Parent Outcomes Research Articles

Research Review: Mechanisms of change and between-family differences in parenting interventions for children with ADHD - an individual participant data meta-analysis.

Understanding the mechanisms of change and between-family differences in behavioural parenting interventions for children with attention-deficit/hyperactivity disorder (ADHD) may help personalise interventions. Therefore, we examined whether improvements in parenting are associated with changes in child behaviour and functional outcomes, and how these associations vary based on parents' baseline parenting levels. We collected individual participant data including 19 randomised controlled trials focusing on children with ADHD (n = 1,720). Immediate post-intervention measures of child ADHD and oppositional behaviour severity, reported by parents and functional impairment reported by either the parent or probably masked clinicians, were treated as outcomes. We estimated pathways from intervention (vs. control) to child outcomes, via immediate post-intervention parent reports of constructive parenting (e.g. praise), non-constructive parenting (e.g. physical punishment) and parent-child affection (e.g. warmth), while controlling for baseline values of both child outcomes and parenting levels. Baseline values of each parenting variable were used as moderators of the mediated pathways. Improvements in parenting behaviours and parent-child affection immediately following the intervention jointly explained concurrent improvements in children's ADHD severity, oppositional behaviour and functional impairment. Furthermore, when reversing the direction of the pathways, improvements in all child outcomes jointly explained improvements in each aspect of parenting. Improvements in non-constructive parenting and parent-child affection uniquely accounted for intervention effects on functional impairment, especially for families with higher baseline levels of non-constructive parenting. Our findings might indicate that improvements in both the behavioural and affective aspects of parenting are associated with concurrent reductions in child behaviour problems and functional impairment. However, more research is necessary to explore the potential causal directionality between parenting and child outcomes. Nonetheless, supporting families with poorer parenting skills may be especially important, as reductions in non-constructive parenting in these families are linked to stronger treatment effects on child functional impairment.

Family-Level Impact of Germline Genetic Testing in Childhood Cancer: A Multi Family Member Interview Analysis

Objectives: Germline genetic testing is increasingly being integrated into pediatric oncology and a large number of families are interested. Current research on the psychological impact of germline genetic testing is limited by a main focus on individual outcomes in parents or children and little is known about its impact at the family level. Our study addresses that limitation by exploring parents’ lived experiences of how their family—as a whole—is affected by germline genetic testing for cancer predisposition. Methods: In six families who opted for germline genetic testing in the context of cancer predisposition, both parents of six ill children (five boys) with an average age of 9.67 years (SD = 3.77 years) were interviewed individually (N = 12). Germline genetic testing was performed by exome sequencing followed by analysis of a panel of childhood cancer predisposition genes in pediatric cancer patients and their parents. Their experiences were elicited through semi-structured interviews and the data were analyzed using Multi Family Member Interview Analysis. This qualitative study was conducted at Ghent University Hospital in Belgium. Results: The findings demonstrated that while germline genetic testing was generally viewed as a valuable and straightforward step in the child’s oncology trajectory, parents found it difficult to distinguish its impact from the overwhelming stressors of their child’s cancer diagnosis and treatment. However, parents recognized that the testing also significantly affected various family-level processes. Five main themes were identified: talking about germline genetic testing, being together matters (more), differences in coping with germline genetic testing between partners, feelings of guilt and mutual forgiveness, and concerns about the future health of the family. Conclusions: Given the expanded use of germline genetic testing in pediatric oncology, it is critical for clinicians to address the family-level impacts of germline genetic testing. Although families are affected by these issues, they often do not raise them due to the overwhelming challenges posed by the cancer diagnosis and treatment. Proactively addressing these themes could improve the support provided to families undergoing germline genetic testing for cancer predisposition.

Abstract TMP94: Mental Health Outcomes In Parents with Children with Pediatric Arterial Ischemic Stroke

Introduction: Previous single-center studies have found a higher prevalence of mental health disorders in parents of children with pediatric stroke compared to general population prevalences of 5% with depression and 6% with anxiety. Social determinants of health may influence mental health outcomes. We aimed to measure associations between social determinants of health and parental report of mental health symptoms following their child’s diagnosis of ischemic stroke. Methods: We performed a multicenter, international prospective study through the International Pediatric Stroke Study (IPSS). From 2016 to 2021, parents of children within 3.5 years after arterial ischemic stroke enrolled and completed validated and standardized surveys on anxiety (Beck’s Anxiety Inventory II), depression (Beck’s Depression Inventory), post-traumatic stress disorder (PTSD) (Post-Traumatic Stress Disorder Checklist for DSM-5), severity of their child’s stroke deficits (Recovery and Recurrence Questionnaire), and social determinants of health. For our statistical analysis we employed a linear mixed-effects model, both unadjusted and adjusted. Results: Fifty-two parents (13 fathers, 39 mothers) of 39 children enrolled. Of the 39 children 21 (54%) had perinatal stroke and 18 (46%) had childhood stroke. Median time from stroke diagnosis to parental survey completion was 1.3 years (interquartile range [IQR] 1.0-2.0). On parental surveys, parents scored in the clinical range for: depression in 35% of mothers and 23% of fathers; anxiety in 2% of mothers and 0% of fathers; PTSD in 26% of mothers and 8% of fathers. Lower parental education was significantly associated with higher levels of depression both in our unadjusted (0.02) and adjusted (0.03) models. Interestingly, the child’s functional outcome and parental income were not significantly associated with any parental mental health outcomes. Conclusion: Among social determinants of health, parental education level may be associated with depression in parents of children with pediatric arterial ischemic stroke and needs further exploration. Parents of children with pediatric arterial ischemic stroke had higher rates of depression and PTSD compared to general population estimates. Further research in this area will help facilitate understanding and development of interventions to prevent these mental health outcomes.

Examining the association between child development and parental mental health after preterm birth-related stress: a systematic review of the literature and meta-analysis protocol.

Preterm infants born before 32 weeks of gestation are generally admitted to a neonatal intensive care unit (NICU) to receive life-saving treatment, resulting in early exposure to stressful events. Yet, NICU admission is not only stressful for the infant but can also have a long-lasting negative impact on parental mental health, who may worry about their child. Parental mental health problems might affect child development through parental behaviour and the parent-infant relationship. Simultaneously, adverse child development after preterm birth can (further) elevate parental stress and mental health problems, straining parental behaviour, the parent-infant relationship and child development. This systematic review and meta-analysis aims to examine the association between preterm-born children's development (<32 weeks' gestation) and parental mental health after preterm birth-related stress following NICU admission at any point in time. A systematic review will be performed and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A concept-based search on preterm birth, child development and parental mental health is performed using MEDLINE, Embase, PsycINFO and Cochrane Library on 22 March 2024. Eligible are studies with original results on the association between child development after preterm birth (<32 weeks' gestation) and parental mental health. Independent reviewers will screen the articles, assess study quality using a Newcastle-Ottawa or Cochrane tool and determine the quality of evidence using Grading of Recommendations, Assessment, Development and Evaluation. Meta-analyses are planned on the association between child development and parental mental health after preterm birth. No ethical approval is required. The results will enhance knowledge of the association between child development and parental mental health after preterm birth-related stress following NICU admission. This might lead to adjustments in follow-up care, optimising outcomes for infants and parents. Findings will be published in an international, peer-reviewed ad open-access journal. CRD42024518307.

Parental Stress and Mental Health Outcomes Following the October 7th Events: Insights from Israeli Families of Children with Special Needs

The October 7th events precipitated an unprecedented psychological crisis for Israeli families, particularly affecting parents of children with special needs. This empirical study aimed to investigate the psychological factors contributing to parental stress and mental health outcomes in a community sample of 2097 parents, comparing those with children with special needs (n = 540) to those with typically developing children (n = 1557). Findings revealed that parents of children with special needs exhibited significantly higher levels of attachment anxiety and avoidance, parental stress, and intolerance of uncertainty, while reporting lower levels of parental competence, perceived social support, and mental health. Notably, meaning in life did not significantly differ between the groups. Correlational analyses indicated that attachment anxiety and avoidance were negatively correlated with parental competence, social support, meaning in life, and mental health while positively correlating with parental stress and intolerance of uncertainty. Mediation analyses showed that attachment anxiety and avoidance significantly predicted increased parental stress and reduced mental health, with these effects mediated by lower parental competence and diminished meaning in life. Moreover, intolerance of uncertainty mediated the effect of attachment anxiety on mental health. However, the mediating role of perceived social support on parental stress was absent among parents of children with special needs. These findings underscore the need for targeted interventions that bolster parental resilience, particularly for families of children with special needs during times of crisis.

Asian American Parenting and Youth Mental Health Outcomes: A Literature Review

ABSTRACTContrary to the “model minority” stereotype of being exceptionally healthy and successful, Asian American (AA) youth experience mental health disparities and are less likely to seek help. In 2020, suicide was the leading cause of death for AA youth aged 10–19. Parenting is essential for promoting youth mental health, and AA parenting is unique in the context of acculturation and enculturation. However, the impact of parenting on youth mental health among AA families remains underexplored and unsynthesized. This review aims to synthesize existing literature from 2003 onward on parenting and mental health outcomes among AA youth. Four databases were searched, yielding 44 articles published after 2003 for inclusion. Empirical studies meeting the following criteria were included: population focused on AA youth, study conducted in the U.S., included a mental health outcome, and included a parenting measure. Findings emphasize the importance of parenting in shaping the mental health outcomes of AA youth. Intergenerational acculturation gaps and family conflicts are associated with increased mental health risks, while parental warmth/support and family cohesion serve as protective factors. These findings highlight the need for culturally tailored parenting interventions to improve AA youth mental health. Future research should evaluate or adapt existing evidence‐based parenting programs to ensure cultural appropriateness and effectiveness in improving mental health of AA youth, ultimately reducing mental health disparities.

Evaluating the Effect on Infants and Parents Attending the Parent-Child Psychological Support Programme®, a Community-Based Program to Promote Attachment Security.

The foremost index of caregiving quality is child attachment, as supported by attachment theory. Research supports the relevance of early parenting interventions in improving child outcomes in attachment quality to promote public health because of their long-term effects on mental health and functioning. This study aimed at evaluating the impact on both parenting and child outcomes of the Parent-Child Psychological Support Programme® (PCPS), a community-based program individually tailored to parents and their infants during periodic center-based visits to promote attachment security. The evaluation involved two cohorts from "vulnerable populations" and used the resources embedded in the program design without interfering with the normal functioning of the service. From an evaluative research approach, the effects on mothers and children were assessed using a quantitative approach. Pre- and post-test measures (parenting questionnaires) and child attachment quality assessments through the Strange Situation Procedure were examined. The equivalence of the cohorts was verified and used as a baseline for parenting outcomes. PCPS participants demonstrated increased parental competence and self-efficacy, as well as reduced levels of parenting stress. Analysis of the two cohorts showed a significant difference in the number of visits and proxies for intervention, which were associated with the expected pre-post changes in parenting dimensions. The proportion of securely attached children was significantly higher in the "medium-high intervention" group than in the "no/low intervention" group (72.7% vs 54.5%). Furthermore, compared with international baselines, this proportion showed no differences in the "no-/low-intervention" group but demonstrated expected significant differences in the "medium-high intervention" group.

Effectiveness of a brief filial therapy model on child, parent, and relationship outcomes.

Effectiveness of a brief filial therapy model on child, parent, and relationship outcomes.

Stakeholder Perceptions of Digital Nutrition Education Modules on Infant Feeding in Home Visiting Programs.

Evaluate the usability and acceptability of a digital infant feeding module for use in a home visiting program. Home visitors (n = 11) and mothers (n = 10) completed a qualitative interview while viewing a digital nutrition education module on infant feeding. Quantitative data were collected using the mHealth App Usability Questionnaire. Qualitative data were analyzed using inductive thematic analysis. Most participants (90%) reported that they would very likely use the module as part of home visits. mHealth App Usability Questionnaire subscale scores supported usability on a scale of 0-7 with ease of use (6.9 ± 0.40), interface and satisfaction (6.9 ± 0.30), and usefulness (6.8 ± 0.50). Barriers to usability included technology access and phone compatibility. The digital infant feeding module was deemed usable and acceptable by home visiting stakeholders. Future research is needed to determine the impact of brief digital educational modules on parental feeding behaviors and child health outcomes.

Wellbeing and quality of life among parents of individuals with Fontan physiology.

To examine global and health-related quality of life (QOL) among parents of individuals with Fontan physiology and determine associations with sociodemographic, parent and child-related health, psychological, and relational factors. Parents participating in the Australian and New Zealand Fontan Registry (ANZFR) QOL Study (N = 151, Parent Mean age = 47.9 ± 10.2years, age range: 31.6-79.6years, 66% women; child Mean age = 16.3 ± 8.8, age range: 6.9-48.7years, 40% female) completed a series of validated measures. Health-related QOL was assessed using the PedsQL 4.0 Core Generic Scales for adults and global QOL was assessed using a visual analogue scale (0-10). Most parents (81%) reported good global QOL (≥ 6), consistent with broader population trends. Nearly one-third of parents (28%) reported at-risk health-related QOL (based on total PedsQL scores) with physical functioning most affected (44%). Psychological factors, including psychological stress and sense of coherence, emerged as the strongest correlates of global and health-related QOL, explaining an additional 16 to 30% of the variance (using marginal R2). Final models explained 35 and 57% and of the variance in global and health-related QOL, respectively (marginal R2). Relational factors, including perceived social support and family functioning contributed minimally when analyzed alongside psychological variables. While parents of individuals with Fontan physiology report good global QOL, challenges in health-related QOL exist. We identified key psychological, sociodemographic, and health-related factors associated with parental QOL outcomes. These data may aid early identification of physical and psychosocial difficulties and guide targeted health resource allocation for this population.

Association between adverse perinatal events and postpartum depressive symptoms in a North American prospective preconception cohort study.

Identifying risk factors for postpartum depression (PPD) is critical to inform early intervention efforts. This study investigated the impact of adverse perinatal events on PPD. We analyzed data from the Pregnancy Study Online (PRESTO), a North American prospective preconception cohort study. Participants (N = 3559) aged 21-45 years completed questionnaires at preconception, during pregnancy, and postpartum. PPD was assessed at six months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). We fit generalized linear models to estimate risk ratios (RRs) and 95 % confidence intervals (CIs) for the associations of adverse perinatal events (preterm birth; birth size for gestational age; infant birthweight; and NICU admission) with PPD (EPDS score ≥ 13), adjusting for confounders including preconception mental health. A total of 9.8 % reported PPD. Preterm birth (i.e., <37 weeks gestational age; RR = 1.30; 95 % CI: 0.92, 1.82), particularly spontaneous preterm birth (RR = 1.38; 95 % CI: 0.90, 2.10), very preterm birth (<34 weeks; RR = 1.88; 95 % CI: 1.04, 3.35), very low infant birthweight (i.e., <1500 g; RR = 1.67, 95 % CI: 0.77, 3.60), and NICU admission (RR = 1.15; 95 % CI: 0.86, 1.55) were associated with increased PPD risk. Stratified analyses indicated preterm birth was more strongly associated with PPD among parous participants and participants with a history of mental health diagnoses. Adverse perinatal events were associated with an increased risk of PPD at 6 months postpartum. Early identification and management of depressive symptoms in those who have experienced adverse perinatal events are crucial for improving both parental and infant health outcomes.

The association between neighbourhood socioeconomic status and parental mental health in the first years after birth - Cross-sectional results from the SKKIPPI project.

The urban environment can influence mental health. However, research on neighbourhood influences on mental health of parents with young children is sparse. This study aimed to analyse the association between neighbourhood socioeconomic status (SES) and mental health outcomes in urban parents in the first years after birth. We included 4707 parents of young children who participated in the SKKIPPI cohort study in Berlin. Data on mental health outcomes (symptoms of depression, anxiety, or both, measured via PHQ- 4) and individual risk factors stemmed from an online questionnaire and were matched with neighbourhood level data from the Berlin Senate Department for Urban Development and Housing. Neighbourhood status (exposure) was categorized in 4 SES categories: high, medium, low, and very low. We use propensity scores to estimate the probability to live in each neighbourhood category to reduce the risk of bias due to neighbourhood self-selection. Binominal generalised linear mixed models with propensity score adjustment were used to estimate the association between neighbourhood SES and symptoms of depression, anxiety, or both. Overall, 9.3% of parents showed depressive, 10.3% anxiety, and 5.3% both symptoms. The occurrence of mental health problems was lowest in neighbourhoods with high SES and highest in neighbourhoods with low/very low SES. The association between neighbourhood SES and mental health outcomes seen in unadjusted regression models disappeared when models were adjusted for individual risk factors/neighbourhood self-selection using propensity scores. We found no association between neighbourhood SES and mental health outcomes in parents in the first years after birth after adjusting for neighbourhood selection. Nevertheless, the unadjusted findings suggest that the occurrence of individual risk factors and mental health problems was highest in neighbourhoods with low/very low SES, which should be focus for social and preventive health measures.

Increasing parent-child play frequency via exclusively online, video-based, peer-to-peer modeling program: randomized controlled trial.

Equipping parents with play skills can foster child development. This study examined the effects of Power of Play Parent Intervention, a short, online, asynchronous, play skill enhancement program, on the frequency of total parent-child play, parents' attitude towards play, and children's screen time in Thailand. From September to December 2023, 112 parents of children aged 12-36 months from social media platforms were block-randomized into two-arm, parallel groups (56 intervention and 56waitlist control). The intervention group received a 2-to-3-min, weekly video clip for 6 weeks. Parent outcomes were measured at baseline, 6 and 10 weeks after starting the intervention. At 10 weeks, compared to control, the intervention group reported increased total parent-child play frequency (Cohen's d = 0.38, 95% Confidence interval (CI) 0.01-0.76), frequency of active physical play (standardized mean difference (SMD) 0.73 ± 1.79, p = 0.003), gentle physical play (SMD 0.643 ± 1.257, p < 0.001) and play with books (SMD 0.375 ± 0.926, p = 0.004), but not attitude and children's screen time. Succinct, online parent play skill enhancement program may be considered as a resource to promote play in time-constrained parents which still remained effective up to one month after intervention. Online play skill enhancement program utilizing modeling strategy, coupled with positive parent-child interaction promotion, effectively increased frequency and types of parent-child play. Practical play intervention can help raise parents' awareness on the different types of play and enhance the application of infrequently-used play techniques such as noisy play. This study highlights the value of prompting and educating parents about play through modeling in everyday pediatric practice.

Parent-focused online video intervention for promoting parenting sense of competence: a randomized controlled trial.

Apart from child behavioral problems which were ameliorated by increasing parenting skills, parental well-being is one of the important components for development of parenting sense of competence (PSOC), which subsequently affects parenting style and child outcomes. This randomized controlled trial study aims to determine whether a brief asynchronous parent-focused online video intervention (POVI) that was easily accessible would be effective in increasing PSOC and parental well-being. One hundred and twenty parents, with a poor Thai Mental Health Indicators-15 score or mild-moderate depression/anxiety, of children aged 3-10 years, were randomized into two parallel groups, intervention and control groups (1:1). The intervention group received six online, weekly, parent-focused sessions. Parent and child outcomes were measured at baseline, 6, and 10 weeks. The Generalized Estimating Equations model was used for the analysis. At 10 weeks, the intervention group reported a higher PSOC (p = 0.005), particularly on the parenting satisfaction subscale, and mental health indicator. Both groups experienced reduced depression and anxiety from baseline, and child behaviors remained unchanged. POVI improved PSOC and parental well-being among parents with mild to moderate mental health problems. POVI may be used as a primary tool to promote parental well-being in general pediatric practice. This study demonstrates the efficacy of a parent-focused online video intervention (POVI) in enhancing parenting sense of competence and parental well-being. It addresses the gap in interventions that focus primarily on parental well-being, particularly for those who face mild to moderate mental health challenges. The findings contribute valuable insights for healthcare professionals, highlighting the potential of POVI, an easy-to-access and less time-consuming intervention, as a primary tool to promote parental well-being in general pediatric practice settings.

Supervised and Unsupervised Screen Time and Its Association With Physical, Mental, and Social Health of School-Going Children in Dhaka, Bangladesh: Cross-Sectional Study.

Children's screen time has substantially increased worldwide, including in Bangladesh, especially since the pandemic, which is raising concern about its potential adverse effects on their physical, mental, and social health. Parental supervision may play a crucial role in mitigating these negative impacts. However, there is a lack of empirical evidence assessing the relationship between parental screen time supervision and health outcomes among school children in Dhaka, Bangladesh. We aimed to explore the association between supervised and unsupervised screen time on the physical, mental, and social health of school-going children in Dhaka, Bangladesh. We conducted a cross-sectional descriptive study between July 2022 and June 2024. A total of 420 children, aged 6-14 years, were enrolled via the stratified random sampling method across three English medium and three Bangla medium schools in Dhaka. Data were collected through a semistructured questionnaire; anthropometry measurements; and the Bangla-validated Strength and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI) Scale, and Spencer Children Anxiety Scale (SCAS). A total of 234 out of 420 students (56%) used digital screen devices without parental supervision. We did not find a substantial difference in the duration of the daily mean use of digital devices among the supervised students (4.5 hours, SD 2.2 hours) and the unsupervised students (4.6 hours, SD 2.4 hours). According to the type of school, English medium school children had a mean higher screen time (5.46 hours, SD 2.32 hours) compared to Bangla medium school children (3.67 hours, SD 2.00 hours). Headache was significantly higher among the unsupervised digital screen users compared to those who used digital screens with parental supervision (175/336 students, 52.1% versus 161/336 students, 47.9%; P<.003). Moreover, students who used digital screens without parental supervision had poor quality of sleep. Behavioral problems such as conduct issues (119/420 students, 28.3%) and peer difficulties (121/420 students, 28.8%) were observed among the participants. However, when comparing supervised and unsupervised students, we found no statistically significant differences in the prevalence of these issues. The findings of the study showed that the lack of screen time supervision is associated with negative health effects in children. The roles of various stakeholders, including schools, parents, policy makers, and students themselves, are crucial in developing effective guidelines for managing screen use among students. Further research is needed to demonstrate causal mechanisms; identify the best interventions; and determine the role of mediators and moderators in households, surroundings, and schools.

Predictors of parent-child bonding and parenting satisfaction during the perinatal period: A structural equation model.

To examine the predictors of parent-child bonding and parenting satisfaction using structural equation models at three time points across the perinatal period: (1) during pregnancy at >24 gestational weeks, (2) one month postpartum, and (3) three months postpartum. This longitudinal exploratory quantitative study recruited a convenient sample of 118 heterosexual couples (236 participants; 118 mothers and 118 fathers) from maternity clinics of a public tertiary hospital in Singapore. Descriptive statistics were used to summarize the parents' characteristics and study variables. Structural equation modeling was used to test the appropriateness of the hypothesized model on the study variables. Multigroup analyses according to gender were conducted to understand the relationships among parental outcome variables for mothers and fathers separately. Goodness-of-fit statistics were used to determine the adequateness of the hypothesized models. An adequate fit between the hypothesized model and the study's data was reported for all analyses. Among couples, no variable was identified as a significant predictor for parent-child bonding, while parenting self-efficacy, parent-child bonding, and social support were identified as significant predictors of parenting satisfaction. Fathers with more social support had stronger father-infant bonds. Mothers with poorer psychological well-being had more maternal-child bonding and maternal satisfaction. Different relationships between the parental variables among fathers and mothers were reported at only one month postpartum. Both parents need to receive perinatal support. Fathers could receive more encouragement to be involved in perinatal care and maternal-infant bonding can be promoted during the first month postpartum.

Associations between parent and adolescent weight outcomes within two parent approaches to family-based adolescent obesity treatment: Secondary analyses from the TEENS+ pilot trial.

To examine associations between parent and adolescent weight change within two parent approaches to adolescent obesity treatment. Adolescent (Mage = 13.7 ± 1.2 years; MBMI = 34.9 ± 7.0 kg/m2) and parent (MBMI = 36.4 ± 7.3 kg/m2) dyads (N = 82) were randomized to TEENS+Parents as Coaches (PAC) or TEENS+parent weight loss (PWL). Anthropometrics were assessed at baseline (0-month), 4 months (post) and 7 months (after 3-month maintenance period). Regression analyses examined associations between parent and adolescent ΔBMI0-4m and ΔBMI4-7m, with parent group as a moderator. Post-treatment, parent and adolescent ∆BMI0-4m were positively related (β = 0.68, p < 0.001), with no group interaction. Parent and adolescent ΔBMI4-7m were related (β = 0.48, p = 0.012) during maintenance, moderated by parent group (β = -0.49, p = 0.010): positive relationships persisted in PAC (β = 0.39, p = 0.011), but not PWL (β = -0.19, p = 0.211). Parent and adolescent weight changes were positively related during treatment in both parent groups. During maintenance, weight change associations persisted only in PAC. These patterns prompt further exploration of parent factors driving weight change relationships.

Raising siblings is stressful: Measuring parental emotion regulation in the sibling context

Parents’ ability to manage intense emotions in the face of conflictual sibling interactions is a significant challenge that has been linked with various child and parent outcomes. With existing instruments focused on raising a single child, we lack validated instruments to assess dimensions of parental emotion regulation in the context of rearing siblings. We tested the factor structure, reliability, divergent and concurrent criterion validity of a new instrument designed to measure parental emotion regulation ( Parental Emotional Regulation in the Sibling Context Questionnaire) while raising two or more children. Participants, 359 mothers from 35 countries, with two children aged 4- to 8-years, completed the new instrument along with established measures of parental emotion regulation, sibling relationship quality, and children’s emotion regulation. A confirmatory factor analysis supported the utility of the instrument in reliably assessing dimensions of parent emotional regulation (Reactivity and Dysregulation). Evidence for divergent validity stemmed from associations with an established measure of general emotion regulation strategies and evidence for concurrent criterion validity stemmed from associations with children’s sibling relationship quality. Findings have implications for the reliable identification of mothers who are facing emotion regulation difficulties, the design of customized intervention strategies, and the evaluation of prevention and intervention programs.

Styles of Delivering News About a Child's Cancer and Parents' PTSD Symptoms.

Receiving a child's cancer diagnosis is a highly traumatic experience for parents, often leading to significant psychological distress, including symptoms of Post-Traumatic Stress Disorder (PTSD). The way healthcare professionals deliver this news can affect the severity of parents' reactions. While some research examines communication style's impact on patients, few studies focus on its effects on parents. This study explores the relationship between the communication style used by oncologists when delivering a child's cancer diagnosis and the subsequent levels of PTSD symptoms, mental resilience, and self-efficacy in parents. One hundred twenty eight parents of children diagnosed with cancer participated. Data were collected using the Styles of Communicating Questionnaire (SCQ), PTSD Checklist for DSM-V (PCL-5), the Connor-Davidson Resilience Scale (CD-RISK), and the General Self-Efficacy Scale. Correlations and hierarchical multiple regressions were performed to examine the relationship between communication style and psychological outcomes. Parents who perceived the oncologist's communication style as more activating (clear, structured, and action-oriented) reported significantly lower levels of PTSD symptoms and higher levels of resilience and self-efficacy. The perception of empathy played a crucial role, particularly when physicians balanced emotional and cognitive empathy. This balance was linked to better psychological outcomes in parents. The study highlights the critical role of communication style in mitigating the psychological impact of a child's cancer diagnosis on parents. Training healthcare providers to balance cognitive and emotional empathy in communication may reduce PTSD symptoms and enhance resilience and self-efficacy in parents, ultimately improving their psychological well-being during such a challenging time.

Community Implementation and Evaluation of the Chicago Parent Program.

The purpose of this study was to describe and evaluate the implementation of the Chicago Parent Program (CPP) in a community setting. Included are details of the co-designed implementation by academic and community partners, and parenting and child behavior outcomes. Two hundred eighty caregivers of children aged 2-5 years participated in the CPP in seven community sites. Measures of parenting and child behavior were administered at pre-intervention, post-intervention, and 3-month follow-up. Caregivers reported broad improvements in parenting and child behavior from pre-intervention through 3-month follow-up. No effects were found for attendance, COVID-19 exposure, and remote versus in-person delivery. The CPP was successfully implemented in a community setting and demonstrated significant changes in parenting and child behavior.