Low Parental Self-efficacy Research Articles

The interplay between emotional and breastfeeding difficulties in first-time mothers

ABSTRACT Aim/Background Both mental maternal health and breastfeeding difficulties impact maternal and infant health. The present study analyses the association between psychosocial and breastfeeding variables and maternal mental health. Design/Methods The participants were 107 first-time mothers from Chile. Sociodemographic variables and breastfeeding difficulties were assessed at 6 weeks postpartum. Depression and anxiety symptoms, parental self-efficacy, and perceived social support were measured using validated, self-report questionnaires at 6 weeks and 5 months postpartum. This study is a secondary analysis of an intervention trial. Results 76% of the women reported having experienced some breastfeeding difficulty in the first postpartum weeks. The number of breastfeeding difficulties was associated with maternal mental health symptoms at 6 weeks postpartum and parental self-efficacy at both assessment times. Women who did not experience breastfeeding difficulties presented significantly fewer depressive (t(102) = 2.5, p = .015) and anxiety symptoms (t(50) = 2.3, p = .028) at 6 weeks postpartum than those who did. Mothers who exclusively breastfed at 5 months postpartum presented significantly higher parental self-efficacy (t(94) = 2.4, p = .044). A higher number of breastfeeding difficulties and low perceived social support contributed to higher depressive symptoms (R2 = .30; F(3,103) = 14.6, p < .001), anxiety symptoms (R2 = .32, F(3.103) = 17.27, p < .001) and lower parental self-efficacy at 6 weeks postpartum (R2 = .39; F(2,103) = 9.4, p < .001). Conclusion Breastfeeding difficulties and social support are associated with fewer mental health symptoms and higher parental self-efficacy during early postpartum in first-time mothers.

Geographic, Sociodemographic, and Clinical Factors Associated With Parental Self-Efficacy in Pediatric Patients With Hearing Loss.

To identify geographic, sociodemographic, and clinical factors associated with parental self-efficacy in a diverse cohort of deaf or hard-of-hearing (DHH) children. Cross-sectional study. Tertiary children's hospital. Four hundred forty parents of DHH children aged 0 to 17 completed the 25-item Scale of Parental Involvement and Self-Efficacy (SPISE) survey from 2014 to 2022. Residential addresses were geocoded and assigned Area Deprivation Index and Social Vulnerability Index rankings, and univariable and multivariable analyses were conducted using sociodemographic and clinical variables, including sex, race/ethnicity, insurance type, survey language, age at the survey, comorbidities, newborn hearing screening results, and hearing loss laterality and severity. Compared to English and Spanish-speaking parents, Chinese-speaking parents were associated with overall lower parental self-efficacy and involvement (regression coefficient = -0.518, [-0.929, -0.106]), Cohen's d = 0.606) and lower scores on items related to their ability to affect multiple aspects of their child's development and expression of thoughts as well as competency in checking and putting on their child's sensory device. Across univariable and multivariable analyses, besides Chinese language, all other sociodemographic, clinical, and geographic variables were not associated with SPISE score. To achieve the best patient outcomes, care teams can use the SPISE to evaluate parental self-efficacy and provide targeted support to parents at risk for having lower knowledge and confidence scores about critical skills necessary to facilitate their child's auditory access and language development. Notably, this study found similar reports of parental efficacy across various sociodemographic, clinical, and geographic variables but significantly lower SPISE scores in Chinese-speaking families.

The urgent need for greater parent support and better health system experiences to enhance outcomes for pediatric anorexia nervosa: A Commentary on Marchetti & Sawrikar (2023).

Marchetti and Sawrikar's (2024) systematic review of parent illness representations of their child's anorexia nervosa provides a valuable synthesis of 32 qualitative studies. The key themes that emerge paint a concerning picture of parents' perceptions of AN as: difficult to identify and understand; of chronic duration; uncontrollable; severe; and associated with serious consequences. A sense of hopelessness and low-parental self-efficacy was identified. This Commentary explores the key findings of this review in four areas: AN treatment and recovery (control/cure); emotional representations of the illness; parent understanding of the illness (coherence) and its causes; and consequences of the AN. These illness perceptions are discussed along with relevant quantitative investigations of parent experiences, with a view to suggesting how the toll on parents might be reduced and how reducing burdens on parents might also lead to improved timely treatment outcomes. It is proposed that two broad features are needed: improved help-seeking experiences in the health care system; and, more parent-focussed support.

Who Responds to an Adaptive Intervention for Adolescents With Anorexia Nervosa Being Treated With Family-Based Treatment? Outcomes From a Randomized Clinical Trial

Anorexia nervosa (AN) is a serious psychiatric disorder with high morbidity and mortality. The current evidence supports the use of family-based treatment (FBT), but recovery rates are only about 40%. Improving treatment outcomes among adolescents with AN will save lives, improve health, and prevent chronicity. This study examined the relative efficacy of adding intensive parental coaching (IPC) to standard FBT for patients who do not respond by weight gain of 2.4 kg by session 4, a clinical predictor of outcome at the end of treatment, to improve remission rates (>94% of expected mean body mass index). The study recruited 107 participants and their families from across the United States; 69 participants failed to respond early and were randomly assigned to continue with standard FBT or to receive 3 sessions of IPC. Participants were adolescents (ages 12-18) meeting DSM-5 criteria for AN; 6.5% were male, and 11% were Hispanic. Main outcomes were mean body mass index >94% expected for age, height, and sex. Secondary outcomes included change in eating-related cognitions. Adding IPC to early nonresponders did not improve outcomes except for participants whose parents demonstrated low parental self-efficacy at baseline (moderator). Early weight gain of 2.4 kg by session 4 was replicated as a predictor of end of treatment remission. Parental self-efficacy moderates IPC as an adaptive treatment for adolescents with AN. Baseline parental self-efficacy assessment can be used to identify families most likely to benefit from adding IPC to FBT. Future studies should consider earlier interventions to improve early response rates. Anorexia nervosa is a serious psychiatric disorder. While family-based treatment (FBT) has the largest evidence base for adolescents with anorexia, recovery rates are only about 40%. This study investigated the addition of 3 sessions of intensive parental coaching intervention (IPC) to FBT among youth with anorexia who did not gain adequate weight early in treatment, a predictor of recovery by the end of treatment. Youth with inadequate weight gain were randomized to either receive FBT with IPC or FBT as usual. Overall, adding IPC did not improve outcomes among youth with anorexia. However among those whose parents demonstrated low parental self-efficacy at baseline, youth who received FBT with IPC had higher remission rates than youth who received FBT alone. Intensive parental coaching shows promise for improving outcomes among youth with anorexia whose parents report low parental self-efficacy. Adaptive Treatment for Adolescent Anorexia Nervosa; https://clinicaltrials.gov/; NCT03097874.

Influence of Maternal Cognitions on Child Mental Health and Educational Experiences at Home During COVID-19

ABSTRACT Suboptimal parenting characterized by low self-efficacy and perceived impact is associated with poor child mental health and academic outcomes, especially for at-risk families. This study capitalized on a longitudinal study conducted prior to and after the onset of the COVID-19 pandemic to test how prior parenting cognitions and environmental risk factors predict mental health and educational challenges faced by children during the pandemic. Pre-pandemic parenting and environmental risk data are available for a sample of 252 low-income mother-child dyads in Toronto, Canada. Research Findings: Mothers who had lower parental self-efficacy, but higher perceived parental impact prior to COVID-19 reported that their children faced educational challenges during the pandemic. In addition, mothers who reported lower levels of pre-pandemic parental self-efficacy reported that their children were more likely to have emotional and conduct problems greater than the sample average during COVID-19. Practice or Policy: Parents with specific profiles of parenting cognitions may need additional support to help their children cope during the pandemic.

Parental Self-Efficacy and Intra- and Extra-Familial Relationships

Relationships are at the heart of well-being. Parental self-efficacy emerges as a powerful construct for understanding parenting and parent–child relationships. However, person-centered approaches that allow identification of different family-specific configurations of mothers’ and fathers’ parental self-efficacy and potential within-family discrepancies remain scarce. Families are more than the sums of their parts, and holistic approaches are needed to deepen our understanding of potential family-level accumulation of relationship well-being and vulnerability. A latent profile analysis of 249 families of preadolescents identified four family profiles of parental self-efficacy: (1) low–low, (2) low–average, (3) high–average, and (4) high–high (a mother’s–a father’s parental self-efficacy within the family). We further applied the Mplus auxiliary function to explore what characterizes mothers’, fathers’, and their preadolescents’ intra- and extra-familial relationships within these profiles. Belonging to the balanced low parental self-efficacy family profile was associated with intra- and extra-familial relationship vulnerability: mothers, fathers, and preadolescents reported the highest social and emotional loneliness, parents perceived their family communication as less open, and preadolescents were evaluated as the least prosocial (in parent, teacher, and peer evaluations) and as the most antisocial (in parent evaluations). Mothers’, fathers’, and preadolescents’ intra- and extra-familial relationship well-being was the strongest in high parental self-efficacy family profiles. Promoting parental self-efficacy can be a promising way to enhance all family members’ relationship well-being. Moreover, as loneliness experiences accumulated in the balanced low parental self-efficacy family profile, efforts to tackle preadolescents’ loneliness should acknowledge the well-being of all family members.

Impact of Parenting Style on Early Childhood Learning: Mediating Role of Parental Self-Efficacy.

The current study examined the impact of parental style on early childhood learning, as well as the role of parental self-efficacy (PSE) as a mediating factor. In the domains of education and psychology, it is increasingly recognized that parents have a considerable impact on their children’s learning and development. Purposive sampling was used and data was gathered over 3 months from school children’s parents. Hypotheses were tested using smart partial least squares-structural equation modeling (PLS-SEM v3.2.8) software. The findings of the present study reveal that an authoritative parenting style is positively associated with learning outcomes among Chinese students. Moreover, the mediating role of parental self-efficacy has been tested and proved to be a potential mediator between parental style and children’s learning outcomes. High PSE is linked to parents’ adoption of a variety of optimum parenting practices throughout childhood, including maternal sensitivity and responsiveness to children’s needs, warm and affectionate parental behavior, and monitoring. Hence, low PSE has been linked to coercive or harsh parenting as well as a proclivity to give up easily when faced with parental difficulties. In China, further study is needed on the relationship between parenting style, parental self-efficacy, and learning outcome. Future parenting programs could also focus on raising parents’ understanding of the need for both parents’ involvement in expressive activities and mentoring. This could help them boost their parenting self-efficacy even more. Lastly, the implications for parents, children, and teachers are discussed.

Parental Self-Efficacy and Physiological Responses to Stress among Mothers of Early Adolescents

Little research addresses how parental self-efficacy is related to stress responses, and no research does so among parents of early adolescents. To fill this research gap, the current study examined the association between maternal self-efficacy and physiological stress responses during early adolescence. Participants were 68 mother-early adolescent dyads with youth in the 6th grade (M = 11 years; 56% female). Physiological responses (i.e., skin conductance, respiratory sinus arrythmia, cortisol) were measured before and after mothers observed their children engage in a modified Trier Social Stress Test for Children. Mothers reported on parental self-efficacy. Mothers with higher parental self-efficacy exhibited a more moderate skin conductance response to the speech portion of the task, and a smaller increase in cortisol, compared to mothers with lower parental self-efficacy. Respiratory sinus arrhythmia change was not related to parental self-efficacy. The findings are consistent with a "caring but confident" physiological profile among mothers with high parental self-efficacy, suggesting that greater confidence about parental influence might reduce parents' experience of stress/anxiety as they observe children face certain challenges.

Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children.

Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.

Latina mothers' mental health: An examination of its relation to parenting and material resources.

The demands and stressors associated with motherhood can increase a mother's risk for mental health concerns. Latina mothers are particularly vulnerable to the relation between motherhood-related stressors and maternal mental health given that they are at an increased risk for mental health concerns, that they are likely to have their mental health needs go unmet, and that traditional Latinx cultural values/gender roles emphasize women assuming the role of primary caregiver of the family's children. In an attempt to better understand how motherhood impacts Latina mother's mental health, this study explored the relations among parental self-efficacy, parenting stress, and maternal mental health. This study also explored how a mother's perception of her material resources influenced these relations. One hundred and thirty-two Latina mothers completed questionnaires to assess parenting stress, parental self-efficacy, and maternal mental health risk. The moderating effect of maternal perception of material resources in the aforementioned relations was assessed through the creation of a composite variable derived from items in the demographic questionnaires. Multiple linear regression analyses were used. Higher levels of parenting stress, but not parental self-efficacy, were related to increased maternal mental health risk. Furthermore, mothers who perceived themselves to have lower material resources were at increased risk for diminished mental health in the context of low parental self-efficacy. Results of this study yielded important information that is necessary for informing healthcare best practices, identifying targets for future interventions, and ultimately improving the health outcomes of Latinx mothers and their families.

Death Anxiety and Loneliness among Older Adults: Role of Parental Self-Efficacy.

Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an unexplored variable among older adults, namely, parental self-efficacy. A convenience sample of 362 Israeli parents over the age of 65 was recruited through means of social media. Participants completed self-reported questionnaires, which included background characteristics, death anxiety, parental self-efficacy, and loneliness measures. The findings showed that death anxiety was positively associated with loneliness among older adults. The findings also confirmed that parental self-efficacy moderated this association in this population. We concluded that the combination of death anxiety and low parental self-efficacy identified a group of older adults that are at higher risk of developing increased loneliness levels. Mental health professionals should consider intergenerational relationships as a fundamental component of older adults’ daily lives, focusing on parental self-efficacy in old age, as this appears to be a resilience resource.

Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model.

Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.

Parental Self-Efficacy Predicted by Parents’ Subjective Well-Being and Their Parenting Styles with Possible Role of Help-Seeking Orientation from Teachers

The current study aims to test the ideas that parental self-efficacy is associated with parenting style, parents’ help-seeking orientation from teachers, and subjective well-being. Based on the literature background presented, two hypotheses were examined: First, autonomy help-seeking orientation, the authoritative parenting style, and high subjective well-being would be positive predictors of parental self-efficacy. Second, dependent help-seeking orientation and non-authoritative parenting styles are negative predictors of parental self-efficacy. One hundred and thirty-two parents of school-age children answered questionnaires measuring the research and background variables. A multivariate regression analysis found that the independent variables explain about 53% of the variance of the parental self-efficacy scores, with subjective well-being and the authoritative parenting style being uniquely associated with high parental self-efficacy, and the permissive parenting style being uniquely associated with low parental self-efficacy. The present study focuses on parental self-efficacy as an important parental component, demonstrating the personal characteristics of parents that may affect their perceived efficacy, and offers an integrative portrait of factors that can describe parents’ attitudes and behavior toward their competence as parents. Implications for intervention are discussed.

Maternal lack of sleep in the first two years after childbirth: Perceived impacts and help-seeking behaviors.

Most evidence-based sleep interventions (e.g., graduated extinction of nighttime crying) are in opposition to many parents' values. This warrants taking a step back and asking the parents about their main concerns regarding their baby's sleep and the type of help they would be likely to use. This study aimed to describe and identify, among mothers of a 0- to 24-month-old child, the perceived impact of lack of sleep, sleep-related help-seeking behaviors as well as the most concerning aspects of the child's sleep, and preferred sleep intervention modalities. Another objective was to identify the factors associated with a negative impact of postpartum sleep, concerns for the child's sleep, and interest in sleep interventions. Canadian mothers (N=932) were recruited by email snowball sampling and through Facebook to complete an online questionnaire designed for the purposes of the study. Most mothers reported a negative impact of postpartum sleep on their romantic relationship (79.4%) and quality of life (76.7%). Low parental self-efficacy (PSE) about managing the child's sleep was the best predictor of a negative impact of lack of sleep and sleep-related concerns, above and beyond any other child's or mother's characteristics. The preferred intervention modalities were reliable websites and online courses on child sleep, with a greater interest in home visits among mothers who need help the most (low self-efficacy, high concerns). Interventions should aim at increasing PSE about the child's sleep in both parents and include home visits for those who need it the most.

Are child autism symptoms, developmental level and adaptive function associated with caregiver feelings of wellbeing and efficacy in the parenting role?

BackgroundMany parents of children with autism have low levels of mental wellbeing, which may be related to low self-efficacy in the parenting role. Few studies have investigated the impact that child characteristics such as autism symptoms, development and functioning have on parental wellbeing and self-efficacy. In this study, we investigated associations between parental mental wellbeing, self-efficacy and child measures of behaviour and function, for families participating in the Paediatric Autism Communication Trial-Generalised (PACT-G). MethodParents of children with autism (N = 248, aged 2–11 years) completed self-report measures of mental wellbeing and self-efficacy. We used a range of parent-report and researcher administered assessments of autism symptoms, child development, emotional and behavioural difficulties, language and adaptive skills. Nonparametric tests (Spearman’s correlations) and multiple linear regression analyses were used to examine the associations between child characteristics and parent wellbeing and parental self-efficacy. ResultsParent mental wellbeing and self-efficacy were highly related. Results of bivariate analyses showed significant negative associations between parent-reported child autism symptoms and parental self-efficacy. Higher child adaptive behaviour was also associated with better parental-self-efficacy. However, in a multivariate regression model, only high parent reported autism symptoms were associated with lower parental self-efficacy. Parent wellbeing was not related to any feature of the child’s profile. ConclusionThese findings indicate that parent-reported autism symptoms are associated with parental self-efficacy, and that self-efficacy may be an important secondary outcome of interventions for children with autism.

A qualitative study examining transgender people\u2019s attitudes towards having a child to whom they are genetically related and pursuing fertility treatments in Greece

BackgroundAdvances in biomedical technologies permit transgender individuals not only to achieve gender transition but also to experience parenthood. Little is known about this topic in Greece, which, although a traditionally conservative country, is changing at the legal level towards a greater recognition of transgender people’s rights. This study aimed to investigate transgender people’s attitudes towards having a child to whom they are genetically related and pursuing fertility treatments in Greece.MethodsThis is a prospective qualitative study conducted with adult individuals who identified as transgender men or transgender women between April 2019 and March 2020. Individual in-depth qualitative interviews were conducted with 12 participants. The interviews were carried out in person and were digitally recorded and transcribed verbatim. We performed a thematic analysis of the data.ResultsThe thematic data analysis resulted in the identification of themes that represent key barriers to pursuing fertility preservation or the use of assisted reproductive technology. Six major themes were clearly present in the findings (lack of adequate information and counseling, worsening gender dysphoria, increased discrimination against transgender people due to the rise of extreme far-right populism, low parental self-efficacy, high costs, and a less-than-perfect legal framework). Moreover, diverse cases were examined, and minor themes, such as the symbolic value of the uterus and pregnancy, the relationship between the type of gender transition and willingness to pursue fertility treatments, and transgender people’s adherence to heteronormative patterns in the context of reproduction, were identified. Various reasons for transgender people’s differing degrees of desire for parenthood were identified.ConclusionOur findings demonstrated contextual factors as well as factors related to transgender people themselves as barriers to pursuing transgender parenthood. Most aspects of our findings are consistent with those of previous research. However, some aspects of our findings (regarding aggressive behaviors and economic instability) are specific to the context of Greece, which is characterized by the rise of extreme far-right populism due to the decade-long Greek economic crisis and a deeply conservative traditionalist background. In that regard, the participants highlighted the (perceived as) less-than-perfect Greek legislation on transgender people’s rights as a barrier to transgender (biological) parenthood.

The effects of morbidity-mortality and economic unpredictability on parental distress: A life history approach

Negative affect caused by stressful life events can carry over to parental relationships and induce parental distress. Such spillover effects, however, may not operate uniformly in men and women, and may not be the same for different types of stressful life events. Employing life history theory, we hypothesized that male parents should experience more parental distress following exposure to cues of extrinsic morbidity-mortality (illness or death of someone close) or economic unpredictability (financial or occupational changes). We tested this hypothesis in two studies. In Study 1 ( N = 207), recent exposures to morbidity-mortality and economic unpredictability were uniquely associated with parental stress, but the effect of economic unpredictability existed only in men. Stronger unpredictability beliefs partially mediated these effects. Moreover, morbidity-mortality and economic unpredictability were indirectly associated with less positive parenting through greater parental stress. Study 2 used a dyadic sample of 105 families transitioning to parenthood. Recent exposures to morbidity-mortality and economic unpredictability were uniquely associated with parental distress (parental stress and postpartum depression) in men only, whereas exposure to other sources of stress was more strongly associated with women’s parental distress. The effects of morbidity-mortality on men’s parental distress were mediated by their lower parental self-efficacy. These findings imply that men’s parental experiences are particularly vulnerable to risky and unpredictable environments.

The interactive effects of parental self-efficacy and child eating styles in relation to naturalistically-assessed craving, overeating, and loss of control eating.

Parental factors have been linked to weight-related outcomes in children, though less is known regarding the role of parental self-efficacy (PSE) for promoting healthy dietary behaviors (HDBs). This study examined associations between PSE for promoting HDBs and child reports of craving, overeating, and loss of control eating in daily life. The interactive effects of PSE and child eating style (emotional eating, external eating, and restraint) were also explored. Thirty-eight youth (ages 8-14; 55.3% female) with overweight/obesity and their parents completed the Dutch Eating Behavior Questionnaire for Children (DEBQ-C) and Parental Self-Efficacy for Healthy Dietary and Physical Activity Behaviors Scale, respectively. Youth completed ecological momentary assessment (EMA) to report craving, overeating, and loss of control eating. Generalized estimating equations indicated no consistent main effects of PSE on EMA outcomes, but PSE interacted with DEBQ-C child eating styles to predict each EMA outcome. Among children of parents with lower PSE, (a) higher emotional eating was associated with greater overeating and loss of control eating; (b) higher external eating was associated with greater craving; and (c) higher restraint was associated with greater loss of control eating and craving. Conversely, these associations were attenuated among children of parents with higher PSE. Together findings suggest the interplay of child characteristics and PSE regarding children's eating behaviors warrants future investigation in the context of eating and weight disorders. In particular, further research is needed to examine the directionality of effects and mechanisms underlying these associations.

Study protocol: randomized controlled trial of manualized components in home visitation to reduce mothers\u2019 risk for child maltreatment

BackgroundThis study tests whether home visitation to prevent child maltreatment can be improved by adding manualized program components, targeting four key risk factors for child maltreatment: low parental self-efficacy, high levels of perceived stress, parental anger, and post-traumatic stress symptoms. Home visitation is widely implemented, but effects on child maltreatment risk tend to be modest at best. Home visitation tends to be rather flexible (i.e., professionals decide how to support each family). We will test whether adding manualized program components increases program effectiveness, by ensuring that key risk factors are addressed, while maintaining flexibility. In addition, we will test whether any component effects on reduced child maltreatment risk can be explained (i.e., is mediated) by ameliorated risk factors. Lastly, we will test whether the components are more effective for some mothers (e.g., those at highest child maltreatment risk) than for others.MethodsWe will conduct a randomized controlled trial among 398 mothers enrolled in a Dutch home visiting program targeting families at risk for child maltreatment. Mothers in the experimental group will receive the manualized components in two consecutive home visits, while mothers in the control group will receive regular home visits (care as usual). Mothers will fill out questionnaires at four time points: before and after each of the two home visits. Outcome variables include the four targeted risk factors parental self-efficacy, perceived stress, parental anger, and (recognition of) post-traumatic stress symptoms, as well as parenting practices (e.g., rejection and affection), and risk for child maltreatment.DiscussionThis study aims to determine whether adding manualized program components to a flexible home visiting program increases program effectiveness on risk for child maltreatment. In addition, our test of whether the effects of the components on risk for child maltreatment is explained (i.e., mediated) by amelioration of the targeted risk factors, may contribute to our understanding of the role of these risk factors in child maltreatment. Our tests of which mothers benefit most from adding the components may help move the field towards evidence-based personalized family support.Trial registrationThis trial has been retrospectively registered in the Netherlands Trial Register (NL8005).

Mothers' well-being, parenting attitudes, and home environment: Cumulative risk and parity in early motherhood.

This study explores mothers' wellbeing, experiences, and attitudes and the impact of cumulative demographic and antenatal risks and parity on parenting outcomes. A secondary aim was to assess mother and infant service utilisation. This study involved an assessment of the baseline characteristics of a sample of mothers (N=190; Mean age=31.6years, SD=5.4) with young infants (average age=10.13weeks, SD=0.8) living in disadvantaged communities in Ireland. Mothers with more risk factors (e.g., lone and/or teenage parenthood, socioeconomic disadvantage, and low social support) reported significantly higher levels of depression and lower parental self-efficacy. Observations of the home environment indicated that at-risk parents engaged in less cognitive stimulation and lower levels of emotional support for their child. The impact of these risk factors differed for primiparous and multiparous mothers. At-risk mothers are more susceptible to mental health difficulties and poorer parenting outcomes during the transition to parenthood. This study also provides important comparative insights into experiences of primiparous and multiparous parents. These findings have important implications for practitioners and policy makers, particularly the provision of universal and proportionate supports to prevent and/or interrupt poor parent-child relationships and negative developmental outcomes.