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Maternal well-being and its association to risk of developmental problems in children at school entry.

ABSTRACT: BACKGROUND: Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternal factors associated with children who screened at risk of developmental problems at school entry. METHODS: An existing cohort of 791 mothers who had been followed since early pregnancy was mailed a questionnaire when the children were aged four to six years. The questionnaire included a screening tool for developmental problems, an assessment of the child's social competence, health care utilization and referrals, and maternal factors, including physical health, mental health, social support, parenting morale and sense of competence, and parenting support/resources. RESULTS: Of the 491 mothers (62%) who responded, 15% had children who were screened at high risk of developmental problems. Based on a logistic regression model, independent predictors of screening at high risk for developmental problems at age 5 were male gender (OR: 2.3; 95% CI: 1.3, 4.1), maternal history of abuse at pregnancy (OR: 2.4; 95% CI: 1.3, 4.4), and poor parenting morale when the child was 3 years old (OR: 3.9; 95% CI: 2.1, 7.3). A child with all of these risk factors had a 35% predicted probability of screening at high risk of developmental problems, which was reduced to 13% if maternal factors were favourable. CONCLUSIONS: Risk factors for developmental problems at school entry are related to maternal well being and history of abuse, which can be identified in the prenatal period or when children are preschool age.

SUBMITTER: Tough SC

PROVIDER: S-EPMC2858134 | biostudies-literature | 2010

REPOSITORIES: biostudies-literature

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Maternal well-being and its association to risk of developmental problems in children at school entry.

Tough Suzanne C SC Siever Jodi E JE Benzies Karen K Leew Shirley S Johnston David W DW

BMC pediatrics 20100325

<h4>Background</h4>Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternal factors associated with children who screened at risk of developmental problems at school en ...[more]

PMID: 20338052

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Project description:BackgroundThe school nurse's role varies across countries. In Scotland, the Chief Nursing Officer recommended that the role should be refocused. The refocused programme emphasises nine care pathways with a view to improve pupils' health and wellbeing. Two sites were identified to test this new programme. Our aim was to assess how, for whom and under what circumstances the programme works in order to provide learning to support school nurse training and intended national roll-out.MethodsThis study was a mixed methods study, using a realist evaluation approach, and conducted in three phases. In phase one, six nurse managers from both study sites took part in individual interviews or focus groups and this was complemented by programme documents to develop initial programme theory. In phase two, the programme theory was tested using qualitative data from 27 school nurses, and quantitative data from the first 6 months of the programme that captured patterns of referral. The programme theory was refined through analyses and interpretation of data in phase three.ResultsThe findings show that the programme enhanced opportunities for early and improved identification of health and wellbeing needs. The context of the nine pathways worked through the mechanism of streamlining referral of relevant cases to school nurses, and yielded positive outcomes by extending school nurses and thus children's engagement with wider services. The mental health and wellbeing pathway was the most frequently used, and nurses referred complex mental health cases to more specialist mental health services, but felt less equipped to deal with low to moderate cases.ConclusionsThe programme facilitated early identification of risk but was less successful at equipping school nurses to actually deliver specific interventions as intended. Capacity building strategies for school nurses should seek to enhance intervention delivery skills within the parameters of the pathways. Realist evaluation provided a useful framework in terms of identifying contextual and mechanistic influences that required strengthening prior to wider implementation.

Project description:This research is part of the last study Drugs and School IX developed in the Basque Country (Spain) by the Instituto Deusto de Drogodependencias (Deusto Institute of Drug Addiction) of the University of Deusto (The study had the support of the Public Health and Addictions Directorate of the Deputy Health Ministry from the Health Department of the Basque Country.) and the data gathered by means of cluster sampling in two stages. The sample is made up of N = 6,007 girls and boys ranging from 12 to 22 years of age in secondary education, and the aims, on the basis of those parameters, are as follows: (1) describe the reality of drug consumption and some psychosocial variables in this sample, as well as analyze several relations between variables; (2) analyze the role of school well-being (SWB), self-esteem, and self-concept regarding consumption; (3) take a close look at the moderating role of age and gender on the relationship of school well-being, self-concept, and self-esteem with consumption; and (4) understand the existing interaction between all these variables, by studying the moderating role of self-esteem and self-concept in the influence of school well-being on consumption. With the use of a correlation, hierarchical regression, and mediation analysis with SPSS (v. 26) and Amos (v. 26) applications, three main conclusions were reached. Firstly, educational and academic well-being, academic self-concept, and self-esteem seem to play the role of protecting factors in adolescence, whereas assertiveness is linked to a higher consumption level. Secondly, academic self-concept has a mediating effect between well-being and consumption. Some of these relations are moderated by the variables of gender and age. Thirdly, age and gender are very relevant sociodemographic variables that must be taken into account in order to understand this phenomenon. Age has shown its covariant effect, which is especially relevant in the influence of academic well-being measured as being held back years. It has also proved to be important in order to understand its experiential or experimental and transitory character. Moreover, significant differences in consumptions have been found based on gender.

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Maternal well-being and its association to risk of developmental problems in children at school entry.

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Maternal well-being and its association to risk of developmental problems in children at school entry.

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