Do Intervention Programs in Child Care Promote the Quality of Caregiver-Child Interactions? A Meta-Analysis of Randomized Controlled Trials.
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ABSTRACT:
SUBMITTER: Werner CD
PROVIDER: S-EPMC4718933 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Purpose of the Study:A noted limitation of dementia caregiver intervention research is a lack of focus on the mechanisms of successful programs. The purpose of this study was to conduct a process evaluation of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) to describe its delivery and determine which of its components were associated with key outcomes (caregiver stress and well-being; care recipient residential care admission). Design and Methods:Adult child caregivers randomly assigned to receive the NYUCI-AC intervention (n = 54) were included. Detailed data on the frequency and duration of each intervention component received, 4-month review checklists, and regular caregiver assessments were collected. Quantitative (descriptive, logistic regression, Cox proportional hazards models, growth curve models) and qualitative thematic analyses were performed. Results:Adult children receiving the NYUCI-AC completed a mean of 5.19 individual and family counseling sessions; it took on average a little over 11 months to do so. All NYUCI-AC counseling components were generally well-received and improved caregivers' management of care-related stress. The individual counseling sessions' clinical benefits in reducing primary subjective stress were most apparent in the first year of the intervention. Caregivers who experienced negative outcomes over time used more family sessions. Implications:A key mechanism of benefit for adult child caregivers in the NYUCI-AC was the frequent use of individual counseling sessions. The qualitative and quantitative results emphasize the value of the NYUCI-AC's flexibility in allowing adult child caregivers to choose the timing and use of specific intervention components.
| S-EPMC5946885 | biostudies-other
Project description:Remotely delivered parenting interventions are suitable to promote child well-being and development, in a context of social isolation, as our society faced due to COVID-19. The objective of this systematic review was to assess the effectiveness of remotely delivered parenting interventions for typically developing children on caregiver-child interaction and child development. We carried out a systematic search to find studies from the inception of the database to September 2021 on six electronic databases: MEDLINE, CINAHL, Embase, Scopus, Web of Science Core Collection and Regional Portal Information and Knowledge for Health (BVS), and gray literature. Eligible study designs were experimental and quasi-experimental studies. We included parenting interventions as long as they were remotely delivered and focused on typically developing children. Two outcomes were considered: caregiver-child interaction and child development. Three randomized controlled trials (RCT) and one quasi-experimental study met the inclusion criteria. Results from two RCT revealed positive, small-to-medium effects on child development. One study showed that the new intervention had a not inferior effect compared to the results achieved by the traditional support. Children who participated in the quasi-experimental study showed significant elevations in language ability. One study reported positive caregiver-child interaction results. There is insufficient evidence to draw definitive conclusions regarding the effectiveness of remotely delivered parenting interventions on child development due to the heterogeneity of participant profiles, mode of delivery, and assessment tools. The results suggest the need to develop future methodologically rigorous studies assessing the effectiveness of remotely delivered parenting interventions for typically developing children on caregiver-child interaction and child development.
| S-EPMC9123827 | biostudies-literature
Project description:Preterm birth may leave long-term effects on the interactions between caregivers and children. Language skills are sensitive to the quality of caregiver-child interactions.Compare the quality of caregiver-child play interactions in toddlers born preterm (PT) and full term (FT) at age 22months (corrected for degree of prematurity) and evaluate the degree of association between caregiver-child interactions, antecedent demographic and language factors, and subsequent language skill.A longitudinal descriptive cohort study.39 PT and 39 FT toddlers individually matched on sex and socioeconomic status (SES).The outcome measures were dimensions of caregiver-child interactions, rated from a videotaped play session at age 22months in relation to receptive language assessments at ages 18 and 36months.Caregiver intrusiveness was greater in the PT than FT group. A composite score of child interactional behaviors was associated with a composite score of caregiver interactional behaviors. The caregiver composite measure was associated with later receptive vocabulary at 36months. PT-FT group membership did not moderate the association between caregiver interactional behavior and later receptive vocabulary.The quality of caregiver interactional behavior had similar associations with concurrent child interactional behavior and subsequent language outcome in the PT and FT groups. Greater caregiver sensitivity/responsiveness, verbal elaboration, and less intrusiveness support receptive language development in typically developing toddlers and toddlers at risk for language difficulty.
| S-EPMC5689464 | biostudies-literature
Project description:BackgroundThe WHO's Integrated Management of Childhood Illness (IMCI) has resulted in progress in addressing infant and child mortality. However, unmet needs of children continue to present a burden upon primary healthcare services. The capacity of services and quality of care offered require greater support to address these needs by extending and integrating curative and preventive care for the child with a long-term health condition and the child older than 5, not prioritised in IMCI. In response to these needs, the PACK Child intervention was developed and piloted in October 2017-February 2019 in the Western Cape Province of South Africa. We report health worker and caregiver perspectives of the existing paediatric primary care context as well as the extent to which PACK Child functions to address perceived problems within the current local healthcare system.MethodsThis process evaluation involved 52 individual interviews with caregivers, 10 focus group discussions with health workers, 3 individual interviews with trainers, and 31 training observations. Interviews and focus groups explored participants' experiences of paediatric primary care, perspectives of the PACK Child intervention, and tensions with implementation in each context. Inductive thematic analysis was used to analyse verbatim interview and discussion transcripts.ResultsPerspectives of caregivers and health workers suggest an institutionalised focus of paediatric primary care to treating children's symptoms as acute episodic conditions. Health workers' reports imply that this focus is perpetuated by interactions between contextual features such as, IMCI policy, documentation-driven consultations, overcrowded clinics and verticalised care. Whilst these contextual conditions constrained health workers' ability to translate skills developed within PACK Child training into practice, the intervention initiated expanded care of children 0-13 years and those with long-term health conditions, enhanced professional competence, improved teamwork and referrals, streamlined triaging, and facilitated probing for psychosocial risk.ConclusionPACK Child appears to be catalysing paediatric primary care to address the broader needs of children, including long-term health conditions and the identification of psychosocial problems. However, to maximise this requires primary care to re-orientate from risk minimisation on the day of attendance towards a view of the child beyond the day of presentation at clinics.
| S-EPMC7842050 | biostudies-literature
Project description:BackgroundBetter caregiver contribution to self-care in heart failure is associated with better patient outcomes. However, caregiver contribution to self-care is also associated with high anxiety and depression, poor quality of life, and poor sleep in caregivers. It is still unclear whether interventions that encourage caregivers to contribute more to patient self-care might increase caregivers' anxiety and depression and decrease their quality of life and sleep.ObjectiveThe aim of this study was to assess the impact of a motivational interview intervention aimed at improving caregiver contribution to self-care in heart failure on caregivers' anxiety, depression, quality of life, and sleep.MethodsThis is a secondary outcome analysis of the MOTIVATE-HF trial. Patients with heart failure and their caregivers were randomized into arm 1 (motivational interview to patients), arm 2 (motivational interview to patients and caregivers), and arm 3 (standard care). Data were collected between June 2014 and October 2018. The article has been prepared following the Consolidated Standards of Reporting Trials checklist.ResultsA sample of 510 patient-caregiver dyads was enrolled. Over the year of the study, the levels of anxiety, depression, quality of life, and sleep in caregivers did not significantly change among the 3 arms.ConclusionsMotivational interview aimed at improving caregiver contribution to self-care does not seem to increase caregiver anxiety and depression, nor decrease their quality of life and sleep. Thus, such an intervention might be safely delivered to caregivers of patients with heart failure, although further studies are needed to confirm our findings.
| S-EPMC10259208 | biostudies-literature
Project description:BackgroundComprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs).MethodsA literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted.ResultsA total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants' age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = - 0.56; 95% CI = - 0.97 to - 0.15, P = 0.007), but had no significant effect on the length of hospital stay.ConclusionsCGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.
| S-EPMC8218512 | biostudies-literature
Project description:This study examines associations between stimulating-responsive social interactions with mothers and nonparental childcare providers during the first 3 years of life and children's vocabulary and mathematics skills through age 15 (N = 1,364). Additive relations were found in which more stimulating-responsive interactions with mothers and with caregivers were linked to higher mathematics achievement in childhood and adolescence. More stimulating-responsive early interactions with mothers were also associated with larger child vocabularies through age 15. Synergistic relations, consistent with the dual-risk hypothesis, also were found. Children whose early interactions with both mothers and caregivers were low in stimulation and responsivity had substantially lower mathematics skills. Implications for early childhood interventions and policies are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
| S-EPMC6861641 | biostudies-literature
Project description:Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasi-experimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.
| S-EPMC7199033 | biostudies-literature
Project description:In museum settings, caregivers support children's learning as they explore and interact with exhibits. Museums have developed exhibit design and facilitation strategies for promoting families' exploration and inquiry, but these strategies have rarely been contrasted. The goal of the current study was to investigate how prompts offered through staff facilitation vs. labels printed on exhibit components affected how family groups explored a circuit blocks exhibit, particularly whether children set and worked toward their own goals, and how caregivers were involved in children's play. We compared whether children, their caregivers, or both set goals as they played together, and the actions they each took to connect the circuits. We found little difference in how families set goals between the two conditions, but did find significant differences in caregivers' actions, with caregivers in the facilitation condition making fewer actions to connect circuits while using the exhibit, compared to caregivers in the exhibit labels condition. The findings suggest that facilitated and written prompts shape the quality of caregiver-child interactions in distinct ways.
| S-EPMC8006285 | biostudies-literature
Project description:IntroductionA wide variety of instruments are used when assessing the methodological quality (MQ) of intervention programs. Nevertheless, studies on their metric quality are often not available. In order to address this shortcoming, the methodological quality scale (MQS) is presented as a simple and useful tool with adequate reliability, validity evidence, and metric properties.MethodsTwo coders independently applied the MQS to a set of primary studies. The number of MQ facets was determined in parallel analyses before performing factor analyses. For each facet of validity obtained, mean and standard deviation are presented jointly with reliability and average discrimination. Additionally, the validity facet scores are interpreted based on Shadish, Cook, and Campbell's validity model.Results and discussionAn empirical validation of the three facets of the MQ (external, internal, and construct validity) and the interpretation of the scores were obtained based on a theoretical framework. Unlike other existing scales, MQS is easy to apply and presents adequate metric properties. In addition, MQ profiles can be obtained in different areas of intervention using different methodologies and proves useful for both researchers doing meta-analysis and for evaluators and professionals designing a new intervention.
| S-EPMC10358327 | biostudies-literature