Low-income Mothers Of Young Children Research Articles

Housing hardship and maternal mental health among renter households with young children

Maternal mental health is crucial to healthy family functioning and child well-being. Housing hardship may increase risk for mood disorders among mothers of young children in renter households. The present study used latent class analysis to investigate manifestations of housing hardship during the postpartum year in a sample of renter mothers in the United States (N = 2,329), as well as whether housing hardship types were associated with subsequent maternal depression and anxiety. The majority of mothers were relatively stably housed (“Stable”), one in six made do with governmental rental assistance (“Rent-Assisted”), and more than one in ten struggled to afford or maintain stable housing (“Cost-Burdened” or “Housing Insecure”). The most severe housing hardship was associated with the greatest depression risk, whereas the best determinant of anxiety risk was whether rent was paid each month; mothers whose rent was paid with government assistance did not differ on anxiety risk compared to those who paid their rent independently. Findings suggest that different types of housing hardship are linked with distinct mental health sequelae. Widely available housing assistance may reduce cost burden and prevent displacement, with the potential to reduce mental disorder among low-income mothers of young children.

Emergency Food Support Preference and Usage During COVID-19: A Neighborhood Study of Low-Income Black Mothers? Use of School-Based Food Distribution and P-EBT.

COVID-19 disrupted families' food supply. Based on in-depth interviews with 45 Black low-income mothers of young children in an underserved Houston, Texas, neighborhood from April 2020 to June 2021, we compared two aid programs-Pandemic Electronic Benefits Transfer cash assistance and in-kind food distributions. We found that mothers preferred cash assistance for boosting existing food strategies, while food distributions presented new challenges for already burdened families. We argue that food assistance interventions can be more successful and equitable by integrating service user context, needs, and preferences. (Am J Public Health. 2023;113(S3):S227-S230. https://doi.org/10.2105/AJPH.2023.307458).

Evaluation of a social marketing approach to healthy, home-cooked family meals for low-income mothers of young children.

Cooking is a complex behavior associated with more frequent and nutrient-dense family meals. The Cook Together, Eat Together (CTET) social marketing program used formative, process, and outcome evaluations over a 3-year period to design a program to increase fruit and vegetable intake and frequency of family meals. We used a quasi-experimental, mixed-methods design with a nonequivalent comparison group to evaluate fruit and vegetable intake and family meals. Eight focus groups of mothers in low-income families with young children revealed two predominant behavioral mediators: (i) importance of family time and (ii) desire for children to learn to cook and become self-sufficient adults. Program design was grounded in formative evaluation and organized by the four Ps of social marketing: (i) product-learning to prepare healthy meals while teaching children to cook; (ii) price-lowered by reducing barriers of food cost, kitchen clean-up, meal planning, grocery shopping; (iii) placement-in neighborhood gathering places with a "cooking social"; and (iv) promotion-flyers, newsletters, and social media. Outcome indicators were assessed pre/post intervention with questions from instruments validated for the audience. Significant changes (n = 68, p ≥ .002, Bonferroni adjustment for p = .05, Cohen's d = .50 medium effect size) were found in consumption of fruits and vegetables with an average increase of half cup each per day. CTET participation significantly increased fruits and vegetables served and eaten at family meals. A social marketing approach can help families with young children increase fruit and vegetable consumption.

Impact of the 2009 WIC Food Package Changes on Maternal Dietary Quality

ABSTRACT The impact of the 2009 changes to the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) on mothers receiving WIC benefits was evaluated using repeated, cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2003–2006 (231 participants) and 2011–2014 (81 participants). Linear regression models assessed maternal dietary quality (measured by Healthy Eating Index-2010 scores) over time. After the 2009 changes, there was no significant change in total HEI-2010 scores among maternal WIC participants. The 2009 WIC changes may have been inadequate to address the financial and cultural barriers to a healthful diet faced by low-income mothers of young children.

A geo-ethnographic analysis of low-income rural and urban women's food shopping behaviors

Many scholars have found evidence that low-income neighborhoods contain fewer supermarkets, but there is a lack of consensus regarding whether and how this matters to residents. A few qualitative studies have asked food desert residents about their experiences of their food environments, while a small number of other studies have utilized spatial analyses to examine actual shopping behaviors. To better understand barriers to food access, this study combines the two in a geo-ethnographic analysis. This study draws on data from a USDA-funded project about families and food to combine quantitative geographic data with qualitative interview data of 100 rural and urban low-income mothers of young children. For each participant, the nearest supermarket, as well most-frequented supermarket, was mapped, and distances to stores were calculated. On average, participants traveled more than twice as far as their nearest supermarket to reach a preferred store. Interviews with participants were conducted to assess the motivations and strategies of shoppers, in particular why they chose to bypass their nearest supermarkets. They shared a variety of reasons for doing so; foremost to find lower prices of food in order to stretch income and SNAP benefits. Access to transportation also played a major role in determining where people shopped for food. This research challenges scholars, policymakers, and health practitioners to look beyond proximate food environments to consider the lived experiences of food desert residents. Efforts to address poor food access should aim to increase household income, in addition to providing targeted food and nutrition assistance.

The Impact of Food Insecurity on the Home Emotional Environment Among Low-Income Mothers of Young Children.

Objectives Household stressors, such as food insecurity, contribute to the home emotional environment and negatively affect child development. Little research on this topic has been conducted among very young children. This study aimed to examine the relationship between food insecurity and the home emotional environment, as well the extent to which the relationship may be mediated by maternal symptoms of depression. Frequency of praise, affection, and discipline of young children by mothers were examined as markers of the home emotional environment. Methods Data were collected in a cross-sectional study of mothers of children under the age of five (N = 4231). Logistic regression was used to assess the relationship between level of food security and frequency of praise and discipline of children. Mediation analysis using the KHB method was conducted to test whether maternal mental health mediated the relationship between food insecurity and each outcome. Results Low and very low food security were significantly associated with higher odds of disciplining children with high frequency. Controlling for all covariates, frequency of praise was not significantly associated with level of household food insecurity. Differences in praise and discipline frequency were found by language of interview, maternal education, and employment. Conclusions for Practice Parent-child interactions, specifically related to discipline, are related to food insecurity. Further research should consider cultural patterns and mechanisms behind the relationship between food insecurity and the home environment. Household stressors begin affecting children at young ages, and early intervention is essential to prevent further negative sequelae as children grow older.

MATERNAL PERCEPTIONS OF PARENTING FOLLOWING AN EVIDENCE-BASED PARENTING PROGRAM: A QUALITATIVE STUDY OF LEGACY FOR CHILDRENTM.

This article presents the findings of a qualitative study of maternal perceptions of parenting following participation in Legacy for ChildrenTM (Legacy), an evidence-based parenting program for low-income mothers of young children and infants. To further examine previous findings and better understand participant experiences, we analyzed semistructured focus-group discussions with predominantly Hispanic and Black, non-Hispanic Legacy mothers at two sites (n = 166) using thematic analysis and grounded theory techniques. The qualitative study presented here investigated how mothers view their parenting following participation in Legacy, allowing participants to describe their experience with the program in their own words, thus capturing an "insider" perspective. Mothers at both sites communicated knowledge and use of positive parenting practices targeted by the goals of Legacy; some site-specific differences emerged related to these parenting practices. These findings align with the interpretation of quantitative results from the randomized controlled trials and further demonstrate the significance of the Legacy program in promoting positive parenting for mothers living in poverty. This study emphasizes the importance of understanding real-world context regarding program efficacy and the benefit of using qualitative research to understand participant experiences.

Depression Treatment by Non‐Mental‐Health Providers: Incremental Evidence for the Effectiveness of Listening Visits

Maternal depression is a prevalent public health problem, particularly for low-income mothers of young children. Intervention development efforts, which often focus on surmounting instrumental barriers to care, have not successfully engaged and retained women in treatment. Task-sharing approaches like Listening Visits (LV) could overcome key instrumental and psychological barriers by leveraging the access of trusted, community caregivers to deliver treatment. A recent randomized controlled trial (RCT) demonstrated the efficacy of LV delivered by non-mental-health providers as compared to usual care. The present report presents results from a follow-up phase of that RCT during which participants who had completed LV were followed for an additional 8weeks and completed measures of depression and quality of life. In addition, participants who were initially randomized to the wait-list control group received LV and were assessed. Treatment gains previously observed in participants completing LV were enhanced during the 8-week follow-up period. Participants receiving LV during the follow-up period experienced significant improvement in depressive symptoms. Results demonstrate the sustainability of LV delivered by non-mental-health providers, and provide preliminary evidence for the replicability of this approach in a sample of predominately low-income pregnant women and mothers of young children.

Maternal Strategies to Access Food Differ by Food Security Status

BackgroundHousehold food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources, and their ability to manage resources. ObjectiveTo examine how maternal behaviors, including shopping, accessing alternative sources of food, and managing resources, are related to household food security status (HHFSS). DesignCross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources, and managing resources obtained from low-income mothers of preschool-aged children. ParticipantsOne hundred sixty-four low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. MeasuresHHFSS was measured using 10 items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when, and how often they shopped; the strategies they use when shopping; their use of alternative sources of food, including federal, state, and local assistance; and their ability to manage their resources. Statistical analysisAnalysis of variance and χ2 analyses assessed the associations between demographic variables, shopping, accessing alternative food sources, and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping, strategies, alternative sources of food, and ability to manage resources. ResultsMaternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (adjusted odds ratio [aOR] 1.10, 95% CI 1.03 to 1.17) and 2.5 times more likely among Spanish-speaking households (compared with non–Spanish speaking [aOR 3.57, 95% CI 1.25 to 10.18]). Food insecurity was more likely among mothers reporting more informal strategies (aOR 1.98, 95% CI 1.28 to 3.01; P<0.05) and perceiving greater inability to manage resources (aOR 1.60, 95% CI 1.30 to 1.98; P<0.05). ConclusionsThe results suggest that low-income mothers use a variety of strategies to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the influence on healthy food choices.

Outcomes of a Randomized Trial of a Cognitive Behavioral Enhancement to Address Maternal Distress in Home Visited Mothers

Objectives To assess the effectiveness of a 6-week, cognitive behavioral therapy (CBT) group-based enhancement to home visiting to address stress and prevent depression as compared with home visiting as usual in low income mothers of young children. Methods We conducted a randomized controlled trial with 95 low-income mothers of young children to assess the effectiveness of a 6-week, cognitive behavioral group-based enhancement to Healthy Families America and Parents as Teachers home visiting (HV/CBT = 49) to address stress and prevent depression as compared with home visiting as usual (HV = 46). Booster sessions for the HV/CBT group were offered at 3 and 6 months. Participants completed measures of coping, stress and depression at three points: baseline prior to randomization, post-intervention, and 6 months post-intervention. Parent child interaction was also measured at 6 months. Results Intent-to-treat analyses found improved coping and reduced stress and depression post-intervention. While impacts on these outcomes were attenuated at 6 months, positive impacts were observed for selected aspects of mothers’ interactions with their children. Maternal characteristics at baseline were associated with participation in the intervention and with post-intervention and 6-month outcomes. Mothers with lower levels of stress and those with fewer children were more likely to attend intervention sessions. Mothers with lower levels of stress had more favorable post intervention outcomes. Conclusions CBT group-based enhancement to home visiting improved maternal coping, reduced stress and depression immediately post intervention but not at 6 months, suggesting more work is needed to sustain positive gains in low-income mothers of young children.

Maternal representations of their children in relation to feeding beliefs and practices among low-income mothers of young children

Identifying maternal characteristics in relation to child feeding is important for addressing the current childhood obesity epidemic. The present study examines whether maternal representations of their children are associated with feeding beliefs and practices. Maternal representations refer to mothers' affective and cognitive perspectives regarding their children and their subjective experiences of their relationships with their children. This key maternal characteristic has not been examined in association with maternal feeding. Thus the purpose of the current study was to examine whether maternal representations of their children, reflected by Working Model of the Child Interview typologies (Balanced, Disengaged, or Distorted), were associated with maternal feeding beliefs (Authority, Confidence, and Investment) and practices (Pressure to Eat, Restriction, and Monitoring) among low-income mothers of young children, with maternal education examined as a covariate. Results showed that Balanced mothers were most likely to demonstrate high authority, Distorted mothers were least likely to demonstrate confidence, and Disengaged mothers were least likely to demonstrate investment in child feeding. Moreover, Balanced mothers were least likely to pressure their children to eat. Findings are discussed with regard to implications for the study of childhood obesity and for applied preventions.

Food- and Health-Related Correlates of Self-Reported Body Mass Index Among Low-Income Mothers of Young Children

ObjectiveTo examine how income-related challenges regarding food and health are associated with variation in self-reported maternal body weight among low-income mothers. DesignCross-sectional design. SettingTwo Northeastern cities. Seven day care centers and a Supplemental Nutrition Assistance Program outreach project. ParticipantsSample of 166 mothers; 67% were overweight or obese, 55% were Hispanic, and 42% reported household food insecurity (HFI). Main Outcome MeasuresMaternal self-reported height and weight to calculate body mass index (BMI). Independent variables were food program participation, supermarket use, 8-item food shopping practices scale, HFI, maternal depressive symptoms, and self-rated health. AnalysisHierarchical multiple regression analysis tested relationships between maternal BMI with the independent variables of interest, adjusting for demographic confounds. ResultsShopping practices to stretch food dollars (P = .04), using community food assistance programs (P < .05), and HFI (P < .04) correlated with heavier maternal BMIs; higher self-rated health corresponded to lower BMIs (P = .004). Conclusions and ImplicationsSome strategies low-income mothers use to manage food resources are associated with heavier BMIs. Nutrition educators, public health practitioners, and researchers need to collaboratively address the associations between these strategies, food insecurity, poor health, and unhealthy weight.

Pathways Linking Victimization, Depression, Personal Mastery, and Perceptions of Parenting Competence Among Low-Income Women

Millions of women experience childhood sexual abuse (CSA) and physical intimate partner violence (PIPV). Yet, little is known about the pathways through which these victimization experiences may impact women’s sense of their parenting competence. We conducted a secondary analysis of a dataset obtained through the National Data Archive on Child Abuse and Neglect. The purpose of our study was to examine associations between CSA, PIPV, depressive symptoms, personal mastery, and perceptions of parenting competence among low-income mothers of young children (N = 264). Our hypotheses were: (a) CSA would be positively associated with PIPV, (b) PIPV would be positively associated with depressive symptoms and negatively associated with mastery and parenting competence, and (c) the association between PIPV and women’s sense of parenting competence would be mediated by depressive symptoms and mastery. The results supported our first and third hypotheses and partially supported our second hypothesis. Our study findings suggest that interventions that reduce mothers’ depressive symptoms may also improve their perceptions of personal mastery and parenting competence.

Barriers to physical activity experienced by low‐income mothers of young children: a pilot study (1021.1)

Barriers to Physical Activity Experienced by Low‐Income Mothers of Young Children: A Pilot Study Het Desai, Debra Palmer‐Keenan: Rutgers, the State University of New Jersey, New Brunswick, NJ.It has been reported that mothers of young children engage in less physical activity than those without dependent children. This issue is likely exaggerated in low‐income communities, due to the increased impact of physical activity barriers. This pilot study sought to examine barriers that mothers, aged 18‐44 with children aged 15 or less, report as well as to identify specific activity barriers, they report affect them to a greater degree than they affect their counterparts without dependent children. The mothers (N=59) were predominantly Black (61%), Hispanic (12%) or White (25%) and approximately 70% had no post‐secondary education. More than 50% of the mothers reported that six out of seven child‐related barriers mothers have previously reported kept them from exercising sometimes, nearly always, or always. These barriers and the percent of mothers who reported their effect to this degree were: needing to pay attention to their child(ren) (75.0%); not having anyone to watch their child(ren) (51.2%); not trusting others to watch their child(ren) (71.2%); interruptions like the phone ringing or the baby crying (63.5%); their child(ren) hanging on them (57.7%); and believing that they get enough exercise caring for their child(ren) (57.7%). In comparison with a demographically similar cohort of women without dependent children, i.e., under high‐school age, four other barriers impacted mothers significantly more. These were: not liking to do it (F=4.45; p&lt;0.05); not motivated to do it (F=11.4; p&lt;0.01); not having time (F=9.33; p&lt;0.01); and (more specifically) chores leaving too little time (F=6.98; p&lt;0.01). Clearly low‐income mothers are a particularly challenged group of individuals who would benefit from targeted assistance and education to achieve adequate levels of activity.

Differences in Feeding Practices and Perceptions of Childhood Obesity Messages among Low-Income Mothers of Young Children

Differences in Feeding Practices and Perceptions of Childhood Obesity Messages among Low-Income Mothers of Young Children

Maternal depression and parental distress among families in the Early Head Start Research and Evaluation Project: Risk factors within the family setting.

This study examined the influence of risk factors within the family environment (inadequate resources, insufficient caregiving support from child's father, higher family conflict) on maternal well being (depression and parental distress) using a longitudinal panel research design. Participants consisted of 2,040 low-income mothers of young children enrolled in the Early Head Start (EHS) Research and Evaluation Project. Findings indicated that greater family resources at 14 months had a protective effect on maternal well-being at 36 months, controlling for demographic variables and maternal well-being at 14 months. Furthermore, the effect of family resources on maternal well-being was moderated by father caregiving support, such that family resources were protective, particularly when father caregiving support was lower. Family conflict at 14 months was associated with lower maternal well-being at 36 months, controlling for demographic variables and maternal well-being at 14 months. Our findings suggest that low-income mothers need the support and resources of programs such as EHS to overcome the hurdles and challenges of parenting in high-risk settings. Implications for clinical practice and EHS are discussed.

Racial and ethnic differences in a regular source of dental care and the oral health, behaviors, beliefs and services of low-income mothers.

In a racial/ethnically-diverse sample of low-income mothers of children aged 3-6, we determine: (1) whether a regular source of dental care (RSDC), self-rated oral health, beliefs and behaviors differ by racial/ethnic group; (2) estimate whether a RSDC is associated with oral health, beliefs and behaviors, and whether these associations differ by racial/ethnic group; and (3) examine these relationships for mothers' dental utilization. Cross-sectional survey. Participants From a population of 108,151 Medicaid children aged 3-6 in Washington state, U.S., 10,909 eligible children were sampled stratified by racial/ethnic group. Eligible mothers completed a mixed-mode survey in the following groups: Black (n=818), Hispanic (n=1310), or White (n=1382). Measures were mothers' RSDC, personal characteristics, self-rated dental health, appearance of teeth, dental problems, brushing duration, flossing frequency, use of toothpicks or whiteners, belief that cleaning prevents cavities or loose teeth, and self-reported services at last dental visit. About 38-40% of mothers had a RSDC. For Black, Hispanic and White mothers, having a RSDC was associated consistently with better oral health, greater likelihood of a dental cleaning and less likelihood of tooth extraction. RSDC was not associated generally with oral health beliefs and behaviors. Oral health behaviors differ by racial/ethnic group. Relationships between RSDC and self-reported oral health, health behaviors, beliefs and dental services are similar for Black, Hispanic and White low-income mothers of young children. Oral health behaviors differ across racial/ethnic groups, which may have implications for mother and child oral health.

A nutrition and physical activity intervention promotes weight loss and enhances diet attitudes in low-income mothers of young children

The purpose of this study was to evaluate a nutrition and physical activity program for reducing body weight and improving nutrition attitudes in mothers of young children. A convenience sample of 114 intervention mothers and 33 comparison mothers was recruited from public health clinics and community centers. Eligibility criteria included Hispanic, African American, or white ethnicity; body mass index of at least 25 kg/m(2); low income (< 200% of the federal poverty index); and youngest child aged 1 to 4 years. For intervention participants, height, weight, percentage of body fat, waist circumference, demographics, nutrition attitudes, and dietary intake were measured at weeks 0 and 8; height, weight, percentage of body fat, and waist circumference were reassessed at 6 months. Overweight mothers in the comparison group provided anthropometric and demographic data at weeks 0 and 8. Changes in anthropometrics, attitudes, and dietary intake were evaluated in intervention mothers. Anthropometric data of intervention vs comparison group mothers were examined. Differences in anthropometrics and attitude scores between weight loss responders (> or = 2.27 kg) and nonresponders (< 2.27 kg) were assessed at week 8. Intervention participants lost weight (x = -2.7 kg; P < .001), whereas comparison mothers gained a slight amount of weight (x = 0.1 kg) by week 8. Weight loss responders had healthier eating attitudes (5.6 vs 5.2; P < .01) and fewer perceived barriers (2.4 vs 2.9; P < .05) than nonresponders postintervention. In conclusion, this dietary and physical activity curriculum is a valuable resource for weight management programs serving low-income women.

Predictors of Weight Loss in Low-Income Mothers of Young Children

Objective To identify predictors of weight loss in a tri-ethnic population of low-income mothers. Design An 8-week dietary and physical activity program was tested. Demographic data were collected at baseline; anthropometric, dietary, physical activity, and psychosocial data were measured at baseline and week 8. Subjects/setting A convenience sample of 114 Hispanic, African-American, and white, low-income mothers with a body mass index ≥25 (calculated as kg/m 2) participated in the intervention. Intervention Weight-loss classes that incorporated nutrition, physical activity, and behavior modification were administered for 8 weeks. Main outcome measures Anthropometry (body weight, weight loss). Statistical analyses performed Analysis of variance, χ 2 tests, and Spearman and Pearson correlations were used to test for associations between baseline and change data and total weight loss. Hierarchical regression was employed to assess the marginal importance of factors beyond socioeconomic influences. Results Correlates of weight loss included less satisfaction with appearance ( r=0.24), greater percentage of energy from protein ( r=−0.22), enhanced nutrition knowledge ( r=−0.23), and higher scores for benefits of weight loss ( r =−0.20) at baseline; and the change in healthful eating attitudes ( r=−0.28) and social support ( r=−0.21) at 8 weeks. The predictive models of baseline and change variables represented 11.4% and 13.8% of the variance, respectively. Conclusions Weight-management programs serving low-income mothers should provide techniques to enhance social support, attitudes toward healthful eating, benefits of weight loss, and nutrition knowledge.

The Work-Faith Connection for Low-Income Mothers: A Research Note

This paper examines the role of religious faith or spirituality in the work lives of low-income mothers of young children, based on forty-four in-depth interviews. Previous research on higher income workers shows that the primary role of religious faith or spirituality with regard to work is to imbue work with a greater sense of purpose and meaning. My study suggests that for very low-income mothers, the primary role is not to contribute meaning but rather to aid in surviving the low-wage service sector workplace. The paper discusses implications for faith-based social services and for future research.