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Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress.

ABSTRACT: We sought to determine impacts of a pediatric primary care intervention, the Video Interaction Project, on 3-year trajectories of parenting stress related to parent-child interactions in low socioeconomic status (SES) families. A randomized controlled trial (RCT) was conducted, with random assignment to one of two interventions (Video Interaction Project [VIP]; Building Blocks [BB]) or control (C). As part of VIP, dyads attended one-on-one sessions with an interventionist who facilitated interactions in play and shared reading through review of videotaped parent-child interactions made on primary care visit days; learning materials and parenting pamphlets were also provided to facilitate parent-child interactions at home. Parenting stress related to parent-child interactions was assessed for VIP and Control groups at 6, 14, 24, and 36 months using the Parent-Child Dysfunctional Interaction subscale of the Parenting Stress Index- Short Form, with 378 dyads (84%) assessed at least once. Group differences emerged at 6 months with VIP associated with lower parenting stress at 3 of 4 ages considered cross-sectionally and an 17.7% reduction in parenting stress overall during the study period based on multi-level modeling. No age by group interaction was observed, indicating persistence of early VIP impacts. Results indicated that VIP, a preventive intervention targeting parent-child interactions, is associated with decreased parenting stress. Results therefore support the expansion of pediatric interventions such as VIP as part of a broad public health strategy to address poverty-related disparities in school-readiness.

SUBMITTER: Cates CB

PROVIDER: S-EPMC4847426 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress.

Cates Carolyn Brockmeyer CB Weisleder Adriana A Dreyer Benard P BP Johnson Samantha Berkule SB Vlahovicova Kristina K Ledesma Jennifer J Mendelsohn Alan L AL

Journal of child and family studies 20150814 3

We sought to determine impacts of a pediatric primary care intervention, the Video Interaction Project, on 3-year trajectories of parenting stress related to parent-child interactions in low socioeconomic status (SES) families. A randomized controlled trial (RCT) was conducted, with random assignment to one of two interventions (Video Interaction Project [VIP]; Building Blocks [BB]) or control (C). As part of VIP, dyads attended one-on-one sessions with an interventionist who facilitated interac ...[more]

PMID: 27134514

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Project description:UnlabelledThe physiological resistance of pathogens to antimicrobial treatment is a severe problem in the context of chronic infections. For example, the mucus-filled lungs of cystic fibrosis (CF) patients are readily colonized by diverse antibiotic-resistant microorganisms, including Pseudomonas aeruginosa. Previously, we showed that bioavailable ferrous iron [Fe(II)] is present in CF sputum at all stages of infection and constitutes a significant portion of the iron pool at advanced stages of lung function decline [R. C. Hunter et al., mBio 4(4):e00557-13, 2013]. P. aeruginosa, a dominant CF pathogen, senses Fe(II) using a two-component signal transduction system, BqsRS, which is transcriptionally active in CF sputum [R. C. Hunter et al., mBio 4(4):e00557-13, 2013; N. N. Kreamer, J. C. Wilks, J. J. Marlow, M. L. Coleman, and D. K. Newman, J Bacteriol 194:1195-1204, 2012]. Here, we show that an RExxE motif in BqsS is required for BqsRS activation. Once Fe(II) is sensed, BqsR binds a tandem repeat DNA sequence, activating transcription. The BqsR regulon--defined through iterative bioinformatic predictions and experimental validation--includes several genes whose products are known to drive antibiotic resistance to aminoglycosides and polymyxins. Among them are genes encoding predicted determinants of polyamine transport and biosynthesis. Compared to the wild type, bqsS and bqsR deletion mutants are sensitive to high levels of Fe(II), produce less spermidine in high Fe(II), and are more sensitive to tobramycin and polymyxin B but not arsenate, chromate, or cefsulodin. BqsRS thus mediates a physiological response to Fe(II) that guards the cell against positively charged molecules but not negatively charged stressors. These results suggest Fe(II) is an important environmental signal that, via BqsRS, bolsters tolerance of a variety of cationic stressors, including clinically important antimicrobial agents.ImportanceClearing chronic infections is challenging due to the physiological resistance of opportunistic pathogens to antibiotics. Effective treatments are hindered by a lack of understanding of how these organisms survive in situ. Fe(II) is typically present at micromolar levels in soils and sedimentary habitats, as well as in CF sputum. All P. aeruginosa strains possess a two-component system, BqsRS, that specifically senses extracellular Fe(II) at low micromolar concentrations. Our work shows that BqsRS protects the cell against cationic perturbations to the cell envelope as well as low pH and reduction potential (Eh), conditions under which Fe(2+) is stable. Fe(II) can thus be understood as a proxy for a broader environmental state; the cellular response to its detection may help rationalize the resistance of P. aeruginosa to clinically important cationic antibiotics. This finding demonstrates the importance of considering environmental chemistry when exploring mechanisms of microbial survival in habitats that include the human body.

Dataset Information

Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress.

Publications

Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress.

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