, and Cox regression analyses of risk of death, independently in the maternal and paternal datasets, modelled by offspring BW and PW.ResultsWe found significant associations between increased paternal type 2 diabetes risk and reduced offspring BW (subdistribution hazard ratio [SHR] 0.92 [95% CI 0.87, 0.98]) and PW (SHR 0.87 [95% CI 0.81, 0.94]). The association of maternal type 2 diabetes risk with offspring BW or PW was not significant. Lower offspring BW was also associated with increased risk of death in both mothers (HR 0.91 [95% CI 0.89, 0.94]) and fathers (HR 0.95 [95% CI 0.92, 0.98]), and higher offspring PW was associated with increased maternal mortality risk (HR 1.08 [95% CI 1.04, 1.13]) when adjusted for BW.Conclusions/interpretationWe identified associations between offspring BW and reduced paternal type 2 diabetes risk, most likely resulting from the independent effects of common type 2 diabetes susceptibility alleles on fetal growth, as described by the fetal insulin hypothesis. Moreover, we identified novel associations between offspring PW and reduced paternal type 2 diabetes risk, a relationship that might also be caused by the inheritance of diabetes predisposition variants. We found differing associations between offspring BW and PW and parental risk of death. These results provide novel epidemiological support for the use of offspring BW and PW as predictors for future risk of type 2 diabetes and death in mothers and fathers.Graphical abstract

MYTime: A Mindfulness and Yoga Program to Promote Health Outcomes in Parents of Children With Autism Spectrum Disorder.

BackgroundParenting a child with Autism Spectrum Disorder can be stressful and result in health consequences for the caregivers, a population that is often overlooked and underserved. While mind-body interventions such as mindfulness yoga can help promote positive health outcomes, limited research has explored the impact of such a program on caregivers of children on the autism spectrum.ObjectiveThe primary objective of this pilot study was to evaluate the effects of a 12-week mindfulness yoga program (MYtime) on perceived stress, anxiety, and depression among urban caregivers of children on the autism spectrum.MethodsTwenty-seven parents were randomized into either MYTime (n = 13) or the control group (n = 14). Perceived Stress Scale (PSS) and Depression, Anxiety, and Stress Scale (DASS) were administered.ResultsThe MYTime group reported lower stress, depression and anxiety while the control group maintained similar scores across pre- and post-assessment. Following 12 weeks of participation the PSS and DASS scores improved by 25% and 49% respectively for parents in the MYTime group. In comparison, PSS scores worsened by 5% and DASS scores improved by 17% for the Control group. Differences in pre-and post-assessment scores were not significant for either group (P > .05).ConclusionThe results from this pilot study indicate that a mindfulness yoga program could be considered among feasible interventions aimed at improving the health of parents of children on the autism spectrum.