Low-income Mexican American Research Articles

Cognitive Distancing Language in Parent-Child Book Sharing Among Low-Income Mexican American and Chinese American Families: Cultural Group Comparisons and Links to Children’s Executive Functions

ABSTRACT Research Findings: In the context of parent-child book sharing, cultural influences on cognitive distancing language and associations with child executive function (EF) have been understudied. This study examined cultural group similarities/differences in parent and child book-sharing distancing language among preschool-aged dual language learners from low-income Mexican American (MA) and Chinese American (CA) families. We further tested concurrent relations between parent/child distancing language and children’s EF. The sample consisted of 88 children (45 MAs, 43 CAs, age = 38–68 months) enrolled in Head Start preschools and their parents. To assess distancing language, utterances were coded for cognitive demand and classified as referential (low demand), behavioral (moderate demand), or inferential (high demand). Cognitive tasks tapping inhibitory control and cognitive flexibility were used to assess child EF. Results showed parents and children from both cultural groups produced comparable numbers of story-related utterances. MA dyads used higher proportions of parent/child inferential statements and a lower proportion of parent referential questions. The proportions of parent behavioral questions and child behavioral statements were positively related to child cognitive flexibility. Practice or Policy: Findings highlight heterogeneity in parent-child verbal interactions among low-income multilingual families and have implications for promoting preschoolers’ cognitive/language development in diverse populations.

Multilevel prenatal socioeconomic predictors of Mexican American children's cardiometabolic health in preschool and school age.

Using a life course perspective, this longitudinal study examines the extent to which prenatal family- and neighborhood-level socioeconomic factors influence the cardiometabolic health of low-income Mexican American children. It was hypothesized that prenatal maternal residence in a more economically disadvantaged neighborhood and more family-level economic hardship would each be associated with higher adiposity and blood pressure (BP) at child age 4.5 years, and higher adiposity, BP, inflammation and a less healthy lipid profile at child age 7.5 years. The sample consisted of 322 low-income, Mexican American mother-child dyads, 181 of whom completed the 7.5-year laboratory visit. Using maternal prenatal residence and U.S. census data, neighborhood concentrated disadvantage index was computed. Higher prenatal neighborhood concentrated disadvantage predicted higher 4.5-year adiposity in children, which, in turn, predicted higher adiposity, BP, and inflammation, and less healthy lipid profile (higher triglycerides, lower high-density lipoprotein cholesterol) at 7.5 years. Higher child 4.5-year BP was concurrently associated with higher adiposity and predicted higher 7.5-year BP. Extending previous work with this sample, the current study found associations between cardiometabolic risk indicators as early as preschool among Mexican American children. Furthermore, this study builds on existing literature by expanding our understanding of the effect of prenatal neighborhood concentrated disadvantage on cardiometabolic phenotypes during early childhood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

0754 Sleep Ecology in Low-Income Mexican American Toddlers

Abstract Introduction Healthy sleep is critical for child development, yet disparities exist, with Latino children disproportionately affected by deficient sleep. Most of what is known about sleep ecology and interventions to improve sleep in young children is based on studies of primarily White, non-Latino, and economically-advantaged families. To ensure the effectiveness of interventions, it is important to understand the contribution of socioecological factors on sleep among toddlers in low-income Mexican American families. Methods This study employed in-depth interviews with a purposeful sample of low-income Mexican American Spanish-speaking (n=10) and English-speaking mothers (n=10) of toddlers (18-34 months old). Interviews focused on daily sleep routines, perceptions of toddler sleep behaviors, and environmental contributors. Transcripts were coded by two investigators and analyzed using a content analytic approach. Results For sleep-related parenting practices, 70% of mothers reported late child bedtimes (≥9:00 pm), 75% reported room/bed sharing, and almost a third of children fell asleep at bedtime with a bottle or cup. Maternal beliefs about child sleep included concerns that child crying during the night might disturb neighbors or wake siblings, and child sleep quality improved when the child is not hungry. Contextual factors impacting sleep included schedules, neighbors, and siblings. Specifically, later weekday bedtimes were attributed to maternal (but not paternal) work schedules, while wake times were often a result of a sibling’s school schedule. Weekend bedtimes were commonly reported to be delayed for toddlers due to families watching movies. Noisy neighbors, in particular upstairs neighbors, were identified as disrupting children’s sleep. Siblings were identified as both facilitating sleep (e.g., helping with routines) and disrupting sleep (e.g., distracting child at nap time). Conclusion Findings provide insights on socioecological factors and parental beliefs about sleep ecology in low-income Mexican American toddlers that have implications for the design of interventions to improve child sleep. For example, commonly used behavioral sleep interventions have children sleeping in their own room, or require some crying during the night. However, these approaches may not be a good fit or feasible for this population. To address sleep health disparities, further work is needed to understand socioecological factors that require inclusive adaptations to pediatric sleep interventions. Support (if any) R01HL163859

Parenting a Toddler in the Era of Pervasive Screens: Interviews with Low-Income Mexican American Parents.

Screen media use starts in early childhood, despite recommendations to limit use. This study explored low-income Mexican American mothers' and fathers' beliefs, parenting practices, and perceived contextual contributors related to toddler screen use. We conducted interviews with 32 low-income Mexican American parents. Transcripts of audio recordings were analyzed to identify themes. Parents perceived numerous benefits to screen use, including learning and enjoyment, as well as seeing it as a helpful tool for parents. Reported risks included harmful mental and physical effects and a risk of use being all-consuming. Parents managed screen use with a variety of practices, including giving close attention to content, monitoring duration, and engaging in co-use. They also used screens for behavior management and in specific situations, such as to prepare for sleep. Some differences in beliefs and parenting practices exist by screen device type. Parents also reported that contextual factors, such as weather and neighborhood safety, influenced screen use. This study extends the current literature regarding child screen use, with its focus on low-income Mexican American toddlers. The findings offer interventionists and providers insight into the management of screens in the lives of this population.

Parent Emotion Talk with Preschoolers from Low-Income Mexican American and Chinese American Families: Links to Sociocultural Factors.

Emotion talk (ET), an emotion socialization practice theorized to promote children's emotion understanding and emotion regulation, has been linked to better socioemotional adjustment in diverse samples. Immigrant children face developmentally unique challenges and opportunities related to their multi-lingual and multi-cultural experiences. The present study aimed to identify sociocultural correlates of parent ET in two groups of low-income immigrant families with preschool-age children: Mexican American (MA) and Chinese American (CA) families. In 90 parent-child dyads (child age = 38 to 70 months, 59% girls; 46 Mexican American and 44 Chinese American) recruited from Head Start programs, parents' (mostly mothers') ET quality and quantity (i.e., use of emotion words, emotion questions and explanations, and overall elaborateness of ET) were coded from verbal transcripts of a shared picture book reading task. First, we found similarities and differences in ET across the two groups. Both MA and CA parents used emotion words, emotion questions, and emotion reasoning, whereas linking the story to personal emotion experience was infrequent. MA parents used more negative emotion words, emotion reasoning, and engaged in more elaborate ET than CA parents. Second, we examined the unique relations of multiple socio-cultural factors (SES, cultural orientations, parent and child demographics) to parent ET. Parent education and child age were associated positively with emotion questions, income was associated positively with emotion reasoning, and parents' heritage culture orientation was associated positively with the elaborateness of ET. The findings highlight the need to consider socio-cultural variations in emotion socialization practices when adapting and disseminating socioemotional learning interventions.

Screen-related discord and dismay in low-income Mexican American families with toddlers: A qualitative study

PurposeUnderstanding parental experiences with managing their toddler's screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. Design and methodsIn-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. ResultsThree themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddler's actual screen use, while living in a screen-saturated world. ConclusionsFindings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddler's screen use. Practice implicationsAlthough discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.

Behind Closed Doors: A Thematic Analysis of Diabetes Community Health Worker Home Visit Content.

The present work studies how community health workers (CHWs) perform the role of educator and how this relates to the implementation of other CHW roles, skills, and qualities. Prior studies on this topic have relied on interviews or focus groups rather than analysis of CHW interactions. We conducted a thematic analysis of 24 transcripts of conversations occurring between CHWs and participants during home visits as part of the Mexican American Trial of Community Health Workers, a randomized controlled trial that improved clinical outcomes among low-income Mexican American adults with type 2 diabetes. Three themes describing interactions related to diabetes self-management education accounted for about half of encounter content. The other half of encounter content was dedicated to interactions not explicitly related to diabetes described by 4 subthemes. In a successful CHW intervention, focused educational content was balanced with other interactions. Interactions not explicitly related to diabetes may have provided space for the implementation of core CHW roles, skills, and qualities other than educator, particularly those related to relationship building. It is important that interventions provide CHWs with sufficient time and flexibility to develop strong relationships with participants.

Association of BMI trajectories with cardiometabolic risk among low-income Mexican American children.

BackgroundThe aim of this study was to identify distinct trajectories of BMI growth from 2 to 7.5 years and examine their associations with markers of cardiometabolic risk at age 7.5 years among a sample of low-income Mexican American children.MethodsThis longitudinal cohort study recruited 322 mother–child dyads to participate prenatally and at child age 2, 3, 4.5, 6, and 7.5 years. Child height/weight, waist circumference, and blood pressure were assessed at each time point. Blood was collected from child at 7.5 years.ResultsCovarying for birthweight, three BMI trajectories were identified: Low-Stable BMI (73% of the sample), High-Stable BMI (5.6% of the sample), and Increasing BMI over time (21.4% of the sample). The High-Stable and Increasing BMI classes had higher waist circumference and systolic blood pressure and lower HDL-c than the Low-Stable BMI class (ps < 0.05). Among children with BMIs below the 85th percentile, 16% had three or more cardiometabolic risk indicators.ConclusionsBMI classes were consistent with existing literature. For youth, standard medical practice is to examine cardiometabolic risk indicators when BMI is high; however, this practice would miss 16% of youth in our sample who exhibit cardiometabolic risk but do not screen in based on BMI.Impact Research indicates Mexican American youth are at risk for cardiometabolic dysregulation relative to other ethnic groups, yet there is a paucity of longitudinal research.An Increasing BMI and a High-Stable BMI class were associated with larger waist circumference, higher systolic blood pressure, and lower HDL cholesterol than the Low-Stable BMI class.BMI trajectories in childhood predict cardiometabolic risk indicators. As the sole screener for deciding when to test cardiometabolic indicators, BMI alone will miss some children exhibiting cardiometabolic dysregulation.

The integrative model of family stress underlying Spanish and English vocabulary development in Mexican American children: Unique effects of financial and sociocultural hardships.

Early oral language development lays an essential foundation for academic and socioemotional competencies but is vulnerable to the impact of family stress. Despite robust evidence that family stress affects early oral language development in monolingual samples, little is known about whether the family stress processes affecting language acquisition are similar among dual language learners. Furthermore, although Mexican American families often face stressors related to their ethnic minority and immigrant status, no studies to date have tested whether exposure to sociocultural stressors may likewise have negative consequences for early language acquisition. The present study examined whether financial and sociocultural stressors were associated with maternal stress perception, parenting sensitivity, and child Spanish and English receptive vocabulary at child age 3 and 4.5 years. Participants included 322 low-income Mexican American mothers and their children followed from pregnancy through 4.5 years postnatal; most mothers preferred to speak Spanish (82%). Results of a path model indicated that links between family stress and child receptive vocabulary varied by language (Spanish or English) and stress type (financial or cultural). Specifically, Spanish acquisition was more closely related to the quality of mother-child interactions, whereas English acquisition was more susceptible to the direct impact of family stress. The consequences of family stress on children's vocabulary acquisition were evident earlier in development for Spanish than English, and appeared more pronounced for financial versus sociocultural stressors. Findings underscore a need to attend to the impact of poverty on children's Spanish and English language development in low-income, Mexican American children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychometric Properties of the Parenting Sense of Competence Scale Among Low-Income Mexican American Mothers

Psychometric Properties of the Parenting Sense of Competence Scale Among Low-Income Mexican American Mothers

Crack cocaine use among aging Mexican American men with heroin use histories: motivations and polydrug use patterns

Background Knowledge about the motivations for crack cocaine use and the long-term effects among people who inject heroin is limited. This study aims to understand motivations associated with this co-use drug pattern among aging men entrenched in established intergenerational heroin subcultures. Methods: A sample of 60 men with diverse injecting heroin use histories was recruited from low-income Mexican American urban communities for semi-structured ethnographic interviews using respondent-driven sampling. Qualitative analysis was then employed to provide an in-depth understanding of patterns and motivations of polydrug use among this older population. Results: The men discussed motivations including tolerance, curiosity and experimentation, a paradox of affordability, alternatives to the health hassles and stigma, and the cross-fertilization of drug markets. Concurrent and switching use patterns were primarily reported among those seeking a new or different high, while replacement patterns were reported by men in methadone treatment or by those who had tired of injection. Discussion: Findings translate to the on-going opioid crisis and the emerging trend in polysubstance use involving crack cocaine, methamphetamine and other psychostimulants among people who use heroin. More research is needed to investigate the full range of social and health consequences associated with these co-use patterns. Targeted and tailored prevention and treatment services are essential to improve outcomes among aging Mexican American men who use heroin and other persons with similar polydrug use patterns.

Prenatal Neighborhood Ethnocultural Context and the Mental Health of Mothers and Children in Low-Income Mexican American Families.

Socioeconomically disadvantaged neighborhoods increase the risk for poor mental health among residents, yet protective factors may operate alongside risk. This study evaluated the influence of the prenatal neighborhood ethnocultural context on child behavior problems and maternal depressive symptoms. Prenatal maternal role expectations, prenatal culture-specific stress, and postpartum depression (PPD) symptoms were evaluated as mediators. Participants included 322 low-income, Mexican American mother-child dyads. Women (Mage =27.8) reported on proposed mediators, maternal depressive symptoms, and child behavior problems at 4.5years. Neighborhood Latinx concentration was obtained from census data. Higher Latinx concentration predicted fewer maternal depressive symptoms and child behavior problems, mediated through role expectations and PPD symptoms. Results suggest prenatal neighborhood context to impact later maternal and child mental health.

Effects of maternal and paternal postnatal depressive symptoms on infants' parasympathetic regulation in low-income, Mexican American families.

Mothers and fathers are at elevated risk for developing depression during the first postnatal year, especially among families from marginalized communities. Although a number of studies demonstrate that exposure to maternal depressive symptoms can undermine infants' regulatory development, less is known about the extent to which paternal depressive symptoms may also contribute. The current study investigated whether maternal and paternal depressive symptoms were uniquely associated with infants' physiological regulation, and whether associations varied depending on infant sex. Participants included 90 low-income Mexican American families. Fathers and mothers self-reported their depressive symptoms when infants were 15weeks old, and infants' resting parasympathetic activity (i.e., respiratory sinus arrhythmia [RSA]) was assessed at 6 and 24weeks. Results indicated that, after controlling for infant 6-week RSA and depressive symptoms in the other parent, paternal depressive symptoms were associated with lower 24-week RSA for both girls and boys, but maternal depressive symptoms were only associated with lower 24-week RSA for boys. Findings highlight a potential mechanism through which the consequences of parent depressive symptoms may reverberate across generations, and suggest that considerations of both infants' and parents' sex may lend insight into how best to intervene.

Leading Inclusive Schools: Principal Perceptions, Practices, and Challenges to Meaningful Change

Background: For over 50 years, special education has been used as a tool to maintain racial segregation, particularly in schools located in low-income communities of color. This study utilized tenets found in disability critical race theory (DisCrit) and inclusive school leadership literature to examine the perceptions, practices, and challenges associated with meaningful change in inclusive schools. Purpose: The purpose of this article was to understand how six elementary school principals, identified as effective inclusive leaders, perceived students with disabilities within a low-income Mexican American immigrant community along the U.S.–Mexico border. Findings: Our study highlights the important role principals play in creating inclusive schools and the ways in which race, disability, family background, language, and immigration status effect principals in their efforts to promote inclusion. While each principal recognized the noted factors above and confronted a multitude of challenges, they differed in their beliefs and approaches to creating inclusive schools. Some leadership practices were aligned to research focused on effective school leadership while others more closely resembled social justice leadership practices. Conclusion: Findings suggest that principals must take into consideration a variety of factors to create inclusive schools and must draw upon a broad range of practices amid resistance and challenges to meaningful change.

Physical activity change after a promotora-led intervention in low-income Mexican American women residing in South Texas

BackgroundThe purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border.MethodsEnlace (‘to link’ in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase.ResultsThere were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009).DiscussionParticipants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women.ConclusionPA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women.Trial registrationNCT02046343.

Infant Vagal Tone and Maternal Depressive Symptoms: A Bottom-Up Perspective

Children vary in their susceptibility to environmental exposures such as maternal depression, but little is known about how children shape those same environments. When raising an infant with low arousal, mothers at risk of depression may experience decreased parenting self-efficacy and increased depressive symptoms. We evaluated a longitudinal mediated moderation model that hypothesized interactive effects of infant vagal tone (indexed by respiratory sinus arrhythmia [RSA]) and maternal postpartum depressive (PPD) symptoms on maternal depressive symptoms in early childhood via parenting self-efficacy. Among a sample of 322 very low-income Mexican American mother–infant dyads (46% male infants), infant RSA was assessed at 6 weeks of age; mothers (M age = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 weeks to 6 months, parenting self-efficacy at 18 and 24 months, and depressive symptoms at 18 and 36 months. Higher PPD symptoms predicted higher maternal depressive symptoms at 36 months, especially among mothers whose infants had lower resting RSA. The interactive effect of PPD symptoms and infant RSA on 36-month depressive symptoms was partially mediated by lower parenting self-efficacy. Lower infant RSA may exacerbate the detrimental effects of PPD symptoms on subsequent maternal well-being via damage to mothers’ beliefs in their ability to parent effectively.

Stress of Language Brokering and Mexican American Adolescents' Adjustment: The Role of Cumulative Risk.

This study focused on early adolescents' stress of language brokering and examined the moderating role of family cumulative risk in the relation of language brokering to adjustment problems. Data came from self-reports of 604 low-income Mexican American adolescent language brokers (54% female; ; SD = 0.97; 75% born in the United States) and their parents (99% foreign-born) in central Texas. Path analyses revealed that brokering stress, but not frequency, was positively associated with adolescents' adjustment problems, including depressive symptoms, anxiety, and delinquency. We also found that the relation between stress of brokering for mothers and adolescents' depressive symptoms was stronger among families with a high cumulative risk. Further, with a high cumulative risk, adolescents exhibited delinquent behaviors regardless of the levels of stress from translating for fathers. Current findings underscore the importance of examining family contexts in assessing the consequences of language brokering for Mexican American early adolescents' well-being.

Mother-infant dyadic dysregulation and postpartum depressive symptoms in low-income Mexican-origin women

The current study evaluated a mechanistic pathway by which prenatal stress increases the risk of postpartum depressive (PPD) symptoms via observed dyadic emotional, behavioral, and attentional dysregulation and associated cortisol responses during mother-infant interactions. MethodsParticipants included 322 low-income Mexican American mother-infant dyads. Depressive symptoms, economic hardship, and negative life events were assessed at a prenatal visit. Dysregulation in dyadic (mother-infant) interactions and cortisol responses to mother-infant interaction were evaluated at 12 weeks after the birth. Twenty-four weeks after the birth, PPD symptoms were predicted from prenatal stress (negative life events and economic hardship) and prenatal depressive symptoms, mediated through dyadic dysregulation and maternal and infant cortisol responses. ResultsMore negative life events in the prenatal period predicted more dyadic dysregulation at 12 weeks postpartum. Dyadic dysregulation and economic hardship predicted elevated 12-week infant cortisol total response and reactivity, and higher total infant cortisol response predicted higher maternal PPD symptoms at 24 weeks. Maternal cortisol response was not associated with dyadic dysregulation, either form of prenatal stress, or PPD symptoms. ConclusionThe results indicate the salience of early psychosocial processes and mother-infant relationship challenges for subsequent maternal affective well-being.

Infants' Biological Sensitivity to the Effects of Maternal Social Support: Evidence Among Mexican American Families.

The identification of infants who are most susceptible to both negative and positive social environments is critical for understanding early behavioral development. This study longitudinally assessed the interactive effects of infant vagal tone (respiratory sinus arrhythmia; RSA) and maternal social support on behavioral problems and competence among 322 low-income Mexican American mother-infant dyads (infants: 54.1% female) and explored sex differences. Infant RSA was calculated from resting HR data at 6weeks of age. Mothers reported on general social support, partner support, and family support at 6months, and infant behavioral problems and competence at 1year. Two-way interactions (RSA×support source) were evaluated to predict behavioral problems and competence, adjusting for covariates. Results indicated higher competence among infants with lower RSA whose mothers reported higher general support or higher partner support. Interactive effects on behavior problems of RSA with maternal partner or family support were only found for female infants: Girls with higher RSA showed more behavior problems when mothers reported low support, but fewer problem levels in the context of high support. Our results suggest that infant RSA is an important moderator of the effects of the early social environment on early development.

Screen-Related Parenting Practices in Low-Income Mexican American Families

ObjectivesTo (1) examine whether the Information–Motivation–Behavioral Skills Model predicts maternal screen-related parenting practices and (2) evaluate the relationship of American Academy of Pediatrics (AAP)–recommended parenting practices with child television (TV) use behaviors. MethodsIn this cross-sectional study, 312 Spanish-speaking and/or English-speaking female primary caregivers of Mexican descent with a child 3 to 5 years of age were recruited from safety-net pediatric clinics. Participants completed a phone interview and screen media diary. Measures included maternal screen-related beliefs, self-efficacy, parenting practices (time restriction, TV in the child's bedroom, allowing viewing while eating meals and while eating snacks), and child viewing behaviors (amount of TV viewing, frequency of eating while viewing). Two path analytic models were estimated. ResultsPositive general beliefs about TV viewing and positive functional beliefs were negatively associated with maternal self-efficacy to restrict TV time (β = –0.14, P < .05; β = –0.27, P < .001). Greater self-efficacy to restrict time was associated with more maternal restriction of time (β = 0.29, P < .001). Greater positive functional beliefs were associated with less self-efficacy to restrict TV viewing with snacks (odds ratio = 0.56; 95% confidence interval, 0.38–0.81). High self-efficacy to restrict viewing with snacks was associated with less allowing of viewing while snacking (β = –0.16, P < .01). Time restriction, TV in the child's bedroom, and allowing viewing while snacking were associated with child TV viewing behaviors. ConclusionsProviders should consider maternal beliefs, including beliefs regarding the functional use of screens, and self-efficacy to engage in AAP-recommended parenting practices, when counseling on screen use in this population.