White British Parents Research Articles

Stress and resilience in British Indian parents with an autistic child: a comparative study with white British and Indian parents

PurposeThis study aims to examine the levels of stress and resilience in a sample of British Indian parents bringing up a child with autism.Design/methodology/approachA total of 52 British Indian parents took part in a survey that included measures of stress, resilience, support and child adaptive functioning. Results were compared to a sample of white British (n = 120) and Indian parents (n = 120).FindingsThe British Indian parents recorded higher levels of stress and less perceived social support than their white British counterparts. British Indian parents took longer to register concern about their child’s development and sought a diagnosis at a later age than the white British group. The delay in concern and diagnosis was similar to that found in the India group.Originality/valueThe research suggests that British Indian parents are disadvantaged in social support and mental well-being compared to white British parents and may face similar community pressures to parents bringing up a child in India.

Impact of a peer-led, community-based parenting programme delivered at a national scale: an uncontrolled cohort design with benchmarking

BackgroundChildhood behavioural problems are the most common mental health disorder worldwide and represent a major public health concern, particularly in socially disadvantaged communities. Treatment barriers mean that up to 70% of children do not receive recommended parenting interventions. Innovative approaches, including evidence-based peer-led models, such as Empowering Parents Empowering Communities’ (EPEC) Being a Parent (BAP) programme, have the potential to reduce childhood difficulties and improve parenting if replicable and successfully delivered at scale.MethodThis real-world quasi-experimental study, with embedded RCT benchmarking, examined the population reach, attendance, acceptability and outcomes of 128 BAP groups (n = 930 parents) delivered by 15 newly established sites participating in a UK EPEC scaling programme.ResultsScaling programme (SP) sites successfully reached parents living in areas of greater social deprivation (n = 476, 75.3%), experiencing significant disadvantage (45.0% left school by 16; 39.9% lived in rental accommodation; 36.9% lone parents). The only benchmarked demographic difference was ethnicity, reflecting the greater proportion of White British parents living in scaling site areas (SP 67.9%; RCT 22.4%). Benchmark comparisons showed scaling sites’ parent group leaders achieved similar levels of satisfaction. Scaling site parent participants reported substantial levels of improvement in child concerns (ES 0.6), parenting (ES 0.9), parenting goals (ES 1.2) and parent wellbeing (ES 0.6) that were of similar magnitude to RCT benchmarked results. Though large, parents reported lower levels of parenting knowledge and confidence acquisition compared with the RCT benchmark.ConclusionDespite common methodological limitations associated with real-world scaling evaluations, findings suggest that this peer-led, community-based, parenting approach may be capable of successful replication at scale and may have considerable potential to improve child and parenting difficulties, particularly for socially disadvantaged populations.

Ethnicity and grandparental child care in the United Kingdom

AbstractCaring for one's grandchildren has become a more common experience for individuals partly as a result of a longer overlap between the lives of grandparents and their grandchildren. Existing research shows that around 50 per cent of grandparents engage in some grandparental child care in most European countries, however, this proportion is higher among older people with a migrant background, partly due to greater economic necessity among migrant families. Research has also highlighted ethnic differences in parents’ child-care selection, even after controlling for their socio-economic status. Building on these strands of work, this paper investigates the differences in the use of (grandparental) child care among parents from different Black and Minority Ethnic (BME) groups in the United Kingdom, using data from Understanding Society. The results show that parents from Other White, Indian, Pakistani, Bangladeshi and African communities are less likely to use child care than White British parents, while the opposite is true for Caribbean parents. However, among parents using child care, individuals from the Other White, Caribbean and African groups are less likely than the White British majority to be using grandparental child care as a supplement to other child-care types, or on its own. Ethnic differentials in the use of child careper seand grandparental child care in particular, have significant policy implications, and may mask other kinds of ethnic differences.

The Role of Felt or Enacted Criticism in Parents' Decision Making in Differing Contexts and Communities: Toward a Formal Grounded Theory.

Felt or enacted criticism was identified as a significant influence on White British parents’ decision making during acute childhood illness in a substantive grounded theory “Containing acute childhood illness within family life.” These parents sought to avoid further criticism, sometimes leading to delayed consultation. Using Glaserian grounded theory principles, we conducted a secondary analysis of data from three studies, to establish the transferability and modifiability of the original theory to other settings and communities in Ireland and England. Felt or enacted criticism was found to operate across the childhood age range, social groups, and settings. Parent’s strategies to avoid criticism reduced contacts with health professionals, access to support and, more worryingly, communication about their child’s health. These findings demonstrate the wider applicability, or “work” in Glaser’s terms, of the concept in the English speaking Western world. Findings indicate the need for nurses to identify and mitigate sources of criticism.

A qualitative study to identify parents\u2019 perceptions of and barriers to asthma management in children from South Asian and White British families

BackgroundOver one million children receive treatment for asthma in the UK. South Asian children experience excess morbidity and higher rates of hospitalization than the White population. This study aimed to explore perceptions and experiences of asthma and asthma management in British South Asian and White British families, to identify barriers to optimal management and to inform culturally appropriate interventions to improve management.MethodsA qualitative methodology, using semi-structured interviews was adopted. Members of 30 families from six major South Asian ethnic-religious groups were purposively sampled (n = 49). For comparison, 17 White British parents were interviewed. Topics included understandings of asthma; day-to-day management; interactions with health care providers and the perceived quality of healthcare services. Data were analyzed using interpretive thematic analysis, facilitated by NVivo. Similarities and differences between South Asian and White families were analysed across key themes.ResultsMany of the problems facing families of a child with asthma were common to South Asian and White British families. Both had limited understanding of asthma causes and triggers and expressed confusion about the use of medications. Both groups reported delays in receiving a clear diagnosis and many experienced what was perceived as uncoordinated care and inconsistent advice from health professionals. No family had received an asthma plan. South Asian families had more difficulty in recognising severity of symptoms and those with limited English faced additional barriers to receiving adequate information and advice about management due to poor communication support systems. South Asian parents reported higher levels of involvement of wider family and higher levels of stigma. Attendance at the emergency department was related to previous experience, difficulties in accessing primary care, lack of knowledge of alternatives and difficulties in assessing severity.ConclusionsBarriers to optimal asthma management exist at the individual family, community and healthcare systems levels. Culturally sensitive, holistic and collaboratively designed interventions are needed. Improved communication support for families with lower proficiency in English is required. Healthcare professionals need to ensure that families receive an asthma plan and make greater efforts to check families’ understandings of asthma triggers, use of medications, assessment of asthma severity and accessing help.

Ethnic differences in parental feeding behaviors in UK parents of preschoolers

Childhood obesity is prevalent among ethnic minorities in the UK but little is known about parent feeding practices in these populations. We administered questionnaires assessing parental feeding behaviors and perceptions and concerns relating to child weight to White British (n = 271), South Asian (n = 59), and Black Afro-Caribbean (n = 42) parents of UK 3-5 year-olds. Child BMI z-scores were determined from measured heights and weights. South Asian and Black Afro-Caribbean parents exhibited greater pressure to eat than White British parents. Black Afro-Caribbean parents additionally scored higher on instrumental feeding and lower on monitoring, while South Asian parents scored higher on emotional feeding. Black Afro-Caribbean parents reported the greatest concern about both child overweight and underweight. Ethnic differences were unchanged by controlling for perceptions and concerns relating to child weight, or for actual BMI z, parent education, or household income. Exploratory analyses suggested some evidence for sex differences within ethnic groups. For example, South Asian parents of daughters scored higher than White British parents of daughters on emotional feeding, with no ethnic differences apparent for parents of sons. Our findings support considering variation in parent feeding behaviors and weight-related attitudes by parental ethnicity and child sex when developing obesity interventions.

Illness perception, help-seeking attitudes, and knowledge related to obsessive-compulsive disorder across different ethnic groups: a community survey.

Despite similar prevalence rates across ethnicities, ethnic minorities with obsessive-compulsive disorder (OCD) are under-represented in research and clinical settings. The reasons for this disproportion have been sparsely studied. We explored potential differences in illness perception, help-seeking attitudes, illness knowledge, and causal attributions that could help explain the lower uptake of treatment for OCD amongst ethnic minorities. Two-hundred and ninety-three parents (139 White British, 61 Black African, 46 Black Caribbean, and 47 Indian) were recruited from the general population in South-East London, UK. Using a text vignette methodology, participants completed a survey including questions on illness perception, help-seeking attitudes, OCD knowledge, and causal attributions. The groups did not differ in socio-demographic characteristics and family history of OCD. White British parents perceived that the OCD difficulties would have more negative impact on their children and that treatment would be more helpful, compared to the ethnic minorities; the largest differences were observed between White British and Indian parents. Ethnic minorities were more prone to say that would seek help from their religious communities. Black African parents were more in favor of not seeking help for the described difficulties and, in general, perceived more treatment barriers. White British parents seemed to be better informed about OCD than ethnic minority parents. The results offer some plausible explanations for the large inequalities in access to services amongst ethnic minorities with OCD. Clinicians and policy-makers need to be aware of these socio-cultural factors when designing strategies to encourage help-seeking behaviors in these populations.

Development of tailored and integrated health-care interventions to reduce inequalities in health outcomes: the Management and Interventions for Asthma (MIA) project

BackgroundSouth Asian children are more likely than others to suffer from their asthma and be admitted to hospital. The UK Public Health Outcomes Framework focuses on partnership across locally led systems to plan and deliver health-care services in the context of broader social determinants of health. The Management and Interventions for Asthma (MIA) project aimed to embody localism by using a collaborative, participatory model to develop an intervention designed to improve asthma management in South Asian children. MethodsThe project was multi-phase, iterative, and participatory, underpinned by the socio-ecological model of health, recognising the importance of issues arising from the individual, family, wider community, and organisational and environmental contexts of family health. Building on this model, the project worked collaboratively with linguistically and culturally competent community facilitators (CFs), to engage and develop a partnership between South Asian community members, parents and children living with asthma, health-care professionals (HCPs), and researchers. The study had four phases. Phase 1 consisted of an evidence review of barriers and facilitators to asthma management in South Asian children. Phase 2 explored lay understandings of asthma in South Asian children using focus groups (n=67) with members of South Asian communities (Indian, Pakistani, Bangladeshi) recruited by trained CFs. Phase 3 explored experiences of asthma management via semi-structured interviews with South Asian and White British parents and children (n=82 participants) recruited from the NHS and by CFs and included semi-structured interviews with HCPs (n=37). Focus groups and interviews were done in the preferred language of the participants. Focus group facilitators and interviewers were trained and supervised to reduce bias. Data were analysed with principles of interpretive thematic analysis facilitated by NVivo. Interviews with a comparison sample of White British parents and children (n=31) identified aspects of asthma management that could be addressed by generic interventions and those needing a tailored approach. Data from phases 1–3 were combined with thematic analysis to identify 11 key themes that needed to be addressed to optimise asthma management. In phase 4, an intervention planning framework was developed, with a novel modified intervention mapping approach incorporating psychological theory. Collaborative workshops, including parents, children, academics, and HCPs, were held to integrate data, develop an asthma intervention planning framework, and prioritise one aspect of asthma management to be used as an exemplar for the tailored intervention programme. FindingsThe 11 key themes were: being able to talk to doctors and nurses, being able to use services, community awareness of asthma, getting a diagnosis, having suitable information on asthma, medicines for asthma, school and my child's asthma, services available for asthma, quality of care, understanding asthma, and what to do day to day. Parents chose getting a diagnosis as a priority and a multifaceted programme, ACT (awareness, context, training) on asthma, was developed as an exemplar intervention, consisting of community awareness, education and training, clinical support, and a central advice centre, coordinated by a central team. Recruitment targets were exceeded and participants gave positive feedback. InterpretationKey issues in optimum asthma management in children arise at the patient, provider, and health-care system levels and interventions must address all these levels. Minority ethnic communities can be successfully engaged in collaborative intervention development with a community focused and culturally sensitive methodology. FundingNIHR Health Services and Delivery Research (HS&DR) Programme (09/2001/19). Views and opinions expressed those of the authors and do not necessarily reflect those of the HS&DR Programme, the NIHR, the NHS, or the Department of Health.

G120 Knowledge and Attitudes; Essential Ingredients For Developing Co Produced Tailored Interventions For Asthma Management (MIA) in South Asian and White British Children

Childhood asthma is a chronic illness affecting quality of life and leading to higher mortality in the UK than other countries. In the UK, prescription rates for relievers and preventers...

Multicultural learning: parent encounters with difference in a Birmingham primary school

In the UK, schools are considered vital to the realisation of intercultural cities, to the strengthening of community relations and to the development of new forms of social learning. This paper brings work on the geographies of education and learning together with work on the challenges of living with difference, to examine how the routines and repetitive interactions of everyday school life shape the capacities of parents to live with difference. Utilising research with white British parents at a multicultural primary school in Birmingham, UK, the paper builds on the growing interest in the spaces and theories of urban encounter to extend work that has examined the value of shared school spaces. While attending to the (re)production of social difference and the problematic accounts of anxiety, hierarchy and belonging that fracture the school community, the paper also examines the shared parental commitments and aspirations that underpin the motivations for intercultural dialogue and learning. In so doing, the paper details how existing knowledges and ways of living are called into question and gradually altered through personal work, pragmatic negotiation and the development of practical competencies and calls for much greater emphasis on these small and incremental changes in future work.

Are parents in the UK equipped to provide adequate burns first aid?

AimSimple first aid following a burn injury has been shown to improve outcome. With this in mind, a prospective study was conducted to evaluate the knowledge of burns first aid amongst parents in South Yorkshire, United Kingdom. This information was used to identify which aspects of burn first aid need to be highlighted in an education campaign and who the target audience should be. A simple mnemonic is suggested to assist parental education on the topic. MethodsParents attending outpatient clinics at Sheffield Children's Hospital were interviewed and asked about the first aid they would provide for a child with a large scald. Removal of hot clothes and jewellery; application of cold water for 10–20min; obtaining medical advice; and covering the burn with a plastic film or clean cloth were all considered to be ideal responses. Variations in responses in relation to the age and ethnicity of the parent were noted. ResultsOne hundred and eighty eight parents were included in the questionnaire. Of these, 81% (n=152) were white British and 20% (n=36) were from other ethnic groups. Only 10% (n=18) of all respondent would give all the ideal first aid steps. Less than 40% (n=73) of parents questioned would remove hot clothes and jewellery. There was no significant difference in responses between ethnic groups when assessing knowledge of the need to remove hot soaked clothing. Although 73% (n=137) of parents would run the burn under cool water, only 35% (n=66) would cool the burn for an adequate length of time. White British parents were significantly more likely to run cool water over the burn, and to continue this for the recommended 10–20min. Whilst 88% (n=165) of parents would seek medical attention, this was significantly less in parents under 20 years old. Finally, 92% (n=173) of parents would protect the wound with appropriate dressings, but of note, 26% (n=9) of parents from minority ethnic groups would potentially impair burn healing by using inappropriate dressings and topical agents including butter, milk, cooking oil and toothpaste. ConclusionsThe questionnaire findings highlighted the need for improved parental awareness of burns first aid. This was across all ethnic groups and ages questioned. In particular, knowledge of appropriate cooling times and the use of inappropriate dressings were highlighted as areas for concern. Ideal burns first aid measures were summarised with the mnemonic STOP–Strip clothes, turn on the tap for 10min, organise help, put on plastic film. This mnemonic is to be used in a pilot educational campaign in the Sheffield area, with possible expansion nationwide.

A Comparison of Levels of Burden in Indian and White Parents With a Son or Daughter With Schizophrenia

Caregiver burden in mental illness is believed to differ between ethnic groups, but few studies have examined this in schizophrenia in the UK. To measure burden in British North Indian Sikh and white British parents with a son or daughter with established schizophrenia managed in outpatient care. A cross-cultural cohort study measuring family factors, patient psychopathology and levels of burden and distress. Overall levels of burden were low with no significant differences between the groups. Burden subscale scores showed Indian parents were more affected by psychotic behaviours than white parents. The groups also differed on several sociodemographic variables. In stabilized community patients, the overall extent of burden experienced by both Indian and white parents is low and comparable. However, Indian parents were more burdened by psychotic behaviours. This may be a result of co-residence as Indian patients are more likely to live with their families. Social and economic factors in the country of residence and levels of acculturation may also influence levels of burden and the illness behaviours found most bothersome by parents.