Parental Confidence Research Articles

Parental influences on screen time and weight status among preschool children from Brazil: a cross-sectional study

BackgroundLittle is known about the influence of parental attributes and parental screen time behaviours on pre-schooler’s screen time and weight status in low-to-middle income countries. The purpose of this study was to examine the relationships between parental screen time, parental self-efficacy to limit screen time, child screen time and child BMI in preschool-aged children in Brazil.MethodsThree hundred eighteen parent-child dyads from Caruaru, Brazil completed a survey measuring sociodemographic data, weekday and weekend screen time, and parental self-efficacy for limiting screen time. Height and weight were measured and used to derive BMI and BMI percentile. Observed variable path analysis was used to evaluate the relationships between the parental and child variables.ResultsAnalyses were conducted for screen time on weekdays and weekend days. Parental screen time was positively associated with child screen time, either directly (weekdays = β = 0.27, p < 0.001, weekends = β = 0.24, p < 0.001) or indirectly through reduced self-efficacy to limit child screen time (weekdays = β = − 0.15, p = 0.004, weekends = β = − 0.16, p = 0.004). After controlling for household income, parental occupation, and parental BMI, greater child screen time on weekends, not weekdays, was associated with higher child BMI percentile (β = 0.15, p = 0.006).ConclusionsParental screen time and self-efficacy to limit screen time are important influences on child screen time and weight status in pre-schoolers from Brazil. Reducing parental screen time and increasing parental confidence to limit screen time may be effective strategy to prevent overweight in Brazilian pre-schoolers.

Predicting children's school grades: Unique and interactive effects of parental beliefs and child inattention/hyperactivity symptoms

Parental beliefs about school involvement are key in predicting individual differences in children's academic success. The current study examined unique and interactive relations between parental beliefs and child inattention/hyperactivity symptoms in predicting children's achievement. Participants (N=348) were caregivers of children aged 8-12. Caregivers completed questionnaires regarding their beliefs and their child's inattention/hyperactivity and achievement. Hierarchical regression analyses indicated lower child inattention/hyperactivity and greater parental confidence in their ability to help their child academically predicted better achievement. Parent/child interactions probed with simple slopes suggested an achievement gap for children with higher inattention/hyperactivity only when their parents felt less efficacious or more responsible for their child's academic success. This suggests parent self-efficacy may buffer the negative relation between children's inattention/hyperactivity symptoms and underachievement, and parents of children with higher inattention/hyperactivity may increasingly assume responsibility for their success due to feedback from the school. Statement of contribution What is already known on this subject? Academic achievement predicts several short- and long-term outcomes for children. Parental involvement beliefs are multi-faceted and predict children's academic success. Child inattention/hyperactivity symptoms are related to lower academic achievement. What does this study add? It provides specificity of previous relations for children with a range of inattention/hyperactivity symptoms. It identifies parental self-efficacy as a promising moderator of the relation between child behaviour and academics. It provides a preliminary evidence base for future work on the role of parental beliefs in child academic outcomes.

The Effect of Peer Coaching as Health Coaching Support on Parenting Self Efficacy to Infant Care in Early Marriage Mother in The Waipare Public Health Center Working Area

Introduction: Early marriage is a practice that is still common in several countries in the world. Getting married at early age will have an impact on childcare. Marriage at an early age needs to obtain knowledge about childcare. Interventions provided to mothers who marry at early age to change her behavior is health coaching support. The purpose of the study was to analyze the effect of health coaching support by peer coaching method on parenting self-efficacy to infant care in mothers who married at early age. Methods: This study used a quasi-experimental design with one group pre-test and post-test design. The study population was early marriage mothers who had infant. We used purposive sampling technique with a sample of 15 participants. The instrument used in this study was the Maternal Self-Efficacy Scale. Results: The results showed that of the 15 participants, the mean pre-test and mean post-test were 1.73 and 3.46. Wilcoxon test results showed before and after being given health coaching support by peer with p-value 0,000 &lt; α = 0.05, so Ho was rejected and Ha was accepted. This showed that there was a significant influence due to the provision of health coaching support by peer coaching methods on infant care. Conclussions: There was an increase in parenting self-efficacy on infant care in mothers who married at early age. It is expected that parents who married at early age could change their behavior and have confidence in parenting.

Nutrition provider confidence in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study.

ObjectiveThe multi-sector, multi-level Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study resulted in improvements in obesity risk factors among children age 2–4 years enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC). The goal of this study was to examine whether the MA-CORD intervention increased WIC provider confidence in their ability to identify childhood obesity and obesity-related behaviors.MethodsAs part of the MA-CORD intervention conducted from 2012 to 2015, we implemented WIC practice changes focused on childhood obesity prevention within two Massachusetts communities. We examined changes in provider confidence to assess childhood obesity risk factors and practice frequency among WIC practices located in MA-CORD intervention communities over a 3-year period, compared to non-intervention sites. We measured provider confidence on a continuous scale using questions previously developed to assess provider and parent confidence to make weight-related behavior change (range 0 to 24).ResultsThere were 205 providers at baseline and 165 at follow-up. WIC providers at intervention sites reported greater confidence in their ability to identify childhood obesity and obesity-related behaviors compared to the usual care sites (β = 1.01, standard error = 0.13). These findings persisted after adjusting for provider gender, years in practice, highest education level, and WIC position.ConclusionsThe MA-CORD intervention was associated with increased WIC provider confidence to assess children's obesity risk. Interventions that increase confidence in assessing obesity-related behaviors may have salutary effects within WIC programs that serve low-income families.

Moving into tummy time, together: Touch and transitions aid parent confidence and infant development.

"Back to sleep" messages can reduce prone practice for infants, with potential for motor delay and cranial deformation. Despite recommendations for "tummy time," young infants fuss in prone, and parents report uncertainty about how to help infants tolerate prone positioning. We hypothesized that a Child'Space Method lesson, teaching proprioceptive touch and transitions to prone, would facilitate prone tolerance, parent behavioral support, and parent self-efficacy. This randomized study recruited parents (N = 37) of 2- to 5-month-old infants. On two visits, parents answered questions about infant behavior and parent experience, and played with their infant. Lesson group parents had the lesson following the first free play. One week later, lesson parents reported that infants tolerated more prone time and that parents showed more supportive behaviors in bringing infant to prone, as compared to waiting parents. Lesson parents' efficacy, and infant behavior during play, trended in the hypothesized direction. The study demonstrated how a lesson in preparatory touch, and gradual transitions, promoted infant prone tolerance and also parent support of rolling, side-lying, and prone positioning. The lesson could be incorporated in parent education and early pediatric visits, helping infants and parents negotiate the prone challenge and setting the stage for further parent support of infant development.

Strengthening resilience through an extended postnatal home visiting program in a multicultural suburb in Sweden: fathers striving for stability

BackgroundTo improve prerequisites for better health development among children growing up in multicultural suburbs in Stockholm County, where poorer health is displayed in several aspects including child health, early support was initiated for first-time parents in one of the suburbs. An extended postnatal home visiting program during the child’s first 15 months was offered to families with first-time mothers during 2013–2014 and consisted of six home visits by a child health care nurse and a parental advisor from social services. Almost all invited families (94%) participated in the program and the program evaluation. Fathers’ participation in two or more home visits within the program was 53%.The aim of this study was to explore the experiences of fathers participating in the program, with respect to their role as a first-time parent from a resilience perspective.MethodsIn-depth interviews were conducted with nine fathers. Constructivist grounded theory (GT) was applied in the analysis.ResultsThe fathers’ experiences formed the core category of the study, ‘striving for stability in living conditions’, as well as three categories: ‘everyday life conditions’, ‘adjustment to fatherhood in Sweden’ and ‘channels of support’. The fathers perceived that the home visiting program strengthened their parental confidence and increased their knowledge of societal services and local resources for their family.ConclusionsIn terms of resilience, the extended postnatal home visiting program benefitted the interviewed migrant fathers on an individual level by meeting part of their need for support regarding knowledge and parental confidence; on a structural level the program helped fathers gain information about available societal services and resources in their local area.Trial registrationThe study was retrospectively registered (11 August 2016) in the ISRCTN registry (ISRCTN11832097 DOI: https://doi.org/10.1186/ISRCTN11832097).

\u201cBeing the best person that they can be and the best mum\u201d: a qualitative study of community volunteer doula support for disadvantaged mothers before and after birth in England

BackgroundDisadvantaged pregnant women and new mothers are at increased risk of psychosocial stress, anxiety and depression. As well as affecting birth outcomes and child development, poor maternal emotional wellbeing can inhibit the development of parenting self-efficacy and successful adjustment to the maternal role. Social support is a protective factor against antenatal and postnatal depression, anxiety and stress, and improves mothers’ confidence in infant care. Community doula programmes have been developed to meet the social support and information needs of disadvantaged women. In these programmes trained volunteer doulas support mothers during pregnancy, at birth and for a short period postnatally.MethodsThis was a descriptive qualitative study, informed by phenomenological social psychology, exploring mothers’ and doulas’ experiences of antenatal and postnatal community doula support. Semi-structured qualitative interviews were undertaken with 13 disadvantaged mothers and 19 doulas at three community volunteer doula projects in England. Interviews were audio-recorded and transcripts were analysed using inductive thematic analysis.ResultsThe overarching theme emerging from the analysis was “Supporting the mother to succeed and flourish”. There were five subthemes: “Overcoming stress, anxiety and unhappiness”, “Becoming knowledgeable and skilful”, “Developing self-esteem and self-efficacy”, “Using services effectively”, and “Becoming locally connected”. Doulas believed that their community role was at least as important as their role at births. Their support was highly valued by vulnerable mothers and helped to improve their parenting confidence and skills.ConclusionsVolunteer doula support before and after birth can have a positive impact on maternal emotional wellbeing, by reducing anxiety, unhappiness and stress, and increasing self-esteem and self-efficacy. Doulas help mothers feel more knowledgeable and skilful, support them to make effective use of maternity services, and enable them to build social ties in their community. To facilitate the best service for vulnerable mothers at the end of doula support, doula projects should consider formalising their relationship with other community organisations that can offer ongoing one-to-one or group support. They might also alleviate some of the potential distress caused by the ending of the doula relationship by increasing the flexibility of the ending, or by organising or permitting informal low level contact.

Evaluating response to group CBT in young children with autism spectrum disorder

AbstractMany children with autism spectrum disorder (ASD) exhibit difficulties with negative affect. Cognitive behavioural therapy (CBT) has been successfully adapted for individuals with ASD to treat these difficulties. In a wait-list control study, for example, group analyses showed promising results for young children with ASD using a developmentally adapted group CBT approach. This report examined response to group CBT in terms of individual-level change in young children with ASD. Eighteen children with ASD, aged 5–7 years, and their respective parents participated in treatment. Parents completed pre- and post-treatment measures of negative affect and related behaviours. Treatment responders and non-responders were grouped based on significant treatment outcomes as assessed by statistically significant change for lability/negativity and 20% decrease in intensity, duration or frequency of emotional outbursts. Results indicated that 67% of children met criteria as a treatment responder, showing meaningful improvement in at least two outcome measures. No significant group differences emerged for initial characteristics before treatment. Wilcoxon signed rank tests determined pre-/post-treatment change in parental confidence for each treatment responder group. Results indicated statistically significant increase for the treatment responder group in parent-reported confidence in their own ability and in their child's ability to manage the child's anger and anxiety, but these results were not significant for the treatment non-responder group. Results provide additional evidence that CBT can significantly decrease expressions of anger/anxiety in children with ASD as young as 5 years, yet also suggest need for further improvement.

The Impact of "Mom/Dad of the Day" Cards, Newborn Heart Auscultation, and Father Skin-to-Skin Care on Parent-Newborn Bonding.

Texas Tech Pediatrics at Northwest Texas Hospital System in Amarillo, Texas, currently practices giving "Mom/Dad of the Day" cards to all new parents, offering the opportunity for fathers to auscultate the newborn heart sound, and encouraging maternal and paternal skin-to-skin contact. New parents were asked to fill out 2 anonymous surveys regarding these practices. Survey results showed statistically significant positive responses by the parents for subjective improvement in fetal sleep and feeding as well as parental confidence and preparedness for taking care of their newborn. Additionally, these practices are desired by parents, with 96% fathers recommending that the hospital routinely offering opportunities for heart auscultation and 94% parents recommending "Mom/Dad of the Day" cards for all future parents in the hospital. Small, nonmedical initiatives such as these are well received and can be feasibly adopted in more hospitals to improve patient quality of care.

Development of a US trust measure to assess and monitor parental confidence in the vaccine system

ObjectiveTo develop a Vaccine Confidence Index (VCI) that is capable of detecting variations in parental confidence towards childhood immunizations centered on trust and concern issues that impact vaccine confidence. MethodsWe used a web-based national poll of 893 parents of children <7 years in 2016 to assess the measures created for the Emory VCI (EVCI). EVCI measures were developed using constructs related to vaccine confidence identified by the U.S. National Vaccine Advisory Committee (i.e., “Information Environment”, “Trust”, “Healthcare Provider”, “Attitudes and Beliefs”, and “Social Norms”). Reliability for EVCI was assessed using Cronbach’s alpha. Using the variables related to each of the constructs, we calculated an overall EVCI score that was then assessed against self-reported childhood vaccine receipt using chi-square and the Cochrane-Armitage trend tests. ResultsRespondents’ EVCI scores could range from 0 to 24, and the full range of values was observed in this sample (Mean = 17.5 (SD 4.8)). EVCI scores were significantly different (p ≤ 0.006 for all comparisons) between parents who indicated their child(ren) received routinely recommended vaccines compared with parents who indicated they had delayed or declined recommended immunizations. There was also a significant, consistent association between higher EVCI scores and greater reported vaccine receipt. ConclusionsWe developed EVCI to reliably measure parental vaccine confidence, with individuals’ scores linked to parental vaccine-related attitudes, intentions, and behaviors. As such, EVCI may be a useful tool for future monitoring of both population and individual confidence in childhood immunization.

Parents’ Experience of Their Sleep and Rest When Admitted to Hospital with Their Ill Child: A Qualitative Study

ABSTRACTThe aim of this study was to explore parents’ experiences of sleep and rest while admitted to hospital together with their ill child. When a child is hospitalized, it can be a traumatic experience for the entire family. Adaptation to the new situation and new parental responsibilities is necessary. Hospitalized children demand more supervision and care, making sleep disturbance a common challenge among these parents. A qualitative exploratory interview study was conducted using semi-structured individual or couple interviews with 17 parents (12 mothers and five fathers) admitted together with their ill child for shorter or longer periods at pediatric wards at a university hospital in Sweden. Interviews were analyzed with content analysis. Sufficient amount of sleep and rest was described as vital for parental functioning. The main theme Factors influencing sleep and rest emerged with three subthemes. Environmental factors describe experiences such as disturbing sounds and uncomfortable beds. Interpersonal factors describe how supportive relations with spouses, relatives, nurses, and doctors were experienced as strengthening the parental confidence and helping parents to relax. Parents wanted to participate in the care but appreciated help from the nurses when they needed rest or support. The last subtheme, Organizational factors, describe how continuous information about the child’s care and prognosis was experienced as the most important factor to feel secure and calm. Parents expressed that a possibility to buy lunch and dinner at the ward would greatly relieve parents’ stress and help them rest. Parents in this study were grateful that they were allowed to stay by their child’s side, but pointed out improvement opportunities. Single rooms with comfortable beds for the parents were in high demand to promote relaxation and sleep. Continuous, adjusted, information was seen as important. All hospitalized children have the right to partake in their own treatment and care, and they need a parent at their side. By optimizing parents’ sleep and rest in the hospital, a more positive experience of the hospitalization can be achieved for the entire family.

Parents’ perceptions of administering a motor intervention with their preterm infant in the NICU

Background: Giving birth prematurely challenges bonding, optimal parent-child interactions and parental confidence in the early care of their preterm infants. In this study we explored the short-term impact of a parent administered motor intervention programme on parents’ perception of competency and relationship building with their preterm infant.Methods: We conducted 11 interviews at infant age term and three months corrected age, involving parents of seven preterm infants who had performed the functional movement intervention programme in the Neonatal Intensive Care Unit. A phenomenological-hermeneutical analysis was conducted.Results: After implementing the intervention, the parents were no longer fearful of moving their babies and expressed heightened awareness of their infant’s responses and competency. The parents enjoyed the infants’ positive responses to handling and movement and this reinforced attachment between the parent and the child. The parents felt empowered by taking control of decision-making and by being more interactive with their child. Their role in contributing to the infant’s development was empowering in itself.Conclusion: Overall, the parent administered intervention programme had a substantial positive impact on parent-infant bonding and parents’ perceptions of empowerment and competency.

Palin Parent–Child Interaction Therapy: The Bigger Picture

Palin Parent-Child Interaction therapy (Kelman & Nicholas, 2008) is an evidence-based intervention for young children who stutter. The evidence consists of multiple single-subject replicated studies, and this demonstrates that the intervention is effective. The aim of this study was to enhance the evidence base by exploring the effectiveness of the therapy with a large cohort of children who stutter. Children and parents completed a range of assessments at 4 time points: start of therapy and then 3, 6, and 12 months later. The following variables were included: stuttering frequency, child's communication attitude, parents' perception of the impact of the stuttering on the child, the severity of stuttering and its impact on the parents, and their knowledge of stuttering and confidence in managing it. Hierarchical multiple regression analyses were conducted to explore whether the variables are predictive for the outcome "parent knowledge and confidence." In addition, we sought a preliminary view of factors associated with outcome level by separating children into 2 groups according to response to treatment (more successful and less successful). The results demonstrated a significant improvement in all variables, and this improvement was maintained for 1 year posttreatment. Measures collected 3 months after the start of therapy showed significant improvement in child attitude to communication, parents' knowledge and confidence in how to manage stuttering, and mothers' ratings of stuttering severity and impact the child's stuttering has on the mothers. By 6 months after therapy onset, there was a significant reduction in stuttering frequency and fathers' perception of severity and their worry about it. Furthermore, these improvements were maintained 1 year posttherapy. Several variables predicted parents' knowledge and confidence 6 months after the start of therapy. Finally, those who made greater improvements had mothers who were more negative in their ratings of severity and worry, and had less knowledge and confidence at the start of therapy. There were no differences between the groups on a range of other variables. The results demonstrate that, over a year, children who attend a course of Palin Parent-Child Interaction show reduced stuttering frequency and a more positive attitude to speech. In addition, parents observe these improvements in the child, feel more confident in managing the stuttering, and are less worried about it. The different times at which specific variables significantly improved provides insight to a process of change over time. Results suggest that parents' ability to notice positive change in fluency and the impact that these observations have on both the child and the family are linked to their confidence in how to support the child. The preliminary findings with regard to response to treatment suggest that children can benefit from this program even with factors that might be predicted to reduce therapy success.

DOES A PERINATAL PARENTING INTERVENTION WORK FOR FATHERS? A RANDOMIZED CONTROLLED TRIAL.

Fathers are increasingly expected to contribute to their parenting role at the transition to parenthood; however, many fathers experience mental health problems during this time. Parenting support for new fathers is limited, and research often only includes the mothers in intervention studies. Clear evidence for parenting programs for fathers has not yet been established. This study evaluated the effects of a parenting intervention (Baby Triple P) on fathers who were expecting their first baby. The design was a randomized controlled trial comparing Baby Triple P with care as usual over three time points (pregnancy, 10 weeks' postbirth, and 6 months' postbirth) for 112 fathers living in Brisbane, Australia. The primary outcomes included paternal psychological distress such as depression, anxiety, and stress and several secondary measures. No significant intervention effects for Baby Triple P were found at either post- or follow-up assessments. Fathers in both groups reported significant increases in their parenting confidence and self-efficacy. The results indicate no conclusive evidence for the effectiveness of Baby Triple P for new fathers. Future research using a sample with greater likelihood of experiencing problems at the transition to parenthood is needed as is offering more tailored need-based support to obtain substantial evidence for this preventative parenting program.

Extended analysis of parent and child confidence in recognizing anaphylaxis and using the epinephrine autoinjector during oral food challenges

Extended analysis of parent and child confidence in recognizing anaphylaxis and using the epinephrine autoinjector during oral food challenges

Addressing Vaccine Hesitancy in Clinical Practice.

Vaccines have had a profound impact on public health; however, parents are increasingly refusing or delaying vaccines for their children. Population-based studies have demonstrated the safety and efficacy of vaccines. Pediatricians should be well informed about vaccine development, safety, and efficacy to inspire parental confidence in vaccines. Systemic challenges in discussing and providing immunizations exist. Discussions about immunizations may be lengthy and time spent discussing immunizations is not routinely reimbursed. Adolescents may be inadequately immunized because they do not routinely present for preventive health visits. Routine immunizations should be offered and discussed at sick visits, particularly for adolescents. Improving immunization rates requires a multifaceted approach. [Pediatr Ann. 2018;47(9):e366-e370.].

Implementing a Parent Education Program in the Special Care Nursery

BackgroundParents of preterm hospitalized infants, whose lengths of stay can range from a few days to several months, often experience emotional liability. Because the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) is a stressful and intimidating environment, prompt attention should be given to reducing parental stress and increasing parental confidence in preparation to care for their child post-discharge. MethodsA quality improvement pilot project was designed to evaluate the parent education and support program, titled HUG Your Baby, in a Level II SCN for its ability to decrease stress and increase confidence for postpartum mothers of preterm infants born at less than 35 weeks gestation during the infant's hospitalization. ResultsThe outcomes demonstrated a statistically significant decrease in maternal stress and a statistically significant increase in maternal confidence. DiscussionThe HUG Your Baby program is an effective parent education and support program that would benefit NICU and SCN families.

Preparing parents for parenthood: protocol for a randomized controlled trial of a preventative parenting intervention for expectant parents

BackgroundBecoming the parent of a new baby comes with a range of challenges including difficulties with emotional adjustment, couple relationship issues and difficulty managing common infant behaviors, such as crying and sleep problems. This time can be especially challenging for couples who experience a range of risk factors. Previous parenting interventions for parents of babies have shown mixed results. This protocol paper describes a randomized controlled trial of a group-based parenting intervention for high-risk parents expecting their first baby.Methods/designParticipants will be randomized to either Group Baby Triple P or Care as Usual (CAU). Group Baby Triple P involves 4 × 2 h group sessions delivered during pregnancy and 4 individual telephone sessions of 30 min each in the early postnatal period. Outcomes will be assessed via parent self-report questionnaire, home observations and a baby diary 10 weeks and 6 months post-birth. Primary outcomes will be parental confidence and perceived competence. Secondary outcomes will include parental responsiveness and bonding with the baby, relationship happiness, life satisfaction, depression, anxiety and stress, and infant crying and sleep. Analyses will involve a series of rANOVA and rMANOVAs, t-tests and a multilevel modeling approach.DiscussionA brief summary, strengths and potential implications are discussed.Trial registrationAustralian New Zealand Clinical Trials Registry: ANZCTR 12613000948796. Registered 27 August, 2013.

Parent and child neurocognitive functioning predict response to behavioral parent training for youth with ADHD.

Parental cognitive functioning is thought to play a key role in parenting behavior and may inform response to behavioral intervention. This open-label pilot study examined the extent to which parent and child cognition impacted response to behavioral parent training for children with ADHD. Fifty-four participants (27 parent-child dyads; Mages = 10.6 and 45.2 for children and parents, respectively) completed tasks assessing visuospatial and phonological working memory, inhibitory control, and choice-reaction speed at pre-treatment. Drift diffusion modeling decomposed choice-reaction time data into indicators of processing speed (drift rate) and response caution (boundary separation). Parents completed a 10-week manualized behavioral parent training program. Primary outcomes were pre- and post-treatment child ADHD and conduct problem severity, and parent-reported relational frustration and parenting confidence. Bayesian multiple regressions assessed parent and child cognitive processes as predictors of post-treatment outcomes, controlling for pre-treatment behavior. Better child visuospatial and phonological WM and higher parental response caution were associated with greater reductions in inattention. For conduct problems, better parental self-regulation (stronger inhibitory control and greater response caution) predicted fewer post-treatment conduct problems. Higher parental response caution also predicted lower post-treatment relational frustration and higher parental confidence. Bayesian evidence supported no relation between parent and child cognitive functions and treatment-related changes in hyperactivity. This pilot study demonstrates that cognitive processes central to etiologic theories of ADHD and models of parenting behavior can be successfully integrated into treatment outcome research to inform which families are most likely to benefit from behavioral interventions. This study demonstrates the feasibility of bridging the translational research gap between basic and applied clinical science and facilitates research on the role of cognition in psychosocial interventions.

Encouraging Parenting Behaviors That Promote Early Childhood Development Among Caregivers From Low-Income Urban Communities: A Randomized Static Group Comparison Trial of a Primary Care-Based Parenting Program.

Objectives Encouraging key parenting behaviors in early infancy may help decrease income-related developmental disparities. In this study we assessed whether a brief, primary care-based program (Sit Down and Play; SDP) could be successful in impacting key parenting behaviors that promote early childhood development. Methods An ethnically diverse group of predominantly low-income caregivers of children 2-6 months of age were enrolled, interviewed, and randomized to intervention (n = 20) or control (n = 20) groups. Intervention families received SDP at recruitment and the subsequent well-child visit. Control families were provided handouts regarding developmental milestones. One month after the second well-child visit, all families were reinterviewed (n = 34; 85% retention rate). Using open-ended questions and standardized measures (i.e., StimQ), parents were asked about parenting behaviors central to children's development: (1) participation in cognitively stimulating activities, (2) provision of learning materials, and (3) the quality of parent-child verbal interactions. Potential impact on perceived parenting confidence was also explored utilizing The Parenting Sense of Competence Scale. Analyses were conducted using chi square tests and analysis of variance. Results A significant main effect of time, and as hypothesized, an interaction between time and condition emerged that favored SDP on play behaviors (p = 0.03). Post-intervention, SDP families had significantly higher levels of interactional activities between a parent and child that promote cognitive development (p = 0.02). Conclusions for Practice Results appear promising for an accessible, low-intensity program delivered in the primary care setting. Further studies to determine the effectiveness of SDP on parenting behaviors and subsequent developmental outcomes are warranted.