Parental Health Research Articles

Does perceived social cohesion moderate the effect of parental stressors on depressive symptoms? A longitudinal, multi-level analysis before and during the COVID-19 pandemic.

Perceived social cohesion (PSC) is a protective factor for mental health. Yet, evidence on social mechanisms influencing mental health is scarce. We examined the moderating role of PSC between parental stressors and depressive symptoms before and during the COVID-19 pandemic. We performed a multilevel moderated linear regression analysis using German Socio-Economic Panel (G-SOEP) data to investigate the interaction of PSC in 2018 and in 2020 with parental stressors (having pre-school-aged child(-ren), concerns about COVID-19 infection, financial insecurity, working from home, changes at work) and depressive symptoms (PHQ-4) in 2020 and 2021. 3,112 observations from 1,621 participants were included in the regression analyses. The parental stressors had mostly negative, although not always significant effects on PHQ-4. Both PSC measures positively moderated the association between experienced financial insecurity and PHQ-4. PCS 2020 positively moderated the association between the stressors "not working from home" and "being unemployed in 2020 or 2021" compared to "having no changes at work" for those employed. It negatively moderated the association between "having some concerns about infection" and PHQ-4. PSC can act as a buffer for parental mental health. Social cohesion should be promoted in public health interventions, especially during pandemics or disasters.

EQ-5D-5L or EQ-HWB-S: Which is the Better Instrument for Capturing Spillover Effects in Parental Carers of Children with COVID-19?

'Caregiver health spillovers' refer to the broader impacts of an individual's illness and interventions on informal caregivers' health and well-being. This study focuses on the spillover effects experienced by parental carers of children with coronavirus disease 2019 (COVID-19), aiming to compare the psychometric properties of the EQ-5D-5L and the experimental EQ Health and Wellbeing Short version (EQ-HWB-S) in capturing these effects. A longitudinal study was conducted with 861 parental carers of children aged 0-18 years with COVID-19 and 231 parents of healthy children as the control group. The EQ-5D-5L and EQ-HWB-S were used to assess parental health and well-being. Analyses included known-groups validity (multivariable regression), test-retest reliability (Gwet's AC1, intraclass correlation coefficient) and responsiveness to health improvement (Glass' Δ effect size). Parents of infected children reported more problems than those of healthy controls. The EQ-HWB-S better discriminated between sub-groups defined by the child's COVID-19 presence, caring time and work impact. Test-retest reliability was fair to good for EQ-HWB-S dimensions (Gwet's AC1: 0.33-0.79), moderate to good for EQ-5D-5L (Gwet's AC1: 0.40-0.76), and good for index scores and EQ VAS (intraclass correlation coefficient: 0.70-0.77). Parental health and well-being improved as children recovered, with the EQ-5D-5L showing slightly higher responsiveness (effect size: 0.77-0.87) than EQ-HWB-S (effect size: 0.62-0.74). Both EQ-HWB-S and EQ-5D-5L are valid, reliable and responsive for measuring parental spillover effects related to a child's COVID-19 infection. EQ-HWB-S outperformed in distinguishing social and emotional impacts of caregiving, while EQ-5D-5L better captured physical health improvements. The choice between tools may depend on study objectives.

Perceived social support correlated with parent mental health: self-report among urban immigrant parents of young children (Birth-5)

Perceived social support correlated with parent mental health: self-report among urban immigrant parents of young children (Birth-5)

Maternal and Child Health Following 2 Home Visiting Interventions vs Control: Five-Year Follow-Up of a Randomized Clinical Trial.

Home-based interventions targeting socially disadvantaged families may help to improve maternal and child health. Only a few studies have investigated how different staffing models affect early home visiting program outcomes. To assess the effects of 2 staffing models of an early childhood intervention on mother and child outcomes. The baseline assessment of this randomized trial was conducted between November 2006 and December 2009 in 15 municipalities in Germany. The follow-up assessment at offspring age 7 years was carried out by interviewers masked to treatment conditions from April 2015 to December 2017. Data analysis was performed from March to August 2023. Pregnant women with no previous live birth, low-income, and at least 1 additional psychosocial risk factor were eligible. A total of 1157 women were referred to the study by gynecologists, psychosocial counseling services, or employment agencies; 755 were randomized to treatment conditions (2 intervention groups and 2 control groups); and 525 completed the follow-up. Based on the Nurse-Family Partnership program, women assigned to the intervention groups received visits by either a midwife (midwife-only model) or by a team consisting of a social worker and a midwife (tandem model) until child age 2 years. Women assigned to control groups had access to the standard health and social services. Average treatment effects (ATEs) on the following primary outcomes were assessed using adjusted regression models with inverse probability weighting: developmental disorders, child behavioral problems, adverse, neglectful and abusive parenting, maternal mental health, and life satisfaction. The mean (SD) age at follow-up was 29.6 (4.36) years for mothers and 7.55 (0.75) years for children; 272 (52.2%) of the children were female. Mothers in the tandem model reported fewer internalizing child behavioral problems compared to their control group (ATE, 2.98; 95% CI, -5.49 to -0.47; absolute reduction, 13.3 percentage points). Beneficial intervention effects were found in the midwife-only group on abusive parenting (ATE, -4.00; 95% CI, -6.82 to -1.18), parenting stress (ATE, -0.13; 95% CI, -0.20 to -0.06), and maternal mental health burden (ATE, -3.63; 95% CI, -6.03 to -1.22; absolute reduction, 6.6 percentage points in depressive symptoms), but not in the tandem group. Both staffing models produced positive intervention effects, with more effects seen in the midwife-only model. These insights can guide future early childhood intervention designs and may help improve health care for socially disadvantaged families. German Clinical Trials Register Identifier: DRKS00007554.

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 Mental Health and Family Conflict on Behavioral Inhibition and Activation Among Youth in the ABCD Study®

Parental Mental Health and Family Conflict on Behavioral Inhibition and Activation Among Youth in the ABCD Study®

Family adversity and co-occurring pain, psychological, and somatic symptom trajectories from late childhood through early adolescence.

This study examined the relative impact of earlier versus proximal childhood exposures to family adversities (parental health problems, family conflict, financial hardship, abuse, violence) and supportive caregiving (warm and supportive parenting behaviors) on youths' symptom trajectories across early adolescence. We used parent-reported survey data to differentiate co-occurring Pain, Psychological, and Somatic Symptom (Pain-PSS) trajectories among youth in the longitudinal Adolescent Brain Cognitive Development Study® (2016-2022). Family adversities and supportive caregiving were derived from youth and parent surveys and coded as occurring earlier (by age 9-11yrs; baseline) or proximally (occurring during study follow-up years 1-4; by age 11-15yrs). Sequential modeling determined whether proximal exposures mediated the effects of earlier exposures on youths' Pain-PSS trajectories (data reflect adjusted relative risk ratios (adj. RRR [95% confidence interval]). Four Pain-PSS trajectories were differentiated among 7,546 youth, 14.3% of whom were classified with High Pain/High PSS. Earlier exposure to any family adversity increased the risk for higher Pain-PSS relative to the lowest symptom trajectory (e.g., parental mental health or somatic problems increased the relative risk for a High Pain/High PSS trajectory to 3.85 [2.84, 5.22] and 5.75 [4.36, 7.58], respectively). Most proximal exposures increased the risk for higher symptom trajectories, fully or partially mediating effects of earlier exposures. Higher proximal supportive caregiving lowered the risk for the High Pain/High PSS trajectory by 80%, fully mediating the impact of earlier caregiving. Findings suggest that family adversities and supportive caregiving may be important interventional targets to lower the risk for co-occurring symptom persistence across early adolescence.

Phenomenological Description of the Experiences of Teenagers With Critically Ill Parents.

Critical illness not only threatens the life of the patient but also may profoundly impact the lives of their loved ones. For teenagers with a critically ill parent, these impacts may have significant, developmentally impactful effects. A descriptive understanding of these effects may advance scholarly understanding of the challenges these teenagers face. In this study, we sought to understand this overlooked population, i.e., teenagers with a critically ill parent, using a descriptive analysis of their experiences. Individual and group interviews were conducted with the participants (n = 9). Interviewers presented standardized semistructured interview questions to all of the participants. The questions explored situational, emotional, relational, and dynamic phenomena related to the experience of having a critically ill parent. Themes describing the participants' lived experiences related to having a parent with a critical illness were examined using a three coding framework. Four themes emerged, including parental health interference on teenagers-fallout, worsening, and interference; emotional experience and how emotions were processed-emotions, cognitive strategies, and behavioral strategies; relationships with others-sharing feelings, company, and relationships; and information and secrecy-learning, secrecy, and history. All of the teenagers in this study were found to suffer from both situational and emotional interference. Parentification, use of selective distraction as an emotion regulation skill, and reliance on support from others were also observed. These results shed light on the overall experience of teenagers who have a critically ill parent. The fallout effects of a parent's health can encompass situational, logistical, emotional, and relationship aspects. Importantly, attention must be paid to how teenagers cope with the emotions experienced during a parent's critical illness. This framework may inform how to more effectively support teenagers through strategies such as providing peer support opportunities.

Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy.

Insomnia and sleep problems are common in pregnancy and have potentially negative impacts on both parental and infant health. This study examined the Sleeping for Two adaptation of cognitive behavioral therapy for insomnia (CBT-I) in pregnancy. A parallel (1:1) randomized controlled trial evaluated CBT-I (n = 32) compared to a treatment as usual waitlist (n = 32) among pregnant individuals from Alberta, Canada experiencing insomnia. Five weekly individual sessions of CBT-I pivoted from in-person delivery to telehealth due to the COVID-19 pandemic physical distancing regulations. Insomnia symptom severity (primary outcome), insomnia diagnosis by structured interview, self-reported sleep problems, as well as sleep parameters measured by diary and actigraphy were assessed pretreatment at 12-28 weeks gestation, 1-week posttreatment, and 6 months postpartum. Birth information (secondary outcomes) were collected via delivery record and parent report of infant sleep (exploratory outcome) was taken at 6 months postpartum. Multilevel modeling using an intention-to-treat approach showed that CBT-I was associated with a decrease in insomnia symptoms and improved sleep quality across time compared to treatment as usual. The CBT-I group had fewer diagnoses of insomnia posttreatment, but the difference did not reach statistical significance until 6 months postpartum. Participants with worse sleep quality at baseline benefitted substantially more from CBT-I vs treatment as usual waitlist. CBT-I delivered in pregnancy can reduce symptoms of insomnia and improve sleep quality, which could in turn minimize risk of negative consequences for birthing parent and infant health. Registry: ClinicalTrials.gov; Name: Sleeping for Two: RCT of CBT-Insomnia in Pregnancy; URL: https://www.clinicaltrials.gov/study/NCT03301727; Identifier: NCT03918057. MacKinnon AL, Silang K, Watts D, etal. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy. J Clin Sleep Med. 2025;21(2):365-376.

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.

The impact of socio-economic and educational level on psychological health of parents having children with Autism: Pre and Post Therapeutic Intervention

The impact of socio-economic and educational level on psychological health of parents having children with Autism: Pre and Post Therapeutic Intervention

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.

Initial Results of the Québec Resilience Project (QRP): a Longitudinal and Representative Population-Based Study of Children's Development Prior to and During the COVID-19 Pandemic (2017-2022).

The COVID-19 pandemic instigated changes in almost all aspects of youth's life. While numerous studies have been implemented to understand how these changes are related to youth's development, few concerned large representative samples. This study introduces the methodology and initial results of the Quebec (Canada) Resilience Project (QRP), a representative longitudinal study. The QRP encompassed three phases: (a) 2017 census survey assessing school readiness in kindergarteners before the pandemic (n = 83,335, aged 6years); (b) 2021 questionnaire study assessing family functioning during COVID-19-related lockdowns (n = 4524, aged 10years); and (c) 2022 questionnaire survey assessing children's school performance and mental health post-lockdowns (n = 8217, aged 11years). In total, 3871 children were assessed either by parents or teachers in the three phases. We explored factors associated with children school performance (maths, reading, and writing) and mental health (emotional, withdrawal, hyperactivity/impulsivity/inattention, and conduct problems symptoms). Population weights were estimated from census data to maintain the representativeness of the population. School readiness vulnerability in kindergarten and parental anxiety and depression during lockdowns were associated with both children's lower school performances and higher levels of all mental health symptoms post-lockdown. Loss in family income and parental difficulties in maintaining work-life balance during lockdowns were associated with children's lower school performance and higher levels of some mental health symptoms (emotional and hyperactivity/impulsivity/inattention) post-lockdown. The results underscore that pandemic-related disruptions were negatively associated with children's school performance, emphasizing the need for interventions in the school environment. Associations between pandemic-related disruptions and children mental health were less consistent yet emphasize the importance of parental mental health.

P-574. Extrapolating Expected Efficacy, Safety, and Pharmacokinetics (PK) of Dolutegravir/Lamivudine (DTG/3TC) in Pregnant People Living with HIV-1 from Pregnancy Data with Combination DTG and/or 3TC Antiretroviral Therapies

Abstract Background Minimizing fetal exposure to unnecessary drugs is a guiding principle during pregnancy. DTG/3TC has demonstrated efficacy, a high barrier to resistance, and a favorable safety profile. Data on DTG/3TC use in pregnant people living with HIV-1 are limited; however, safety and PK data for the individual components are extensive from DTG- and 3TC-containing 3-drug regimens (3DRs) as preferred regimens in pregnancy. Randomized trial data and PK from pregnant participants receiving DTG 3DRs or 2-drug regimens were used to extrapolate anticipated DTG/3TC efficacy, safety, and PK in pregnancy. Methods A literature review of articles, conferences, Antiretroviral Pregnancy Registry (APR) Interim Summary, and other non-interventional studies including DTG and/or 3TC in PubMed (Jan 1998-Nov 2023) using the search terms dolutegravir, lamivudine, and pregnancy was conducted. Efficacy, safety, PK, vertical transmission, and birth outcomes data were extracted. Clinical utility of DTG/3TC in pregnancy was evaluated in context of current perinatal treatment guidelines. Results Two studies evaluated DTG/3TC efficacy and safety in pregnancy: 30/31 (97%) participants maintained virologic suppression (&amp;lt; 50 c/mL); no vertical transmission occurred. Among 194 studies of DTG and 492 of 3TC, 3 randomized trials of DTG 3DR efficacy and safety in pregnancy were found. While DTG PK in pregnancy was generally lower and 3TC PK was slightly lower than postpartum, both were well above thresholds associated with efficacy in non-pregnant adults. Overall birth defect prevalence rate with DTG exposure at conception was 0.95% (16/1683, Tsepamo) and 0.88% (43/4902, Eswatini). The APR reported overall birth defect prevalence of 3.3% (32/957) with first-trimester and 5.3% (29/549) with second/third-trimester DTG exposure, which did not significantly differ from the population-expected rate (Metropolitan Atlanta Congenital Defects Program, 2.7%; Texas Birth Defects Registry, 4.2%). Conclusion DTG/3TC is anticipated to be similarly effective and tolerated for parental health and vertical transmission prevention with fetal exposure to fewer drugs. Pregnancy is not anticipated to significantly impact DTG/3TC exposure. DTG and 3TC are well tolerated with a well-established safety profile in pregnancy. Disclosures William R. Short, MD, Gilead: Grant/Research Support|Janssen: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Honoraria Parul Patel, MSW, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Gustavo Verdier, BSc, BPharm, MBA, ViiV Healthcare: Employee Ana Puga, MD, FAAP, AAHIVS, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Andrew Weber, MS, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Leigh Ragone, MS, GlaxoSmithKline: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time employee Eva Fernvik, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Vani Vannappagari, MBBS, MPH, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time Employee|ViiV Healthcare: Stocks/Bonds (Public Company) V. Paul DiMondi, PharmD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Clifford B. Jones, BSc MSc MB ChB, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee

Mamá Empoderada: study protocol for a pilot trial of a novel parenting and mental health prevention intervention for migrant mothers with young children at the Mexico-US border

IntroductionMigrant women in transit face high risk of developing mental health problems such as depression and anxiety, driven by gendered social-structural factors including violence, social isolation, migration uncertainty, limited access...

Neonatal unit admission and offspring mental health trajectories across childhood and adolescence: a nationally representative UK cohort study

ObjectiveTo investigate the associations between neonatal unit admission (NNU) and subsequent emotional and behavioural difficulties during childhood and adolescence.DesignLongitudinal general population cohort study.SettingThe Millennium Cohort Study: nationally representative UK-based cohort.ParticipantsAll...

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.

Utang na loob, perceived parental academic pressure and mental health status among Filipino college students

Utang na loob, perceived parental academic pressure and mental health status among Filipino college students

Parental Mental Health and Child Maltreatment in the COVID-19 Pandemic: Importance of Sampling in a Quantitative Statistical Study.

Results on parental burden during the COVID-19 pandemic are predominantly available from nonrepresentative samples. Although sample selection can significantly influence results, the effects of sampling strategies have been largely underexplored. This study aimed to investigate how sampling strategy may impact study results. Specifically, we aimed to (1) investigate if outcomes on parental health and child maltreatment during the COVID-19 pandemic from a convenience sample differ from those of a specific representative sample and (2) investigate reasons for differences in the results. In 2020, we simultaneously conducted 2 studies: (1) a web-based survey using a convenience sample of 4967 parents of underage children, primarily recruited via social media, and (2) a study using a quota sample representative of the German adult population with underage children (N=1024), recruited through a combination of telephone interviews and computer-assisted web interviews. In both studies, the same questionnaire was used. To evaluate the impact of sampling, we compared the results on outcomes (parental stress, subjective health, parental mental health, general stress, pandemic-related stress, and the occurrence of child maltreatment) between the 2 samples. To explain differences in the results between the 2 studies, we controlled for sociodemographic data, parent-related risk factors, and COVID-19-related experiences. Compared to parents from the quota sample, parents from the convenience sample reported significantly more parental stress (η2=0.024); decreased subjective health (η2=0.016); more anxiety and depression symptoms (η2=0.055); more general stress (η2=0.044); more occurrences of verbal emotional abuse (VEA; φ=0.12), witnessing domestic violence (WDV; φ=0.13), nonverbal emotional abuse (NEA; φ=0.03), physical abuse (φ=0.10), and emotional neglect (φ=0.06); and an increase of child maltreatment (VEA: exp(B)=2.95; WDV: exp(B)=3.19; NEA: exp(B)=1.65). Sociodemographic data, parent-related risk factors, and COVID-19-related experiences explained the differences in parental stress (remaining difference between samples after controlling for covariates: η2=0.002) and subjective health (remaining difference between samples after controlling for covariates: η2=0.004) and partially explained differences in parental mental health (remaining: η2=0.016), general stress (remaining: η2=0.014), and child maltreatment (remaining: VEA: exp(B)=2.05 and WDV: exp(B)=2.02) between the 2 samples. The covariates could not explain the difference in NEA (exp(B)=1.70). We discuss further factors that may explain the unexplained differences. Results of studies can be heavily impacted by the sampling strategy. Scientists are advised to collect relevant explaining variables (covariates) that are possibly related to sample selection and the outcome under investigation. This approach enables us to identify the individuals to whom the results apply and to combine findings from different studies. Furthermore, if data on the distribution of these explanatory variables in the population are available, it becomes possible to adjust for sample selection bias.

Parental and individual determinants of dental trust in children: a path analysis of a conceptual model

BackgroundUnderstanding the interactions among predictors of dental trust in children is important for designing effective interventions in pediatric dental care.AimThis study aimed to develop and validate a conceptual model to evaluate factors influencing dental trust in children.DesignThis cross-sectional study included 267 parent-child dyads. Data collection tools included a sociodemographic data form, the Turkish Oral Health Literacy Assessment Task (TOHLAT-P), the Dental Trust Scale (DTS), the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), and the Early Childhood Oral Health Impact Scale (ECOHIS). The conceptual model explored the factors influencing dental trust in children by incorporating endogenous and exogenous variables. Path analysis was conducted to test model fit.ResultsDental trust was significantly associated with parental oral health literacy (β = −0.20; P < 0.001), dental anxiety (β = −0.18; P < 0.001), and oral health-related quality of life (β = −0.15; P < 0.001). The path analysis confirmed the validity of the proposed model, showing significant pathways between these variables and dental trust in children.ConclusionsThis study presents a validated model illustrating the relationships between parental and child-related factors and dental trust in children. These findings underscore the importance of addressing these factors in clinical strategies to enhance dental trust and improve pediatric dental outcomes.