Parental Resources Research Articles

Parenting during the COVID-19 Lockdown in Portugal: Changes in Daily Routines, Co-Parenting Relationships, Emotional Experiences, and Support Networks.

The COVID-19 pandemic challenged parental resources pertinent to coping with lockdowns. The main objective of this work was to study parenting during the COVID-19 lockdown. Specifically at focus were parental behaviors concerning key domains for the family (daily routine, co-parenting, emotional experience, and support network) and changes related to the pandemic and associated with the parents’ employment statuses. An online survey was carried out through an ad hoc questionnaire where participants completed questions about their sociodemographic data and rated how much their family routines, their co-parenting relationship, their emotional experiences, and the support available in the family network varied on a 5-point scale. The participants included 1384 parents, of which 286 responded to open questions regarding impactful experiences during the lockdown. The results showed differences in daily routine, co-parenting, emotional experience, and support network according to the parents’ employment statuses. Between-group comparisons showed that at-home parents caring for children with governmental aids generally revealed more positive parenting behavior changes, while at-home parents who were teleworking reported more difficulties in parent-child activities and co-parenting. Furthermore, the content analysis of the data confirmed how important themes such as family dynamics, professional activities, and the relationship with the school community were throughout the participants’ accounts of gains and losses. Overall, parents’ employment statuses are associated with diverse experiences during lockdown. The COVID-19 pandemic highlighted the importance of family resources and parental resilience, particularly during circumstances jeopardizing the ever-sensitive work-family balance.

Improving Our Understanding of Medical Decision-Making Competence in Puberty Suppression.

Improving Our Understanding of Medical Decision-Making Competence in Puberty Suppression.

A Narrative Evaluation of a Grief Support Camp for Families Affected by a Parent's Suicide.

Background: Children of parents who suffer mental ill-health and die by suicide are vulnerable to developing psychological and social problems themselves; they also have a severely elevated risk of dying at a young age – particularly through suicide. This highlights the need to design supportive measures that can counteract such negative developments after a parent's suicide.Aim: This narrative evaluation of a grief support camp for families affected by a parent's suicide arranged by the non-profit organization Children's Rights in Society in Sweden investigates whether children [N = 11] and parents [N = 11] perceived their participation as meaningful and, if so, in what way, and the changes to which the program was said to have contributed.Methods: Family members were invited to reflect on their experiences in narratively structured interviews that took place 18 months after participation. Their narrated experiences were analyzed to examine how the program was integrated into their biographies and with what significance. Narratives of change were identified in particular in order to grasp the self-perceived effects of participation.Results: Both children and parents attributed major significance to their encounters with other suicide bereaved. This led to support exchange and normalization, which countered a perceived “suicide stigma” in everyday life. Help to narratively construct destigmatizing understandings of suicide was also said to have relieved self-blame and shame. Overall, the participants described changes in the form of a better-informed position in grief, increased manageability and enhanced family communication. The parents also reported improved ability to support their children and a more hopeful view of life ahead.Conclusion: The evaluation showcases how this psychoeducational intervention, at a relatively low cost compared to traditional approaches, has great potential to lessen the negative effects of a suicide in the family by assisting families with psychological processing and de-stigmatization. Parental resources are also strengthened, which can serve as continuing support for the children.

The Smart Money is in Cash? Financial Literacy and Liquid Savings Among U.S. Families

Most financial advisors recommend storing three to six months of expenses in liquid assets in case of an emergency. Yet we estimate that more than half of U.S. families do not have at least three months of their non-discretionary expenses in liquid savings. We find that financial literacy is strongly predictive of having three months of liquid savings, controlling for income, income variability, and even parental resources. We also find that financial literacy predicts liquid savings across the income distribution. These results indicate that accumulation of an emergency fund is not simply a function of income. Finally, financial literacy is predictive of liquid savings even among high illiquid wealth households. This suggests that the phenomenon of "wealthy hand-to-mouth" families may reflect financial mistakes rather than portfolio optimization. Our paper highlights the importance of financial knowledge in explaining families' preparedness to deal with unexpected expenses or disruption in their income.

Living with a child who has a life-limiting condition: The functioning of well-siblings and parents.

Living with a child who has a life-limiting condition (LLC) is likely to have a major impact on all family members. There is a need to have a clearer understanding of the nature and extent of this impact on parents and well-siblings. The current study aimed to investigate the psychosocial functioning of well-siblings and parents living with a child with an LLC. Further, the study aimed to assess the resilience resources of both well-siblings and parents, giving consideration to how these relate to psychosocial functioning. Participants included 48 well-siblings (6-21 years) and 42 parents of children with LLCs. Parents and well-siblings independently completed validated measures of child and adult functioning and personal resilience. Parents provided demographic information about the patient and family. The emotional, social and school functioning of well-siblings in the current study was found to be significantly poorer than published norms (all p's < .01). Parental self-reported depression, anxiety and stress scores were also all significantly poorer than published norms (all p's < .01). There was negligible agreement between well-sibling self-reported functioning and parental proxy-report of the well-siblings functioning (all r's < .126, all p's > .464). Sibling self-reported resilience was positively correlated with each of the measures of psychosocial functioning (all r's > .318, p's < .05). Parental resilience was significantly negatively correlated with depressive symptoms (r = -.369, p < .05) and anxiety symptoms (r = -.473, p < .01) but not stress scores (r = -.074, p = .644). Family members living with a child who has an LLC were found to have significantly poorer psychosocial functioning than published norms. Although one cannot infer a causal direction from the current study, greater self-reported well-sibling and parental resilience were associated with aspects of better self-reported psychosocial functioning. Future studies should assess the impact of psychosocial interventions aimed at enhancing the resilience and functioning of both well-siblings and parents.

Trust in medical professionals and its influence on the stress experience of parents of premature infants.

To examine parents' perceptions of stress and their trust in physicians and nursing staff and to investigate whether trust influences the parental perceptions of potential stressors resulting from their infant's hospitalisation in a neonatal intensive care unit. Parents of very and extremely low birth weight infants were surveyed in a nationwide retrospective cross-sectional study 6-18months after their child's birth. Parental stress was measured utilising the PSS:NICU_German/2-scales, and trust was measured by the scales Trust in Physicians and Trust in Nursing Staff. In addition to descriptive analyses, multiple linear regression models were conducted. The change in parents' anticipated roles was assessed as more stressful than their infant's appearance and behaviour. Trust in nursing staff significantly influenced the parental stress level. Although the level of trust in physicians was rated higher than trust in nursing staff, trust in physicians did not yield a significant effect on the parental stress experience. Efforts to foster parental trust in nursing staff may reduce the parental stress level and hence enable parents to better cope with the situation. The parental resources unleashed in this way can be employed to enhance parenting.

Rendering Multivariate Statistical Models for Genetic Diversity Assessment in A-Genome Diploid Wheat Population

Diversifying available natural resources to cope with abrupt climatic changes and the necessity to equalize rising agricultural production with improved ability to endure environmental influence is the dire need of the day. Inherent allelic variability regarding significant economic traits featuring both enhanced productivity and environmental adaptability is one such prominent need. To address this requirement, a series of analyses were conducted in this study for exploring natural diploid wheat germplasm resources. The current study involved 98 Recombinant Inbred Lines (RILs) populations developed by crossing two diploid ‘A’ sub-genome wheat species, Triticummonococcum and Triticum boeoticum, enriched with valuable alleles controlling, in particular, biotic and abiotic stresses tolerance. Their 12 phenotypic traits were explored to reveal germplasm value. All traits exhibited vast diversity among parents and RILs via multivariate analysis. Most of the investigated traits depicted significant (p &lt; 0.05) positive correlations enlightening spikelet per spike, total biomass, seed weight per spike, number of seeds per spike, plant height, and days to heading as considerably focused traits for improving hexaploid wheat. Principal component analysis (PCA) exhibited 61.513% of total variation with three PCs for 12 traits. Clustering of genotypes happened in three clades, and the two parents were separated into two extreme clusters, validating their enrichment of diversity. This study provided beneficial aspects of parental resources rich in diverse alleles. They can be efficiently exploited in wheat improvement programs focusing on introgression breeding and the recovery of eroded genetic factors in currently available commercial wheat cultivars to sustain calamities of environmental fluctuations.

Inequality of Educational Opportunities and the Role of Learning Intensity

Over the 2000s, many federal states in Germany shortened the duration of secondary school by one year while keeping the curriculum unchanged. The quasi-experimental variation arising from the staggered introduction of this reform allows me to identify the causal effect of increased learning intensity, the ratio of curricular content covered per year, on Inequality of Educational Opportunity (IEOp), the share in educational outcome variance explained by predetermined circumstances beyond a student’s control. Findings show that higher learning intensity aggravated IEOp due to parental resources becoming more important through support opportunities like private tuition, adapting to an intensified educational process. The effect is stronger for mathematics/science than for reading, implying the existence of subject-dependent curricular flexibilities. My findings underscore the importance of accounting for distributional consequences when evaluating reforms aimed at increasing educational efficiency and point to the role of learning intensity for explaining changes in educational opportunities influencing social mobility.

Interactions between parental and personal socioeconomic resources and self-rated health: Adjudicating between the resource substitution and resource multiplication theories

A small body of research has documented intriguing findings, mostly from the United States but also from Europe, which suggest that the positive health effects of socioeconomic resources in adulthood may be conditioned by socioeconomic circumstances in childhood. There are two competing theories in this literature. The first contends that socioeconomic resources have a stronger effect on adult health for people from disadvantaged backgrounds because socioeconomic resources in adulthood substitute or compensate for a paucity of health-related resources earlier in life. The second contends that socioeconomic resources have a stronger effect on adult health for people from advantaged backgrounds because socioeconomic resources in adulthood compound or multiply the health effects of socioeconomic resources earlier in life. We used survey data from the 2012 Longitudinal and International Study of Adults linked to current and historical income data from the Canada Revenue Agency to investigate interactions between parental and personal socioeconomic resources – education and income, treated separately – as predictors of self-rated health in a sample of Canadians aged 25 to 50. Consistent with the resource multiplication theory, we found that the presumed benefits of personal family income for self-rated health were stronger for women from wealthier backgrounds than for women from poorer backgrounds. We found no evidence to support either theory among men. Overall, none of the interactions involving the education of parents or their adult children reached statistical significance. Our results are indicative of the importance of distinguishing between education and income for adults and their parents when adjudicating between these two theories.

Cannabis education resources for parents: an environmental scan and critical content analysis in the context of legalization

Cannabis was recently legalized for adult use in Canada and many American states. In this context, there is a pressing need for educational resources – aimed at youth and their parents/caregivers – to reduce potential harm. However, little is known about the current state of such resources. This paper presents findings of an environmental scan, mapping and critically analyzing the present landscape of cannabis resources for parents/caregivers. We systematically searched the grey literature identifying English-language resources. Search terms included: youth, young people, child, adolescen*, teen*, train*, tool*, talk, engage*, educat*, involve*, family, parent, adult, caregiver, cannabis, marijuana, pot, weed, prevent*, and harm. Overall, 60 resources met the inclusion criteria. Most were developed in the United States (n = 37) and Canada (n = 19), with three from Australia and one from the United Kingdom. Of these, 42 (70%) were categorized as abstinence-based, 14 (23%) harm-reduction oriented, and 4 (7%) had an unclear approach. Few (10/59) consulted youth in their development and none explicitly included parent/caregiver input. Results can inform the development of new, more appropriate and accessible family-oriented resources – priority in a legalized context where cannabis conversations are shifting away from stigma and abstinence, towards pragmatic approaches with harm reduction goals.

Birth order and prosociality in the early adolescent brain

Birth order is a crucial environmental factor for child development. For example, later-born children are relatively unlikely to feel secure due to sibling competition or diluted parental resources. The positive effect of being earlier-born on cognitive intelligence is well-established. However, whether birth order is linked to social behavior remains controversial, and the neural correlates of birth order effects in adolescence when social cognition develops remain unknown. Here, we explored the birth order effect on prosociality using a large-scale population-based adolescent cohort. Next, since the amygdala is a key region for sociality and environmental stress, we examined amygdala substrates of the association between birth order and prosociality using a subset neuroimaging cohort. We found enhanced prosociality in later-born adolescents (N = 3160), and observed the mediating role of larger amygdala volume (N = 208) and amygdala-prefrontal functional connectivity with sex-selective effects (N = 183). We found that birth order, a non-genetic environmental factor, affects adolescent social development via different neural substrates. Our findings may indicate the later-born people’s adaptive survival strategy in stressful environments.

Examining an In-Home Behavioral Parent Training Protocol Among Parents Who Use Substances Involved Child Welfare: Effectiveness of SafeCare.

Given the detrimental impact of substance use (SU) on both parent and child outcomes including child maltreatment, research and service efforts have focused on incorporating parenting resources into integrated SU treatment programs. While promising, it is imperative to examine and test parenting programs in a variety of settings. This study examined whether SU moderated the relationship between treatment condition and parenting outcomes among parents who participated in SafeCare, and parent ratings of engagement, service satisfaction, and perceived cultural competency of services. Results indicated that SU did not moderate the relationship between treatment condition and abuse potential, but did moderate this relationship for depression and parental distress such that parents with higher levels of SU reported less improvement in depression and parental distress. Results underscore that SU problems may impact the effectiveness of SC on specific risk factors, such as depression and parental distress, potentially indicating unique treatment needs and the need to adapt interventions to ensure treatment success. In addition, this study found that SafeCare was not found to be beneficial for parents with SU problems above and beyond the treatment as usual condition. Finally, results indicated that parents with SU concerns and without SU concerns engaged very similarly in SafeCare.

Family Communication, Resources, and Income in Adolescence and Financial Behaviors in Young Adulthood

This research examined how parental communication and family resources provided during adolescence relate to domain-specific financial management behaviors for a sample of 1,245 young adults age 18–34. Using data collected by an online survey administration organization, bivariate analysis results indicated that higher levels of parental communication about proper consumer skills and tangible and intangible family resources were associated with better financial behaviors. Financial behaviors were also found to vary significantly across different levels of family income. Multivariate regression analyses revealed two noteworthy interactions in which intangible resources and financial behaviors varied by level of family income. Better financial behaviors in adulthood were associated with more intangible resources for middle- and upper-income families during adolescence. The reverse was indicated for young adults from lower income families. Control variables of education level, employment status, and gender also showed significance with financial behaviors.

Development of 4to24, a Transition Application for Parents of Students With Visual Impairments

Introduction This article focuses on the development of 4to24, an informational app for parents of students with visual impairments, with emphasis on obtaining stakeholder input, developing content, and establishing content validity. The app provides information, resources, and activities to help students, ages 4–24 years, prepare for independence and employment as an adult. Method App design and content development involved multiple phases of iterative design and writing. Stakeholder input was obtained via an advisory board and user focus groups with parents and students. Experts reviewed and validated content with ratings and recommendations on accuracy, age-appropriateness, and relevance. Results Advisory board members identified important domains to address in 4to24 including social skills, technology, travel skills, health and fitness, independent living, career education, and self-determination. They recommended focusing on elevating parents’ expectations and confidence in supporting and teaching their children. Focus group participants recommended accessibility, ease of use, and relevant information to make the app appealing to users. The content validation process supported the content’s relevance, accuracy, and age-appropriateness and resulted in a final count of 410 informational modules. Discussion Parent involvement and expectations are critical to students’ preparation for future employment. 4to24 provides support for parents to collaborate with service providers and reinforce concepts and skills outside of school. Development of the app technology and its large volume of content required a full 5-year process. Implications for practitioners Lessons learned from this project can inform future resource development projects, including recommendations to start small and define goals early in the process. The 4to24 app is a new resource for parents of students with visual impairments that can supplement services provided by professionals.

Beyond overwhelmed: A new measure of the functional impact of toxic stress on parents of young children

This study investigates the reliability and construct validity of the Functional Impact of Toxic Stress for Parents (FITS-P) measure in an online crowdsourced pilot sample (n = 202) and a pediatric clinic sample (n = 889). The objective of the FITS-P is to provide a low burden (i.e., four items) measure for capturing aspects of the parental side of the toxic stress equation, specifically defining toxic stress as being severe enough to go beyond feelings of overwhelm to functional impairment in major domains of life. Patterns of item endorsement were analyzed in both samples, and construct validity was assessed in the clinic sample in relation to a series of measures of parental stress and psychological resources also administered to parents. Overall, analyses supported reliability and validity, and suggest utility of this new measure. Most importantly, it was found that only a single FITS-P item endorsed was sufficient to produce a significant increase in risk for most of the construct validity measures. This suggests that, as hoped, functional impact may capture parental variance in the toxic stress constellation more efficiently and effectively than typical methods such as life event stress, adverse childhood experiences, or perceived stressfulness of only the parenting role. Results are discussed in terms of the promise of the FITS-P as a low-burden assessment that can be used in two-generational approaches to ameliorating toxic stress.

97 Decreasing invasive urinary tract infection screening in a paediatric emergency department: A quality improvement initiative

Abstract Primary Subject area Emergency Medicine - Paediatric Background Fever is a common presentation among children coming to the Emergency Department (ED) and a urinary tract infection (UTI) often needs to be excluded. Sterile techniques, like catheterization, are invasive, can be traumatizing to children, and are time consuming to complete. A two-step approach has been shown to reduce the catheterization rate in febrile, young children without unintended consequences. Objectives Our aim was to implement a two-step approach for UTI screening in febrile children 6-24 months in order to decrease unnecessary urine catheterizations by 50% without impacting ED length of stay (LOS) or return visits (RVs). Design/Methods After engaging key stakeholders and a nursing champion, we created a process map to understand the current urine collection process in our ED, and areas for targeted improvement. Using the model for improvement, we adopted a 2-step pathway for a suspected UTI in children 6-24 months as our change idea. The pathway involved identifying children who met inclusion criteria for UTI screening, followed by urine bag application and urinalysis (UA) if clinically indicated. Only if the UA was positive, a second urine sample was collected via catheterization, for repeat UA and culture. Through multiple PDSA cycles, our pathway was implemented in the ED along with concurrent staff education. The outcome measure was the rate of ED urine catheterizations. Process measures included the total number of urine cultures sent to microbiology and percent positivity. The balancing measures included ED LOS and RVs. Results Since project initiation in July 2019, the ED catheterization rate decreased from 73% to 53% (Figure 1) and the number of urine cultures sent to Microbiology decreased by 23%. The number of urine cultures sent to Microbiology decreased by 23% with a mild improvement in the positivity rate by 2% (Figure 2). There was no significant change in RVs. There was a slight 10-min increase in ED LOS, most likely confounded by the COVID pandemic. Conclusion Using improvement methodology, we successfully decreased the number of unnecessary catheterizations in children and the number of urine cultures sent to microbiology. Further refinements to our intervention are ongoing and include optimizing urine screening equipment in patient rooms, poster reminders, re-education for providers, and introducing a parent resource explaining the 2-step pathway. This improvement work is also being spread to the paediatric wards and can easily be adopted by other paediatric centres. It has also been adapted by the Choosing Wisely hospital campaign.

My body, my decision: the lived experience of young people with a variation in sex characteristics in New Zealand

Abstract Background Young people born with a variation in sex characteristics (VSC), or disorders of sex development (DSD) face numerous challenges in navigating issues relating to identity and to their lived and embodied experience. There is limited research amplifying the voices of young people with a VSC in the literature, especially in Aotearoa/New Zealand. There has been issues raised from a Humans Rights perspective which public health forums are yet to address. Methods This original qualitative study provides an up-to-date picture of the lived experiences of 10 young people with a VSC in Aotearoa/New Zealand using face to face interviews and thematic analysis. The research was conducted in collaboration with the advocacy group, Intersex Youth Aotearoa, and explored the level of support provided by health services, peers and advocacy groups in relation to the ways the participants viewed themselves and their bodies, and their health related decision-making. Results Our research reveals the pressure on young people with a VSC to conform to cultural and societal norms, specifically, heteronormative and traditional constructs of how male and female bodies should look prevalent within Aotearoa/NZ society. Such views, often held and perpetuated by health professionals and parents, contributed to the complexities surrounding identity, agency and acceptance of difference experienced by these young people. Young people wanted the right to bodily autonomy. Conclusions Implications of these findings are: better public education of VSC, development of resources for parents and young people and advocacy for psychological and peer support systems for young people.

Developing an educational resource for parents on pediatric catheter-associated urinary tract infection (CAUTI) prevention

BackgroundPediatric catheter-associated urinary tract infection (CAUTI) prevention guidelines encourage family engagement; however, there is a dearth of research on parent-facing CAUTI prevention resources. We aimed to meet the learning needs of parents about CAUTI prevention in the hospital by developing and refining an educational pamphlet with parents. MethodsPhase 1: We compiled existing evidence from CAUTI prevention guidelines and conducted a focus group with parents to form learning objectives. Phase 2: We developed prototype design elements, tested initial designs with a survey, and conducted qualitative participatory design sessions with parents to iteratively refine the pamphlet until design saturation was reached. ResultsWe identified the following key themes and preferences: (1) Clear boundaries for engagement (e.g., parents would not be emptying the catheter); (2) Positive, actionable framing (e.g., what should proper catheter positioning look like?); (3) What to expect (e.g., is the catheter painful for my child?); (4) Parents considered both their and their child's comprehension of the content when providing feedback. ConclusionsOverall, we demonstrated the utility of remote participatory design methods in developing and refining a CAUTI prevention resource based on parents’ preferences. Future research should consider adapting these methods and implementing formal evaluation for comprehension for eventual integration into clinical practice.

Associations between women's empowerment and child development, growth, and nurturing care practices in sub-Saharan Africa: A cross-sectional analysis of demographic and health survey data.

Approximately 40% of children 3 to 4 years of age in low- and middle-income countries have suboptimal development and growth. Women's empowerment may help provide inputs of nurturing care for early development and growth by building caregiver capacity and family support. We examined the associations between women's empowerment and child development, growth, early learning, and nutrition in sub-Saharan Africa (SSA). We pooled data on married women (15 to 49 years) and their children (36 to 59 months) from Demographic and Health Surveys that collected data on child development (2011 to 2018) in 9 SSA countries (N = 21,434): Benin, Burundi, Cameroon, Chad, Congo, Rwanda, Senegal, Togo, and Uganda. We constructed a women's empowerment score using factor analysis and assigned women to country-specific quintile categories. The child outcomes included cognitive, socioemotional, literacy-numeracy, and physical development (Early Childhood Development Index), linear growth (height-for-age Z-score (HAZ) and stunting (HAZ <-2). Early learning outcomes were number of parental stimulation activities (range 0 to 6) and learning resources (range 0 to 4). The nutrition outcome was child dietary diversity score (DDS, range 0 to 7). We assessed the relationship between women's empowerment and child development, growth, early learning, and nutrition using multivariate generalized linear models. On average, households in our sample were large (8.5 ± 5.7 members) and primarily living in rural areas (71%). Women were 31 ± 6.6 years on average, 54% had no education, and 31% had completed primary education. Children were 47 ± 7 months old and 49% were female. About 23% of children had suboptimal cognitive development, 31% had suboptimal socioemotional development, and 90% had suboptimal literacy-numeracy development. Only 9% of children had suboptimal physical development, but 35% were stunted. Approximately 14% of mothers and 3% of fathers provided ≥4 stimulation activities. Relative to the lowest quintile category, children of women in the highest empowerment quintile category were less likely to have suboptimal cognitive development (relative risk (RR) 0.89; 95% confidence interval (CI) 0.80, 0.99), had higher HAZ (mean difference (MD) 0.09; 95% CI 0.02, 0.16), lower risk of stunting (RR 0.93; 95% CI 0.87, 1.00), higher DDS (MD 0.17; 95% CI 0.06, 0.29), had 0.07 (95% CI 0.01, 0.13) additional learning resources, and received 0.16 (95% CI 0.06, 0.25) additional stimulation activities from their mothers and 0.23 (95% CI 0.17 to 0.29) additional activities from their fathers. We found no evidence that women's empowerment was associated with socioemotional, literacy-numeracy, or physical development. Study limitations include the possibility of reverse causality and suboptimal assessments of the outcomes and exposure. Women's empowerment was positively associated with early child cognitive development, child growth, early learning, and nutrition outcomes in SSA. Efforts to improve child development and growth should consider women's empowerment as a potential strategy.

The Challenges and Resources of Adoptive and Long-Term Foster Parents of Children with Trauma Histories: A Mixed Methods Study

Adoption can be an important protective factor for foster children; however, if adoptive parents are not adequately prepared to deal with trauma-based difficulties, such children remain at risk for negative outcomes. The present study used mixed methods to access the lived experiences of parents adopting children from foster care. Results indicated that adopted children’s behavioral difficulties strongly contributed to parental stress. However, number of resources did not moderate the relation between child behavior problems and parenting stress, and parents reported that some "resources" promoted stress. Results have important implications for interventions with such parents.