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Long-Term Effects of Parenting-Focused Preventive Interventions to Promote Resilience of Children and Adolescents.

ABSTRACT: In this article, we address three questions concerning the long-term effects of parenting-focused preventive interventions: 1) Do prevention programs promote effective parenting in families facing normative stressors as well as those facing frequent adversity? 2) Do parenting programs prevent children's long-term problems? 3) Do changes in parenting mediate long-term effects of programs? We address these questions by summarizing evidence from 22 programs with randomized trials and followups of three years or longer. We describe in more detail two interventions for divorced and bereaved families, suggesting that they prevent a range of problems and promote a range of developmental competencies over a prolonged period. Program effects to strengthen parenting mediated many of these long-term outcomes.

SUBMITTER: Sandler I

PROVIDER: S-EPMC6407875 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Long-Term Effects of Parenting-Focused Preventive Interventions to Promote Resilience of Children and Adolescents.

Sandler Irwin I Ingram Alexandra A Wolchik Sharlene S Tein Jenn-Yun JY Winslow Emily E

Child development perspectives 20150715 3

In this article, we address three questions concerning the long-term effects of parenting-focused preventive interventions: 1) Do prevention programs promote effective parenting in families facing normative stressors as well as those facing frequent adversity? 2) Do parenting programs prevent children's long-term problems? 3) Do changes in parenting mediate long-term effects of programs? We address these questions by summarizing evidence from 22 programs with randomized trials and followups of t ...[more]

PMID: 30854024

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Project description:BACKGROUND: Preventive interventions improve healthy behaviours and they also increase knowledge regarding back care in children and adolescents, but studies exhibit great variability in their contents, duration and number of sessions, and in the assessment methods. The purpose of this study was to review the empirical evidence regarding preventive physiotherapy interventions for back care in children and adolescents, and to ascertain the most efficacious treatments, in what way and under which circumstances. METHODS: Studies were located from computerized databases (Cochrane Library, Medline, PEDro, Web of Science and IME) and other sources. The search period extended to May 2012. To be included in the meta-analysis, studies had to use physical therapy methodologies of preventive treatment on children and adolescents, and to compare a treatment and a control group. Treatment, participant, methodological, and extrinsic characteristics of the studies were coded. Two researchers independently coded all of the studies. As effect size indices, standardized mean differences were calculated for measures of behaviours and knowledge, both in the posttest and in the follow-up. The random and mixed-effects models were used for the statistical analyses and sensitivity analyses were carried out in order to check the robustness of the meta-analytic results. RESULTS: A total of 19 papers fulfilled the selection criteria, producing 23 independent studies. On average, the treatments reached a statistically significant effectiveness in the behaviours acquired, both in the posttest and in the follow-up (d+?=?1.33 and d+?=?1.80, respectively), as well as in measures of knowledge (posttest; d+?=?1.29; follow-up: d+?=?0.76). Depending on the outcome measure, the effect sizes were affected by different moderator variables, such as the type of treatment, the type of postural hygiene, the teaching method, or the use of paraprofessionals as cotherapists. CONCLUSIONS: The interventions were successful in significantly increasing the behaviours and knowledge acquired both in the posttest and in the follow-up. The combined treatment of postural hygiene with physiotherapy exercise exhibited the best results. The small number of studies limits the generalizability of the results.

Project description:A long-term follow-up was made of 12 elbows operated upon between 1971 and 1986, with more than 20 years' follow-up, in nine males and three females, age at the time of surgery between 10 and 19 years . Eight right and four left elbows were involved, and there were three aetiological causes. Seven cases were sequelae of elbow fractures, of which five were supracondylar and two were of the olecranon. There were four cases of juvenile rheumatoid arthritis and one was post-osteomyelitis. The surgical technique involved a modification made by Vainio of MacAusland's technique (wider resection of the osseous ends and total covering of the bloody surfaces) [5, 9]. After extirpating the tissue blocking the joint, we proceeded to remodel the distal humerus in a wide V shape, the proximal end of the ulnar and, if necessary, the radial head. The proximal end of the ulna was sectioned transversely. All surgery was carried out sub-periosteally. Then, an interposition material was placed in one piece and sutured over the distal humerus and cut ends of the ulna and radius. The articular ends were brought together, and the capsule was closed using equidistant stitching, as is the skin. A small compression bandage was applied, and the arm was immobilised with a collar and cuff sling, with the forearm flexed to slightly less than a right angle. In ten cases, the interposition material was fascia lata grafts; in one case, skin graft and in one case, Gelfoam graft. Early rehabilitation began when post-operative pain allowed. Follow-up ranged from 25 to 32 years. Pre-surgical movement ranged between 90 degrees and 120 degrees of flexion and 30 degrees and 90 degrees of extension. Post-operative range varied between 90 degrees and 150 degrees of flexion. The five cases of full pre-operative ankylosis achieved between 90 degrees and 150 degrees of flexion and between 0 degrees and 70 degrees of extension. The total range of motion at the latest follow-up varied from 35 degrees to 150 degrees . Patients who were able to perform flexion of 120 degrees or more were considered to be excellent, those between 90 degrees and 119 degrees were graded good, from 60 degrees to 89 degrees fair and those 59 degrees or less poor. The ability to attain a hand to mouth position requires a mobility of 120 degrees . We obtained excellent results in two patients, good results in three, fair results in four and poor results in three. The fascia lata was used in 83% of cases, obtaining excellent to good results in five patients (41%). Elbow interposition arthroplasty has its indications in children and adolescents where arthrodesis or total joint replacement cannot be performed.

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Long-Term Effects of Parenting-Focused Preventive Interventions to Promote Resilience of Children and Adolescents.

Publications

Long-Term Effects of Parenting-Focused Preventive Interventions to Promote Resilience of Children and Adolescents.

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