Positive Parenting Strategies Research Articles

A pragmatic trial of a family-centered approach to childhood obesity treatment: Rationale and study design

BackgroundFamily-based behavioral treatment (FBT) is an effective intensive health behavior and lifestyle treatment for obesity reduction in children and adolescents, but families have limited access. The purpose of this randomized, pragmatic, comparative effectiveness trial was to examine changes in child relative weight in a 12-month, enhanced standard of care (eSOC) intervention combined with FBT (eSOC+FBT) vs. eSOC alone. MethodsChildren aged 6 to 15 years with obesity, and their primary caregiver, were recruited from primary care clinics. Families were randomized 1:1 to eSOC, a staged approach led by the primary care provider that gradually intensified dependent on a child's response to care and aligns with the American Medical Association guidelines, or the eSOC+FBT arm, which included regular meetings with a health coach for healthy eating, physical activity, positive parenting strategies, and managing social and environmental cues. Both treatments align with the 2023 American Academy of Pediatrics clinical practice guidelines. Assessments occurred at baseline, midpoint (month 6), end-of-intervention (month 12), and follow-up (month 18). Primary outcome was change from baseline to 12 months in child percent overweight (percentage above the median body mass index in the general US population normalized for age and sex). Secondary outcomes were parent weight, child psychosocial factors, heterogeneity of treatment effects, and cardiometabolic risk factors. Exploratory outcomes assessed reach, effectiveness, adoption, implementation, and maintenance. ConclusionThis pragmatic trial will generate evidence for the comparative effectiveness of implementing two guidelines-based approaches in primary care for obesity reduction in children and adolescents.Trial registration:ClinicalTrials.gov Identifier: NCT03843424

The efficacy of an evidence-based parenting program in preventing child maltreatment in mainland China

BackgroundThere is limited evidence regarding the effectiveness of online parenting programs for preventing child maltreatment in low- and middle-income countries. Therefore, this study aimed to examine the effectiveness of the online Parenting for Lifelong Health for Young Children (PLH-YC) program in preventing child maltreatment among Chinese families specifically. MethodsA quasi-experiment was conducted, wherein 274 parents with children aged 2–9 years were assigned to either the online PLH-YC group (n = 135) or a waitlist control group (n = 139). Data were collected at baseline and one week after intervention. A difference-in-differences (DiD) design with propensity score weighting was used to estimate the between-group difference for child maltreatment as well as the associated risk and protective factors. ResultsCompared to the parents in the control group, parents in the online PLH-YC intervention reported a significant reduction in the occurrence of corporal punishment (b = −1.21; 95 % CI [−2.37, −0.03]), emotional abuse (b = −3.09; 95 % CI [−5.36, −0.82]), and general maltreatment (b = −4.94; 95 % CI [−8.86, −1.02]) as well as an increased frequency of positive parenting strategies (b = 6.46; 95 % CI [2.21, 10.72]). Additionally, parents with high levels of depressive symptoms were significantly more likely to drop out of the program, and those with lower education levels engaged in fewer sessions. ConclusionThe online PLH-YC program can benefit families with young children by reducing the incidence of child maltreatment through improved positive parenting strategies. More randomized controlled trials with long-term follow-ups are required to further verify the accuracy of the results obtained in this study.

Associations between nature exposure, screen use, and parent–child relations: a scoping review protocol

BackgroundToday’s youth are growing up in an evolving digital world, and concerns about the potential detrimental effects of excessive screen use on biopsychosocial outcomes in childhood are mounting. Parents worry about the impacts of screen-use on their children’s wellbeing but at the same time frequently fail to meet their own ideal screen time limits regarding their children’s screen use. There is an opportunity to shift research focus away from inflexible and often unrealistic childhood screen time guidelines towards exploration of positive parenting strategies that may have multiple beneficial and significant effects on children’s screen-related outcomes. An emerging body of literature suggests that screen time and nature exposure act on psychosocial outcomes in contrasting ways. There is evidence to suggest that exposure to natural environments may counteract some of the potential negative psychosocial effects of excessive screen use; however, this relationship is poorly understood. The overarching aim of this scoping review is to source, categorise, and synthesise existing research exploring the associations between nature exposure, screen use, and parenting across childhood.MethodsThis mixed-methods systematic scoping review will be conducted following Arksey and O’Malley’s framework with methodological enhancements from Levac and associates and recommendations from the Joanna Briggs Institute’s methodological guidance for conducting scoping reviews. Five electronic databases will be searched from August 2022 onwards. Two reviewers will independently screen titles, abstracts, and full-text articles. Peer reviewed articles related to the constructs of nature exposure, screen use, and parent/child relations will be considered in the context of early to late childhood. Study characteristics will be collated using a data charting tool collaboratively developed by the research team. Evidence will be presented using tabular and textual form and described using qualitative thematic analysis.DiscussionThis review will gather information about how key definitions are conceptualised, defined, and measured across the literature and map existing trends and areas for future research. It is intended that this review will inform and guide future research direction, recommendations, and programs aimed at supporting parents to navigate the challenges of parenting in a digital age.OSF registrationhttps://doi.org/10.17605/OSF.IO/TFZDV

The effectiveness of parent-Child observation in parent-Mediated programmes for children with developmental disabilities and externalizing disorders: A systematic review and meta-analysis.

This systematic review evaluated the treatment effects of communication-focused parent-mediated interventions (CF-PMT), a form of intervention that involves therapists observing parent-child interactions and giving feedback to parents on how they can practice positive parenting strategies to prevent or reduce externalizing behaviours in children with developmental disabilities. A literature search was conducted on three electronic databases. To be included in the review, studies had to: evaluate CF-PMT where therapists give feedback after observing parent-child interactions; examine changes in externalizing behaviours amongst children with any forms of developmental disability; and adopt a randomised controlled trial study design. Fifteen studies met eligible criteria for the literature review, of those, 13 studies had available data on changes in the primary (child externalizing behaviours) and secondary outcomes (parental stress, child linguistic abilities and child social responsiveness). We found significant treatment effects for CF-PMT in reducing child externalizing behaviours (d = -.60) but not for any of the secondary outcomes. A sensitivity analysis showed a small but significant treatment effect for parental stress (d = -.18). Considerable bias was observed due to the lack of available information reported by studies on aspects measured by the Mixed Methods Appraisal Tool. Overall, we found evidence to support the benefits of complex interventions which incorporate direct parent-child observations and feedback to improve behavioural outcomes amongst children with developmental disabilities.

An Assessment of Trends in Parenting and Child Outcomes in a Rural South African Community and Consequent Intervention Design

The high prevalence of child maltreatment requires innovative, scaleable solutions. Three community-wide surveys (2012, 2013, and 2016) in Touwsranten, South Africa, assessed parents’ positive parenting and corporal punishment; their mental health, substance misuse, parenting stress and intimate partner violence; children’s mental health; and interest in parenting support, in preparation for an intervention to support positive parenting. The first two surveys followed parents longitudinally. Focus group discussions were also held in 2017. Across surveys one and two, corporal punishment and positive parenting were reported as frequent. Child and parent mental health problems, parenting stress, intimate partner violence, and risky alcohol use increased across surveys 1 and 2 and remained steady at the third survey. Survey 3 revealed no change in corporal punishment, parent or child mental health, or intimate partner violence; reports of risky alcohol use and parenting stress increased; and there was a small increase in use of positive parenting strategies. Qualitative data suggested that corporal punishment, alcohol use, and intimate partner violence may have been under-reported. Parents indicated a desire for parenting support. The consequent intervention design included the delivery of four parenting programs alongside a social activation process intended to amplify the message of parenting programs, with the intention of increasing positive parenting and reducing corporal punishment community-wide.

Environmental predictors of children’s executive functioning development

ABSTRACT Executive functioning (EF) abilities develop through childhood, but this development can be impacted by various psychosocial environmental influences. Using longitudinal data from the Health Outcome and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort study, we examined if psychosocial environmental factors were significant predictors of EF development. Study participants comprised 271 children and their primary caregivers (98.5% mothers) followed from birth to age 12. We identified four distinct EF developmental trajectory groups comprising a consistently impaired group (13.3%), a descending impairment group (27.7%), an ascending impairment group (9.95%), and a consistently not impaired group (49.1%). Higher levels of maternal ADHD and relational frustration appear to be risk factors for increased EF difficulty over time, while higher family income may serve as a protective factor delaying predisposed EF impairment. Important intervention targets might include teaching positive and effective parenting strategies to mothers whose children are at risk for EF dysfunction.

Need Analysis of Parenting Application Based on Riau Malay Culture

The role of parents in children’s lives has always been significant, but in today’s changing world, parents face new challenges brought about by shifts in society and technology. This study aims to analyze parents’ specific needs for parenting information delivered through technology. The research utilized survey methods and gathered data from 62 parents with children aged 0-6 years in three districts of Riau Province: Pekanbaru, Kampar, and Indragiri Hilir. The analysis of the collected data reveals that most parents prefer digital resources for obtaining parenting information, with Android being the most commonly used platform. The most sought-after information by parents includes positive parenting strategies, interaction skills, and effective communication techniques. Furthermore, parents show a preference for visual and video content when receiving parenting information. It is noteworthy that 51.5% of parents have already utilized parenting applications, but a significant majority (82.3%) remain unaware of any parenting applications based on Riau Malay culture. Parents express the desire for Malay cultural values, which are closely associated with Islam, to be integrated into parenting practices, as it is believed that this approach can effectively instil Islamic values in children.

The Impact of Maternal Depression on Internet-Parent–Child Interaction Therapy for Child Attention-Deficit/Hyperactivity Disorder: A Case Study

Conduct disorders and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid, with an estimated prevalence rate of 51.5% for children between 2–17 years of age (Centers for Disease Control and Prevention, 2020). Parent–Child Interaction Therapy (PCIT) is an empirically supported behavioral parent training program for children with disruptive behavior. PCIT research consistently demonstrates decreases in disruptive behaviors and increases in positive parenting strategies among families of young children with ADHD; however, PCIT has yet to become widely recognized as a treatment for ADHD. This case study presents the treatment of a 6-year-old boy with ADHD and severe behavior problems. The case was further impacted by the single mother’s depressive symptoms and internet delivery of PCIT during the COVID-19 pandemic. Findings from this case report documented an improvement in disruptive child behaviors and emotion regulation and increased positivity during parent–child interactions, despite worsening maternal depressive symptoms. This case study highlights the utility of PCIT to improve child disruptive behaviors and ADHD symptoms in the midst of several complicating factors.

Parental Divorce Process and Post-Divorce Parental Behaviors and Strategies: Examining Emerging Adult Children's Attachment-Related Anxiety and Avoidance.

The main goal of this study was to examine the role of parental behaviors during both the process of divorce and the post-divorce period on emerging adult children’s attachment-related anxiety and avoidance. Specifically, we analyzed how recalled coparental respect and cooperation, interparental conflict, positive parenting strategies, and both parents’ emotional state and instability from adult children’s perspective during the divorce process and the post-divorce period were associated with emerging adult children’s current attachment representations. Our sample consisted of 173 emerging adults (Mage = 22.01). The results of this study demonstrate that paternal coparental respect and cooperation along with freedom provided by the mother to talk about the father during the divorce process and post-divorce period were both related to lower attachment-related avoidance. Our findings also confirm a significant link between some paternal positive attitudes during the divorce process (i.e., freedom provided by the father to talk about the mother) and low attachment-related anxiety. Overall, the results of this research confirm that beyond divorce perse, several variables surrounding the divorce process better explain variations in adult children’s attachment representations, which contribute to better comprehending the effects of parental divorce.

SEEMe Therapeutic Playgroup for Parent-Child Interaction and Social-Emotional Growth: Effectiveness and Feasibility for Early Intervention

Abstract Date Presented 03/31/2022 Therapeutic playgroups have potential to benefit families and children enrolled in early intervention. Results indicate improvements in parent efficacy and parent-child interaction (affection and responsiveness) after participation. Parents and providers report improvements in engagement and social interaction. This session explores the role of the OT in therapeutic playgroup teaming and the importance of the play environment to support positive parenting strategies. Primary Author and Speaker: Sarah Fabrizi

Externalizing and Internalizing Behaviors in Children with ADHD during Lockdown for COVID-19: The Role of Parental Emotions, Parenting Strategies, and Breaking Lockdown Rules.

Lockdown experience for COVID-19 pandemic significantly affected children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) exacerbating or promoting the onset of externalizing and internalizing symptoms. However, few studies have considered how externalizing and internalizing behaviors changed in relation to parental emotions and parenting strategies. In the present study, 992 caregivers of children and adolescents with ADHD from 5 to 18 years were presented with an online survey evaluating youths’ externalizing and internalizing behaviors, their non-compliance with lockdown rules, and parental factors related to parental emotions and parenting strategies. Two hierarchical linear regression models were performed to examine the contribution of children’s non-compliance with lockdown rules, parental emotions, and parenting strategies on children’s externalizing and internalizing behaviors. Results revealed that externalizing behaviors were higher in children and adolescents with ADHD non-compliant with lockdown rules. Moreover, positive parenting strategies moderated the relationship between non-compliance with lockdown rules and externalizing behaviors. Differently, higher internalizing behaviors were observed in children with ADHD who had parents reporting more negative emotions and positive parenting strategies. In this case, parents’ negative emotions had a moderator effect in the association between internalizing behaviors and non-compliance to lockdown measures. The clinical implications of these two different patterns of relations are discussed.

Parenting Behaviors and Parental Stress Among Foster Parents

While associations between child behavior, parenting behaviors, and foster parent stress have been established, a more nuanced understanding of the relationship between parenting behaviors and parental stress in foster parents is needed. This study included a convenience sample of 65 licensed foster caregivers from across the United States to address the following research question: is there an association between foster parenting behaviors and parental stress? Separate models were run for (a) adaptive parenting behaviors (involvement, positive parenting) as it relates to parenting stress and (b) maladaptive parenting behaviors (poor monitoring/supervision, inconsistent discipline, and corporal punishment) and parental stress. Results indicated that higher levels of parental involvement with children were associated with lower levels of parental stress. For maladaptive parenting behaviors, it was identified that more inconsistent discipline and higher endorsement of corporal punishment as a discipline strategy were associated with higher levels of stress, however, poor monitoring was not found to be associated with levels of stress in this model. Results support the importance of training foster parents in positive parenting strategies or intervening with foster parents who may endorse more negative forms of behavior modification.

Army home visitors’ implementation of military family violence prevention programming in the context of the COVID-19 pandemic.

The Army New Parent Support Program (Army NPSP) provides home visitation services that promote positive parenting strategies and aims to prevent family violence for expectant military parents and military families with children from birth to age 3. Since the onset of the novel coronavirus (COVID-19), Army NPSP services have rapidly adapted to a telehealth model to fit with the suggested practices of physical distancing. Employing a grounded theory approach, nine virtual focus groups with 30 Army NPSP home visitors across eight installations were conducted to examine how this rapid shift has impacted their services, practice, and professional role. The present study identified two overarching themes: (1) working with families (e.g., continued engagement with families, increased communication, shifting family needs) and (2) adjusting to telework (e.g., technology, professional collaboration and communication, professional growth). Findings from these focus groups indicated that home visitors were actively engaged with their clients and experienced both challenges and benefits of telehealth. While the rapid transition was a big change, and home visitors missed the face-to-face interactions, they expressed that they were adapting and improving their virtual service delivery with time. Increased concerns regarding families' well-being due to social and physical isolation, increased symptoms of anxiety and depression, and grief for losses due to COVID-19, along with the ability to continue connections with these highly mobile families, points to the importance of telehealth as a means to implement parenting programs vital to military family well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Effects of the COVID-19 Pandemic on Parental Burnout and Parenting Practices: Analyses Using a Retrospective Pretest

Background Many of the conditions of the COVID-19 pandemic were consistent with factors shown to be predictive of parental stress and burnout. The purpose of the current study was to use a retrospective pretest method to gain an understanding of the effects of the COVID-19 pandemic on levels of parental burnout and on parenting practices. Method A brief survey was conducted using a retrospective pretest method to examine parental burnout (The Parental Burnout Assessment, Roskam et al, 2018) and parenting practices (The Alabama Parenting Questionnaire, Frick, 1991). The survey asked parent participants to answer questions about their experiences before and during the pandemic. Results Findings indicated that the pandemic had a significant impact on parents, increasing overall levels of parental burnout and impacting parenting practices by reducing use of positive parenting strategies and increasing use of inconsistent discipline and corporal punishment. These changes in parenting practices were even more pronounced for parents whose levels of parental burnout moved from “normal” levels before the pandemic to clinical levels during the pandemic. Conclusion The findings of the current study suggest that the COVID-19 pandemic has had a negative impact on levels of parental burnout and parenting practices. Although additional research is needed, the results suggest that there is a need for clinicians to understand the effects that the pandemic may have had on parents and families with an understanding that families may be at ongoing risk despite a relaxation of COVID-19 restrictions.

Children's behavioral problems, screen time, and sleep problems' association with negative and positive parenting strategies during the COVID-19 outbreak in Brazil

Families' health, safety, and economic stability were jeopardized during the pandemic. Parental stress is a risk factor for hostile and less supportive parenting. Parenting styles are a set of attitudes, feelings and behaviors related to parenting that modulate the child's psychosocial functioning and might impact on the adaptability to a stressful time. ObjectiveTo investigate the group differences among children raised by negative and positive parenting families during COVID-19 pandemic. MethodsWe have done an online survey with 329 parents. Parents answer about parenting strategies and styles, children's behavior, Covid related questions, socio-economic information, sleep and gaming disorders. ResultsParents' frequent use of negative strategies were a risk factor to have a negative outcome related to mental health, games, sleep, and children behavior. DiscussionParenting strategies are some targets pointed in this study for intervention. Parents' styles and strategies training to better manage children might be even more important to avoid negative consequences for children in stressful times.

Long-term cross-over effects of the family check-up prevention program on child and adolescent depression: Integrative data analysis of three randomized trials.

The present study examined prevention effects of the family check-up (FCU) prevention program on longitudinal changes in youth depression, using harmonized data collected across three prevention trials, including one trial initiated in early childhood and two initiated in early adolescence (total N = 2,322). Data from parent and youth reports of youth depression were harmonized using Moderated Nonlinear Factor Analysis (MNLFA), which provides a robust means to examine differential item functioning (DIF) across subgroups of participants (e.g., age groups, ethnic groups), and creates scale scores based on all available items while accounting for individual differences. Long-term intervention effects were tested using a multi-informant growth model examining changes in depression from baseline to up to 14-year postbaseline. Across trials, significant long-term effects of the FCU on reductions in depression were observed, although effects were found to wane after approximately 10 years. FCU effects on depression across trials were attained with a relatively brief parenting program designed to reduce behavior problems and improve relational functioning that emphasized parental motivation to change while supporting positive parenting strategies. Implications of these results are discussed, along with directions for future work in this area. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Moderating Effects of the Families Improving Together (FIT) for Weight Loss Intervention and Parenting Factors on Family Mealtime in Overweight and Obese African American Adolescents.

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child’s weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent’s weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.

Supporting Positive Parenting and Promoting Healthy Living through Family Cooking Classes.

Background: The family is an important setting in the promotion of child health. The parent–child relationship affects the social and health development of children, and children’s healthy behaviors are associated with positive parenting strategies. The parent–child relationship is bi-directional and the connection between parenting and child health is complex. However, few parenting interventions work with parents and children together, and more knowledge is needed on how to develop and implement interventions promoting healthy parent–child relationships. Focusing on a family cooking class program, this study addresses how community initiatives engaging parents and children together can contribute to integrating parenting support with local health promotion. Methods: Participant-driven photo-elicited interviews (nine families), focus group evaluations (nine parents/14 children) and observations during cooking classes (10 classes) were applied to analyze the tools and mechanisms that can support positive parenting. Results: The study found that visual, practical and sensory learning techniques, applied in a context-sensitive learning environment that ensured guidance, safety and a friendly social atmosphere, contributed to positive parent–child interaction and bonding. Conclusion: The cooking program facilitated parenting practices that support child involvement and autonomy. Thus, the program constituted an effective intervention to strengthen parent–child relationships and positive parenting.

Engagement with a Multi-Component, Preventative Program to Reduce Child Maltreatment: Program Satisfaction and Acceptability

The development and implementation of interventions to prevent child maltreatment (CM) is particularly challenging in view of the numerous stressors experienced by families within the child welfare system (CWS). Difficulties engaging families, particularly those who are most vulnerable, can lead to lower program dose and poorer outcomes. This qualitative study, conducted as part of a larger process evaluation, explored participant perspectives of a newly developed, multi-component, community-based intervention designed to reduce the risk of CM in families with young children. The study involved one-to-one interviews with a sub-sample of mothers (n = 12) recruited through statutory and community-based social work services. Several brief program satisfaction questionnaires were also completed by parents. Mothers reported a stronger parent–child bond and greater use of positive parenting strategies (e.g. improved communication and discipline strategies) following the intervention. Facilitator and group support emerged as strong themes throughout the interviews and were important factors in facilitating engagement and reducing drop-out. High levels of program satisfaction were also reported. The study findings demonstrate how a multi-component program, which combines an evidence-based treatment (EBT) with community-based supports, may offer a promising approach for social work practitioners in reducing CM and in better meeting the more complex needs of families within the CWS. However, a more thorough understanding of the factors which promote program engagement and retention, is crucial to maximizing the benefits of interventions designed to support more vulnerable families.

Does Parenting Explain the Link Between Cumulative SES Risk and Child Problems in the Context of Parental Depression?

The accumulation of socioeconomic stressors, such as being a single parent and having a limited income, is associated with childhood maladjustment and prospective poor health. Evidence suggests both positive and negative parenting strategies (e.g., warmth and praise; criticism and neglect) may account for the relationship between socioeconomic adversity and child outcomes. However, despite the common co-occurrence of parental depression and socioeconomic stress, models of cumulative socioeconomic risk and parenting have yet to be tested in parents who are also coping with depression. In a sample of children whose parents have a history of depression, this study extends findings from a previous report (i.e., Sullivan et al. in J Fam Psychol 33:883-893, 2019) to test whether behavioral observations of parenting account for the association between a cumulative risk index of socioeconomic stress and child psychological problems in the same sample of 179 children (Mage = 11.46 years, SDage = 2.00) of parents with depression. Both positive and negative parenting accounted for the relationship between socioeconomic risk and both child- and parent-reported externalizing problems, whereas no evidence emerged for parenting accounting for the relation between cumulative risk and internalizing problems. This study highlights the central role socioeconomic stress plays in child maladjustment among parents coping with depression, as well as how parenting may be a critical mechanism linking socioeconomic stress and child externalizing problems.