Suboptimal Parenting Research Articles

Association between parents’ perceived social support and children’s psychological adjustment: a cross-sectional study

BackgroundThis study examined the relationship between parents’ perceived social support and their children’s psychological adjustment.MethodsThis cross-sectional survey study was conducted in 52 kindergartens and 78 preschools in Nagoya, Aichi, a major metropolitan area in Japan. Parents of eighth-grade children aged 13–14 years (N = 1,195) completed a questionnaire. A total of 602 valid responses were received. To accurately assess the relationship between parents’ perceived social support and behavioral characteristics, respondents diagnosed with a developmental disability or who failed to answer the required questionnaire items were excluded from the analysis. Consequently, 536 (89.0%) of the 602 participants met the eligibility criteria.ResultsThe results indicated that the stronger the social support for parents, the lower the scores for externalizing and internalizing problems, and the higher the scores for prosociality. Conversely, insufficient social support may pose a risk to parental mental health and lead to suboptimal parenting practices. Issues in parental mental health adversely affect parenting, leading to fewer positive interactions with young children, increased rates of negative interactions and hostility, diminished communication, and delayed responses to children’s behaviors.ConclusionsThese results underscore the significant influence of parents’ perceptions of social support on their parenting beliefs and behaviors, which may, in turn, affect the development of their children’s mental health. Therefore, parents’ perceptions of social support are likely positively associated with children’s mental health.

An Interpersonal and Meta-analytic Approach to Parenting Behaviors and Adolescent Sleep.

Two dimensions of parenting behaviors-affiliative/non-affiliative and autonomy/control- are each consistently linked to adolescent sleep health. Parenting behaviors that facilitate good sleep likely involve affiliation (i.e., warmth) and some degree of parental guidance and appropriate autonomy-granting to the adolescent; however, these domains are often confounded in parenting assessments, which limits understanding and specificity of recommendations for providers and families on how to optimize adolescents' sleep. Thus, we categorized existing literature according to an interpersonal developmental framework to identify parenting behaviors most strongly linked to adolescent sleep health. Studies (k = 42) included 43,293 participants (M age = 14.84, SD age = 2.04). Structural analysis of social behavior (SASB)interpersonal coding was applied to define and operationalize parenting behaviors (independent variables). Dependent variables included measures of sleep health (i.e.,sleep regularity, duration, efficiency, latency, timing, quality, alertness/sleepiness) and sleep disturbance. The final effect size of interest for analysis was a correlation coefficient r. Optimal parenting behaviors (e.g., warm, autonomy-granting, moderately controlling) were associated with longer sleep duration, earlier bedtime, less daytime sleepiness, shorter sleep latency, and fewer sleep disturbances. Suboptimal parenting behaviors (e.g., hostile, controlling) were associated with more daytime sleepiness and more sleep disturbances. This is one of the first studies to specify that, when paired with affiliation, both moderate control and moderate autonomy-granting were associated with better adolescent sleep health. Findings indicate that the importance of parental interpersonal warmth extends into adolescence and further suggest that the interpersonal security necessary for good sleep includes appropriate use of control and autonomy-granting behaviors.

Improving parenting and healthy nutrition for stunted toddler mothers through community service programs

Stunting is a significant public health problem, especially among toddlers, caused by chronic malnutrition and suboptimal parenting. This community service program aims to overcome these problems by providing relevant education and interventions to mothers of toddlers who experience stunting. This program aims to improve the knowledge and skills of mothers under five in terms of parenting and healthy nutrition, as well as encourage behavioral changes that support optimal child growth and development. This program is carried out through a series of educational activities, including training on balanced nutrition, how to serve nutritious food, and parenting techniques that support children's health. In addition, this activity also involves direct counseling and the provision of educational materials that are easy to understand by mothers of toddlers. The evaluation was carried out to measure the improvement of parenting knowledge, skills, and practices and their impact on the nutritional status of children. Early results showed a significant increase in maternal knowledge about the importance of balanced nutrition and healthy parenting. Practical skills in the presentation of nutritious food have also improved. Further evaluation showed that there was an improvement in the nutritional status of toddlers and a decrease in the prevalence of stunting in the target community. This community service program has succeeded in improving parenting and healthy nutrition knowledge for mothers of stunted toddlers. This intervention is expected to be a model for similar programs in other regions and make a positive contribution to reducing stunting rates more broadly

Human service professionals’ observations of suboptimal parenting: Barriers to intervention and potential solutions

This study was designed to learn about the types of sub-optimal parenting observed by human service professionals and the barriers they faced in moving from being a bystander to an intervenor on behalf of children. Twenty-four human service professionals participated in an in-depth audio interview about the types of poor parenting they observed and the barriers they perceived to their intervening. Using an inductive grounded theory approach, a set of themes were identified based on the content of the interviews. Teams of coders independently coded statements extracted from the transcripts according to these themes and subthemes (average kappa = 0.80). Seven types of problematic parenting were mentioned (physical aggression, verbal aggression and rejection threats, lack of supervision, poor parental coping, interfering with a child abuse investigation, and imposing their own needs on the child) along with five main categories of barriers to intervention (role constraint, behavior not bad enough, bad timing, uncertain what to do, and fear of parental response). Human service professionals are in a position to observe parents engaging in behaviors that if persistent or severe would qualify as child maltreatment. Many do not intervene even though they are concerned about the impact of these parental behaviors on children. Agencies that provide human services to parents and children can benefit from providing their workers with enhanced training, support, and practice in intervening in ways that can feel helpful and respectful. In addition, they could engage in efforts to improve the environments and culture of their agencies to reduce parental stressors which are significant triggers for poor parenting.

Interventions to Reduce Child Maltreatment: A Systematic Review with a Narrative Synthesis

Child maltreatment has been a prominent topic on the political agenda for the past decade. However, while there are several types of interventions that can potentially benefit the prevention of child maltreatment, uncertainties remain regarding the transferability of these interventions to different contexts and their overall impact. Consequently, we conducted a systematic review of intervention studies aimed at preventing child maltreatment. We searched for studies published between 2016 and 2021, using predefined keywords from various bibliographical databases including PsycINFO, SocINDEX, Social Care Online, Web of Science, and ASSIA. The initial literature search yielded 3221 studies based on titles and abstracts, after removing duplicates. Out of these, 251 studies were screened based on full texts, resulting in the selection of 56 studies that met our inclusion criteria and were retained for extraction and analysis. The screening and data extraction processes were conducted by at least two independent reviewers. Given the heterogeneity of the included studies, we performed a narrative synthesis and categorized the 56 studies based on intervention type, control condition, outcomes, effects and quality. The results indicated that most of the studies employed individual randomization, with the control group most often receiving treatment as usual. Home visiting programs and educational interventions emerged as the most prevalent types of interventions. The review also demonstrated that a significant number of the included studies reported positive effects on one or more outcomes, such as indicators of maltreatment, suboptimal parenting practices, and problematic child behaviors. While nearly one-third of the studies did not report an effect size, those that did reported varying types of effect sizes. Additionally, only a few studies met the assessed quality criteria.

Parent - Young Adult Relationship with Self-esteem among Undergraduate Students

Worldwide, there are over 1.8 billion young people living today and 90 % of who live in developing countries1. Parent–child relationships are central to psychological development and several studies have shown that suboptimal parenting is an important risk factor for psychological disorder in clinical and representative community samples.2 This study is an insight to know the Parent - Young Adult Relationship in the current generation of young adult and its impact on Self - esteem. Research results carried out on this topic suggest & promote Parents and Young Adult to have a better relationship. The aim of the study was to correlate relationship between Parent - Young Adult with Self-esteem among undergraduate students in selected college at Puducherry. Methods: A Quantitative Descriptive Research Design was used to assess the correlation between Parent - Young Adult Relationship with Self-esteem among undergraduate students in selected college at Puducherry. After taking a written consent, both male and female (117) undergraduate students (18 - 21 years) were selected using Simple Random Sampling Technique. The Parent - Young Adult Relationship among undergraduate students was assessed by Parent Adult Child Relationship Questionnaire (PACQ) and level of Self esteem was assessed by Rosenberg's Self - esteem Scale. The data was analyzed by using frequency, percentage, mean and Standard Deviation. Correlate the relationship between Parent - Young Adult Relationship and Self – esteem was analyzed by using Pearson’s correlation coefficient test. The association between the demographic variables between Parent - Young Adult Relationship and Self – esteem was analyzed by using Fisher’s exact test Result: The results show the correlation between Parent - Young Adult Relationship with Self-esteem among 117 undergraduate students. The mean self esteem score was 19.26 ± 3.791 and it ranged from 6 to 29. The level of self - esteem among nursing college students was normal, high and low, for 88.0%, 5.1% and 6.9%, respectively. There was a weak negative correlation observed between Parent - Young Adult relationship (Father) with Self - esteem in control aspect which implies greater the control by father lower the Self - esteem of the students. There was no statistically significant correlation was observed between Parent-Young Adult Relationship (Mother) with self -esteem at the significance level of p>0.05. Statistically significant association was found between Parent-Young Adult Relationship (Father - Regard) with gender, (Father -control) with Occupation, (Father - Responsibility) with feels more attached. Statistically significant association was noted between Parent-Young Adult Relationship (Mother - Responsibility) with year of studying implying B.Sc (N) - II Year and with area of residence, (Mother - Regard) with time spent every day (1-2 hours). Borderline statistically significant association was found in (Father - Control) with feels more attached & area of residence and (Mother - Responsibility) with Occupation. Conclusion: The findings of the study reflect that the Undergraduate relationship with both of their parents and majority Undergraduate students had normal self - esteem. The way parents raise their children influences the development of their self-esteem. Stronger relationship with parents boosts the self-esteem level in an individual. The study participants get benefited by participating in the study. Conducting this research in another society and with a greater sample size and in different setting may generate different results.

Commentary: Addressing stigma through relational research design

The history of research on parenting autistic children is complicated by the inheritance of “mother-blaming,” which continues to occur, albeit indirectly or implicitly. Parents of autistic children often experience and internalize stigma, which arises from the messaging that suboptimal parenting can exacerbate a child's autistic traits. This stigmatization is echoed by parents of other neurodivergent groups, including ADHD. For neurodivergent parents of neurodivergent children, this stigma may be compounded, since stigma is experienced both as a neurodivergent individual, and as the parent of a neurodivergent individual. Researchers have an ethical duty to pay attention to experiences of stigma when we study any vulnerable group so that stigma does not become a barrier to participation. In this commentary, I critically reflect on a study I designed, which did not adequately address parents’ potential stigma or sufficiently anticipate the impact of experiences of stigma on participation. I then outline the steps I took to modify the design, framed within a relational ethics of care, to acknowledge and account for the stigma that might have otherwise excluded parents of autistic children—especially parents who are autistic and otherwise neurodivergent themselves—from participating.

Implikasi Pernikahan Usia Remaja Terhadap Pola Asuh Anak dalam Keluarga

Early marriage remains prevalent in village communities deeply rooted in culture and customs, leading to various social problems. This study aims to describe the implications of early marriage on child care in Larangan Perreng Village, focusing on factors causing early marriage, forms of child care, and the resulting implications. Qualitative field research was conducted in Larangan Perreng Village to gather data, and triangulation techniques were employed to ensure data validity. Economic, self, and parental factors were identified as contributors to early marriage in the village. Couples who married early adopted democratic, permissive, and authoritarian parenting styles to raise their children. The findings revealed that early marriage had negative implications on parenting, including increased household conflicts, adverse effects of physical punishment on children's well-being, suboptimal parenting practices, and insufficient independence in child-rearing. These outcomes highlight the importance of addressing early marriage and promoting effective child care strategies within the community.

0116 A theory-driven, meta-analytical approach to evaluating optimal parenting behaviors and adolescent sleep

Abstract Introduction For adolescents, affiliative parenting behaviors (e.g., warm) are generally associated with better sleep and non-affiliative parenting behaviors (e.g., hostile) are associated with deficient sleep. However, specificity of interpersonal behaviors is unknown. We applied an interpersonal theoretical framework and conducted a meta-analysis to test and operationalize the theory that safety and security are necessary for good sleep. Methods Included in the meta-analysis were 41 studies on adolescent (10-19 years) sleep health and parenting behaviors. Studies included a total of 57,549, primarily female (52%), participants (Mage = 14.92, SDage = 2.00). Race/ethnicity was 76.7% White, 5.9% Black, 6.5% Hispanic, 1.5% Asian, and 9.4% Other. Structural analysis of social behavior (SASB) was applied to define and operationalize optimal (e.g., affiliative and autonomy granting/taking) and sub-optimal (e.g., non-affiliative and autonomy granting/taking) parenting behaviors (independent variable). Dependent variables were sleep regularity, duration, efficiency, latency, timing, quality, alertness/sleepiness, and disturbance. The final effect size of interest for analysis was a correlation efficient r. Results Optimal parenting behaviors were associated with longer sleep duration (r = 0.11, p = .02), decreased latency (r = -0.16, p < .001), less daytime sleepiness (r = -0.28, p < .001), and less sleep disturbances (r = -0.22, p < .001). Suboptimal parenting behaviors were associated with decreased sleep duration (r = -0.04, p = .05), increased latency (r = 0.12, p < .01), and more sleep disturbances (r = 0.38, p < .001). Conclusion This study applied interpersonal theory to define and operationalize parenting behaviors and their association with adolescent sleep. Findings support anthropological theory that parental interpersonal warmth is important for adolescent sleep and further indicate that security likely includes appropriate use of structure and autonomy granting behaviors. SASB analysis additionally revealed significant methodological issues that hamper understanding of the role of parental control (versus autonomy-granting) as separate from parental affiliation (versus hostility). This topic points the way to a crucial next step in developing an empirically grounded and comprehensive interpersonal model of sleep. Support (if any)

Factors Associated with Stunting in Children Under Five Years

Stunting is a condition in which a child experiences growth disorders, resulting in a height that exceeds his age due to long-term dietary deficiencies. In 2021 Pekanbaru City was designated as a stunting focus location, totaling 15 urban villages with 303 stunting toddlers. This study aimed to determine the factors associated with stunting in children under five in Pekanbaru City in 2022. This type of research is quantitative analytic observational with a case-control design. The sample in the case group was stunted children under five, while the sample for the control group was children under five who were not stunted. The sample size for the case and control groups was 73 children under five, so the overall sample size was 146 children under five. The sampling technique used stratified random sampling at the integrated service center level. Data analysis was univariate and bivariate with a chi-square test. The results showed that exclusive breastfeeding (OR = 10,247), quality of complementary feeding (OR = 9,362), Infectious Diseases (OR = 4,1940, Mother's Knowledge (OR = 9,4410, and parenting patterns (OR = 10,065) associated with stunting. This study concludes that not exclusively breastfeeding, poor quality complementary feeding, presence of infectious diseases, low maternal knowledge, and suboptimal parenting have more risk for stunting in children under five. Public health center in order to provide information and education to the public regarding the risk factors for stunting.

Early Childhood Temperamental Trajectories following Very Preterm Birth and Their Association with Parenting Style.

Childhood temperament is an early characteristic shaping later life adjustment. However, little is currently known about the stability of early temperament and its susceptibility to the environment in children born very preterm (VPT; <33 weeks’ gestation). Here, we investigated infant-to-childhood temperamental trajectories, and their interaction with parental practices, in VPT children. Maternal reports of infant temperament were collected in 190 infants (mean age: 11.27 months; range 9–18 months) enrolled in the longitudinal Evaluation of Preterm Imaging (ePrime; Eudra: CT 2009-011602-42) study, using the ePrime questionnaire on infant temperament. At 4–7 years of age, further assessments of child temperament (Children’s Behavior Questionnaire—Very Short Form) and parenting style (Arnold’s Parenting Scale) were conducted. Results showed that more difficult temperament in infancy was associated with increased Negative Affectivity in childhood, regardless of parenting practices. This lends support to the stability of early temperamental traits reflecting negative emotionality. In contrast, a lax parenting style moderated the relationship between easy infant temperament and Negative Affectivity at 4–7 years, such that an easier infant temperament was increasingly associated with higher childhood Negative Affectivity scores as parental laxness increased. These results highlight a potential vulnerability of VPT infants considered by their mothers to be easy to handle, as they may be more susceptible to the effects of suboptimal parenting in childhood.

Exploring differences in perceptions of child feeding practices between parents and health care professionals: a qualitative study

BackgroundEvidence on child feeding practice is often based on the perspectives and experiences of parents and less that of health practitioners. In this study, we explored child feeding practice in Aboriginal communities in northern Australia from both the parents and health practitioners’ perspectives with the aim of informing nutrition improvement programs.MethodsQualitative research methods were employed. Using semi-structured interviews, parents (n = 30) of children aged 2–5 years, and 29 service providers who were involved in the delivery of child health and nutrition programs in the same communities, were asked about child feeding attitudes and practices. Responses were analyzed through inductive and deductive analysis, recognizing that worldviews influence child feeding practices.ResultsSharing food was a central practice within families. Parents highly valued development of child independence in food behavior but were conflicted with the easy access to unhealthy food in their communities. This easy access to unhealthy food and inadequate food storage and kitchen facilities for some families were major challenges to achieving optimal diets for children identified by Aboriginal families and service providers. The responsive style of parenting described by parents was often misunderstood by service providers as sub-optimal parenting when viewed through a dominant western lens.ConclusionsApproaches to support healthy feeding practices and optimal child nutrition require health-enabling food environments. Along with a community-based Aboriginal health workforce, it is paramount that the non-Aboriginal workforce be supported to be reflective of the impact of worldview on their practice, to ensure a culturally safe environment for families where parenting styles are understood and appropriately supported.

Medication and healthcare use, parent knowledge and cough in children: A cohort study.

Cough is an important contributor to the health burden of children and their families. There are limited data describing healthcare utilization and medication use over the course of a cough illness beyond the initial presentation. Our primary objective was to describe medication and healthcare use in children with a respiratory illness with cough as a symptom over the course of the illness. A cohort study of children aged less than 15-years presenting to three primary healthcare centers and three emergency departments with a cough illness between July 7, 2015 and October 6, 2018. Children with immunosuppression, known chronic lung diseases (except asthma) and those requiring hospitalization at screening were excluded. The primary outcomes were cough-related frequency and type of healthcare seeking and medication use up to 28 days following enrolment. Data for 465 children were analyzed; median age 2.2-years (interquartile range = 1.1-5.3). Cough at Day 28 persisted in 117 children (25.2%). Overall, 436 (94%) children received medications in the week before and/or 4 weeks following enrolment. Half with upper respiratory tract infections were prescribed antibiotics. Amongchildren with no diagnosis of asthma, reactive airways disease or croup (n = 404), 16.8% were given steroids. Fifty-eight percent of children sought healthcare at least once before their baseline presentation (median = 1, range = 0-20) and 49.7% had at least one further presentation in the following 28 days. High healthcare utilization, inappropriate medication use, and suboptimal parent knowledge regarding cough suggests targeted education is needed to improve management and reduce cough burden.

CBGA-ES+: A Cluster-Based Genetic Algorithm with Non-Dominated Elitist Selection for Supporting Multi-Objective Test Optimization

Many real-world test optimization problems (e.g., test case prioritization) are multi-objective intrinsically and can be tackled using various multi-objective search algorithms (e.g., Non-dominated Sorting Genetic Algorithm (NSGA-II)). However, existing multi-objective search algorithms have certain randomness when selecting parent solutions for producing offspring solutions. In a worse case, suboptimal parent solutions may result in offspring solutions with bad quality, and thus affect the overall quality of the solutions in the next generation. To address such a challenge, we propose CBGA-ES+, a novel cluster-based genetic algorithm with non-dominated elitist selection to reduce the randomness when selecting the parent solutions to support multi-objective test optimization. We empirically compared CBGA-ES+ with random search and greedy (as baselines), four commonly used multi-objective search algorithms (i.e., Multi-objective Cellular genetic algorithm (MOCell), NSGA-II, Pareto Archived Evolution Strategy (PAES), and Strength Pareto Evolutionary Algorithm (SPEA2)), and the predecessor of CBGA-ES+ (named CBGA-ES) using five multi-objective test optimization problems with eight subjects (two industrial, one real world, and five open source). The results showed that CBGA-ES+ managed to significantly outperform the selected search algorithms for a majority of the experiments. Moreover, for the solutions in the same search space, CBGA-ES+ managed to perform better than CBGA-ES, MOCell, NSGA-II, PAES, and SPEA2 for 2.2, 13.6, 14.5, 17.4, and 9.9 percent, respectively. Regarding the running time of the algorithm, CBGA-ES+ was faster than CBGA-ES for all the experiments.

Maternal-fetal bonding among pregnant women at psychosocial risk: The roles of adult attachment style, prenatal parental reflective functioning, and depressive symptoms.

Pregnancy offers a unique period for initiating preventive parenting interventions. Disturbances in maternal-fetal bonding may indicate suboptimal parenting and a need for intervention. However, more knowledge is needed on the development of maternal-fetal bonding among at-risk groups. The study aim was to examine psychosocial correlates of maternal-fetal bonding among pregnant women identified to be at risk socially and regarding their mental health. The sample consisted of 78 at-risk pregnant women participating in a perinatal intervention study: Godt på Vej Sammen [A Good Start to Life-an Early Cross-sectorial Intervention]. This study was cross-sectional reporting on the baseline characteristics of the participants. In the beginning of the second trimester, participants completed questionnaires assessing maternal-fetal bonding (the Maternal Antenatal Attachment Scale [MAAS]), prenatal parental reflective functioning, adult attachment style, and depressive symptoms. We compared the distribution of MAAS styles with norms from a recent Dutch community sample. In addition, we tested associations between psychosocial variables and the quality and intensity of MAAS scores in regression models and performed Chi-square analyses to assess the association of MAAS styles with psychosocial variables. First, compared to women from a community sample, approximately half of the women in our sample presented lower and suboptimal MAAS scores. Second, insecure avoidant adult attachment style was negatively associated with MAAS intensity, and depressive symptoms were negatively associated with MAAS quality. Third, prenatal parental reflective functioning positively correlated with both quality and intensity of MAAS. Fourth, we found no association between insecure anxious adult attachment style and MAAS scores. Fifth, women with a negative disinterested MAAS style demonstrated the highest avoidant attachment scores, while women with a positively preoccupied MAAS style demonstrated the highest prenatal parental reflective functioning scores. The results suggest that there is a need to differentiate among at-risk pregnant woman and that prenatal screening using the MAAS may help identify those who need preventive parenting interventions and what those interventions should focus on. A main limitation of the study is the lack of a representative group of at-risk pregnant women which limits the generalizability of the study results to all risk groups.

Poverty and Food Insecurity Predict Mealtime Structure: Mediating Pathways of Parent Disciplinary Practices and Depressive Symptoms.

Structured, well-organized mealtime routines can provide many physical and mental health benefits for children. Poverty and food insecurity (FI) are socioeconomic risk factors for less effective mealtime routines. However, the specific mechanisms by which these social factors may negatively impact mealtime structure are not well-understood. We test whether poverty and FI are associated with parenting factors (mental health and parent disciplinary practices), and whether these parenting factors in turn associate with less mealtime structure. Low-income families (N = 270), recruited when children were approximately 6-years-old (wave 1), were followed for 2 years (wave 2). Socioeconomic and parenting factors were assessed at W1 via parent-report. Associations of poverty and FI with two measures of mealtime structure (parent-reported and observed mealtime structure at wave 1 and wave 2), mediated by parent factors (depressive symptoms, lax and overreactive parent disciplinary practices) were assessed in separate path analyses. The association between higher depth of poverty and less mealtime structure in early childhood was mediated by greater parent depressive symptoms. FI was associated with less mealtime structure in early childhood, mediated by overreactive parenting, and with less mealtime structure in early and mid-childhood, mediated by lax parenting. Poverty and food insecurity may contribute to suboptimal parent disciplinary practices and poor parent mental health, which may reduce mealtime structure for children. Addressing parent mental health and parent disciplinary practices in the context of socioeconomic adversity may be one way in which interventions can improve mealtime structure for low-income families.

Earlier and Concurrent Food Insecurity Are Associated with Suboptimal Parenting in Early Childhood

Food insecurity (FI) is associated with poor health, suboptimal nutrition, and disadvantaged linguistic, social, and academic development for children. Given the prominent role that parents play in children's development, FI may be associated with parenting practices. We aimed to understand how FI and its change over time relate to parenting in early childhood. Data were from the Early Childhood Longitudinal Study-Birth Cohort: parental interviews and child assessments at 9 mo and 2, 4, and 5 y old. Dependent variables were parenting practices in years 2, 4, and 5 in parent-child interaction, discipline, rules, and routines in general and food-related settings. Stratified by gender, parenting outcomes were regressed on earlier FI and child, parent, and contextual covariates, then additionally regressed on concurrent FI, using models with full-information-maximum-likelihood and cluster control. Earlier FI was associated with harsh discipline (girls, year 5: β1=0.0811, P<0.05) and frequent evening meals at a regular time (girls and boys, years 2 and 4), before adding concurrent FI. Accounting for earlier FI and covariates, concurrent FI was associated with harsh discipline (girls, years 2 and 4: β2=0.0489 and 0.0705, P<0.05; boys, year 2: β2=0.0584, P<0.05), rules about foods (girls, year 4), frequent evening meals as a family (girls, years 2 and 4), and frequent evening meals at a regular time (girls, years 2 and 4; boys, year 2); earlier FI remained associated with harsh discipline (girls, year 5) and frequent evening meals at a regular time (girls, years 2 and 4; boys, year 4). FI was linked with suboptimal parenting practices in structuring a general and food-related living environment, particularly for girls and by the age of 5 y.

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

BackgroundThe majority of children receiving care in the emergency department (ED) are discharged home, making discharge communication a key component of quality emergency care. Parents must have the knowledge and skills to effectively manage their child’s ongoing care at home. Parental fatigue and stress, health literacy, and the fragmented nature of communication in the ED setting may contribute to suboptimal parent comprehension of discharge instructions and inappropriate ED return visits. The aim of this study was to examine how and why discharge communication works in a pediatric ED context and develop recommendations for practice, policy, and research.MethodsWe systematically reviewed the published and gray literature. We searched electronic databases CINAHL, Medline, and Embase up to July 2017. Policies guiding discharge communication were also sought from pediatric emergency networks in Canada, USA, Australia, and the UK. Eligible studies included children less than 19 years of age with a focus on discharge communication in the ED as the primary objective. Included studies were appraised using relevant Joanna Briggs Institute (JBI) checklists. Textual summaries, content analysis, and conceptual mapping assisted with exploring relationships within and between data. We implemented an integrated knowledge translation approach to strengthen the relevancy of our research questions and assist with summarizing our findings.ResultsA total of 5095 studies were identified in the initial search, with 75 articles included in the final review. Included studies focused on a range of illness presentations and employed a variety of strategies to deliver discharge instructions. Education was the most common intervention and the majority of studies targeted parent knowledge or behavior. Few interventions attempted to change healthcare provider knowledge or behavior. Assessing barriers to implementation, identifying relevant ED contextual factors, and understanding provider and patient attitudes and beliefs about discharge communication were identified as important factors for improving discharge communication practice.ConclusionExisting literature examining discharge communication in pediatric emergency care varies widely. A theory-based approach to intervention design is needed to improve our understanding regarding discharge communication practice. Strengthening discharge communication in a pediatric emergency context presents a significant opportunity for improving parent comprehension and health outcomes for children.Systematic review registrationPROSPERO registration number: CRD42014007106.

Family Care Curriculum: A Parenting Support Program for Families Experiencing Homelessness

Purpose In the United States, families with children characterize the fastest growing portion of the homeless population. Parenting for families experiencing homelessness presents unique challenges since families facing homelessness are disproportionately more likely to experience a myriad of interpersonal and contextual stressors that heighten the risk of parents engaging in suboptimal parenting approaches. This article describes the development and implementation of the Family Care Curriculum (FCC) train-the-trainer parenting support program specifically designed to support positive parenting in families experiencing homelessness. Description The FCC is a 6-week theory-based parenting intervention aimed to create positive shifts in parental attitudes to enhance sensitive and nurturing parenting and positive parent-child relationships. FCC assists parents in reflecting on how their own experiences contribute to some of their parenting beliefs, patterns, and behaviors. Parents are coached to imagine and understand the emotions, attachment, and developmental needs behind their children's behaviors so they can maintain empathic and nurturing parenting responses in the context of cumulative and chronic stress. Parents are supported through learning to engage in self-care. A unique and important feature of the FCC is the inclusion of a culturally sensitive approach that takes into consideration the effects of racism, classism, and oppression on parent-child relationships. Conclusion FCC was designed, implemented, and championed by expert providers in the fields of family therapy, social work, and pediatrics to support parents experiencing homelessness. FCC adds to the body of effective attachment-based, trauma-informed, and culturally sensitive parenting interventions for improving parent-child relations and family health amongst vulnerable populations.

Reconsidering the links between sibship size, maternal sensitivity, and child attachment: A multidimensional interactive approach.

Despite being a well-documented predictor of children's cognitive and social development, sibship has received remarkably little attention in the attachment and maternal sensitivity literature. The only study that has examined both sensitivity and attachment in relation to sibship found greater maternal sensitivity but no more secure attachment among first-born infants. In the current study, we sought to examine the same links while testing two related hypotheses: that sibship size relates only to some specific aspects of sensitivity, and that sibship size relates to sensitivity only among certain mothers, namely those who are at risk for suboptimal parenting because of an insecure attachment state of mind. We assessed three dimensions of maternal sensitivity at 12 months and child attachment at 15 and 25 months among 258 mother-infant dyads living in intact biparental families. Compared with mothers who had fewer children, those with more children were observed to be less accessible/available, less positive, but not less cooperative/attuned, when interacting with their infant. These links were moderated by maternal attachment state of mind, such that significant relations were observed only among mothers presenting a more insecure state of mind. Finally, sibship size was unrelated to attachment. These findings suggest that failure to consider different dimensions of sensitivity or important parental moderators may result in the erroneous conclusion that birth order and sibship size are inconsequential for parent-child relationships. (PsycINFO Database Record