Parental perspectives on successful parent education and behavioral intervention.
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ABSTRACT:
SUBMITTER: Walz A
PROVIDER: S-EPMC8115604 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Adults and children in Canada are not meeting physical activity guidelines nor consuming sufficient nutrient-rich foods. High engagement in these unhealthy behaviours can lead to obesity and its associated diseases. Parent-child interventions aimed at obesity prevention/treatment have assisted families with making positive changes to their nutrition and physical activity behaviours. Given that the home environment shapes early health behaviours, it is important to target both parents and children when addressing diet and physical activity. One method that has been shown to improve health outcomes is co-active coaching. The current study explored the impact of a three-month co-active coaching and/or health education intervention on the dietary intake and physical activity behaviours of parents with overweight/obesity and their children (ages 2.5-10; of any weight). Body composition (i.e., body mass index [BMI] and waist circumference), changes in parental motivation with respect to physical activity and dietary behaviours, and parental perceptions of program improvements were collected. A concurrent mixed methods study comprised of a randomized controlled trial and a descriptive qualitative design was utilized. Fifty parent-child dyads were recruited and randomly assigned to the control (n = 25) or intervention (n = 25) group. Assessments were completed at baseline, mid-intervention (six weeks), post-intervention (three months), and six-month follow-up. A linear mixed effects model was utilized for quantitative analysis. Inductive content analysis was used to extract themes from parent interviews. No significant results were observed over time for the dependent measures. Parents in both control and intervention groups reported varied program experiences, including developing changes in perspective, increased awareness of habits, and heightened accountability for making positive changes in themselves, and consequently, their families. Parents also shared barriers they faced when implementing changes (e.g., time, weather, stress). Qualitatively, both groups reported benefitting from this program, with the intervention group describing salient benefits from engaging in coaching. This research expands on the utility of coaching as a method for behaviour change, when compared to education only, in parents with overweight/obesity and their children.
| S-EPMC7560045 | biostudies-literature
Project description:The parent-adolescent relationship has been a classic research topic, and researchers have found that parenting styles (e.g., authoritative, authoritarian) are closely related to various qualities of parent-adolescent relationships (e.g., cohesion, conflict). However, little empirical work has addressed how these variables correlate with each other in mainland China, nor has prior research addressed internal psychological mechanisms. The present study investigated the associations between parenting styles and parent-adolescent relationship factors, examined the mediating effects of adolescents' expectations of behavioral autonomy and beliefs about parental authority, and explored whether adolescent gender moderated these effects. Results from a sample of 633 Chinese adolescents (7th grade: M age = 13.50 ± 0.62 years, 9th grade: M age = 15.45 ± 0.67 years, 11th grade: M age = 17.30 ± 0.75 years) suggested similar levels of parent-adolescent conflict frequency for all parenting styles. However, for parent-adolescent conflict intensity, youth of neglectful and authoritarian parents reported higher levels compared to those with indulgent parents. The highest levels of cohesion with both parents were reported by adolescents with authoritative parents, followed by indulgent, authoritarian and neglect parenting styles. Cohesion with mothers for youth with authoritative or indulgent mothers was higher for girls than boys. Adolescents' expectation for behavioral autonomy mediated the links between parenting style and conflict, whereas adolescents' beliefs about the legitimacy of parental authority mediated the links between parenting style and cohesion; some of these mediating effects differed by gender. Findings highlight the importance of studying potential effects of adolescents' values and attitudes within the family system in specific cultural contexts.
| S-EPMC6243060 | biostudies-literature
Project description:ObjectiveThe goal of this study is to examine the association between parental incarceration and parent-youth closeness.BackgroundDespite the established complex repercussions of incarceration for relationships between adults, and the well-known intergenerational consequences of parental incarceration, little is known about how incarceration structures these intergenerational relationships.MethodIn this paper, I use data from the Future of Families and Child Wellbeing Study (N = 3,408), a cohort of children followed over a 15-year period, to examine how parental incarceration is associated with relationships between youth and their (incarcerated and non-incarcerated) parents.ResultsResults suggest three conclusions. First, parental incarceration is negatively associated with closeness between youth and their incarcerated parents. Second, the timing of first parental incarceration is important. Parental incarceration in early or middle childhood is negatively associated with closeness between youth and their incarcerated parent, and parental incarceration in adolescence is positively associated with closeness between youth and their non-incarcerated parent. Third, relationships between parents themselves explain some of the association between paternal incarceration in early childhood and father-youth closeness.ConclusionTaken together, these findings advance our understanding of both the relational and intergenerational consequences of criminal legal contact and our understanding of the correlates of parent-youth relationships and, in doing, so, highlights how family ecological contexts contribute to inequality.
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Project description:Poor participant engagement undermines individual and public health benefits of early intervention programs. This study assessed the extent to which three types of engagement (participant enrolment, retention and involvement) were influenced by individual, program and contextual factors. Data were from a cluster randomised controlled trial (N?=?1447) of a community-based parenting program, delivered at two levels of intensity (group sessions with and without individualised home coaching) conducted in Victoria, Australia. Individual (parent and family) factors and program factors were assessed by parent report and administrative records, and contextual factors by area-level population statistics. Data were analysed using multilevel logistic or linear regression models. Individual and contextual factors predicted enrolment, while family and program factors were more influential on program retention and parents' active involvement. Provision of individualised support was important to all forms of engagement, particularly for families experiencing the greatest barriers to participation. These findings indicate that different strategies are required to effectively support families in the processes of enrolling, continuing to attend and actively participating in early intervention programs.
| S-EPMC6182377 | biostudies-literature
Project description:Parent-Child Interaction Therapy (PCIT) is an empirically supported intervention originally developed to treat disruptive behavior problems in children between the ages of 2 and 7 years. Since its creation over 40 years ago, PCIT has been studied internationally with various populations and has been found to be an effective intervention for numerous behavioral and emotional issues. This article summarizes progress in the PCIT literature over the past decade (2006-2017) and outlines future directions for this important work. Recent PCIT research related to treatment effectiveness, treatment components, adaptations for specific populations (age groups, cultural groups, military families, individuals diagnosed with specific disorders, trauma survivors, and the hearing-impaired), format changes (group and home-based), teacher-child interaction training (TCIT), intensive PCIT (I-PCIT), treatment as prevention (for externalizing problems, child maltreatment, and developmental delays), and implementation are discussed.
| S-EPMC5530857 | biostudies-other
Project description:In studies of case-parent triads, information is often collected about history of the condition in the parents, but typically parental phenotypes are ignored. Including that information in analyses may increase power to detect genetic association for autosomal variants. Our proposed approach uses parental phenotypes to assess association independently of the usual case-parent-based association test, enabling cross-generational internal replication for findings based on offspring and their parents. Our model for parental phenotypes also resists bias due to population stratification. We combine the information from the two generations into a single coherent model that can exploit approximate equality of parental and offspring relative risks to improve power and can also test that equality. We call the resulting procedure the Parent-phenotype Informed Likelihood Ratio Test (PPI-LRT). When some parental genotypes are missing, one can use the expectation-maximization algorithm to fit the combined model. We also develop a second composite test (PPI-CT) based on a linear combination of the parent-phenotype-based test statistic and that from the traditional log-linear, transmission-based test. We evaluate the proposed methods through non-centrality parameter calculations and simulation studies and compare them to the previously proposed approaches, parenTDT and combTDT. We show that incorporation of parental phenotype data often improves statistical power. As illustration, we apply our method to a study of young-onset breast cancer and find that it improved precision for SNPs in FGFR2 and that estimated relative risks based on triads are closely replicated using the parental data.
| S-EPMC4477179 | biostudies-literature
Project description:IntroductionThe thalamus is the hub of the brain and has a significant role in various brain activities.PurposeThis study explored racial differences in the association between parental education and thalamus volume among American children.MethodsUsing data from the Adolescent Brain Cognitive Development (ABCD), we analyzed the structural Magnetic Resonance Imaging (sMRI) data of 11141 9-10 years old children. The main outcome was the left thalamus volume. The independent variable was parental education. Age, sex, ethnicity, family marital status, and intracranial volume were the covariates. Race was the moderator. To analyze the data, we used mixed-effects regression models.ResultsIn race-stratified models, high parental education was associated with smaller thalamus volume in White but not Black children. In the pooled sample, significant interactions were found between race and parental education suggesting that the effect of parental education on left thalamus volume is significantly smaller for Blacks and mixed/other race children than White children. We did not find similar findings for the right thalamus volume.ConclusionsThe effect of parental education on children's left thalamus volume seems to be weaker for Black and other/mixed-race children than their White counterparts. This finding is in support of Minorites' Diminished Returns (MDRs) that suggest due to social stratification and racism, economic resources have weaker-than-expected effects for minority than majority populations.
| S-EPMC8297613 | biostudies-literature
Project description:Decades of research supports a widely held view that providing parent care is stressful, and that these stresses are associated with adverse mental health outcomes. However, some recent studies suggest an additional possibility, namely that "noncaregiver stress"-a consequence of having a parent with major care needs, but not being an active caregiver-may be a serious problem as well. This finding emerges in data which permit separate controls for parental needs for care and offspring provision of parent care. We extend these results using Generations and Gender Programme data from five countries-Bulgaria, France, Georgia, Romania, and Russia-for which the necessary variables can be comparably measured. Our outcome variable is a depression score based on a 7-item scale. In country-specific regressions, we find two instances of statistically significant associations of depression with the regular provision of personal care to a parent with care needs, i.e., the usual "caregiver stress" result. However, we also find two instances of statistically significant differences in respondents' depressive symptoms that are associated with having a parent with care needs, i.e., instances of "noncaregiver stress." We find limited evidence of gender-specific responses to both forms of stress. Our evidence supports both the typical caregiver stress response and the less-studied noncaregiver stress response, which suggests the need for additional research.
| S-EPMC5549236 | biostudies-other
Project description:This study examined Morbidity and Mortality (M&M) review practices and perspectives of physicians and parents regarding parent participation in M&M review. Surveys were distributed to parents of children with a prior hospitalization for congenital heart disease (CHD) and physicians caring for pediatric CHD patients. Response distributions and Fisher's exact tests were performed to compare parent and physician responses. Qualitative survey data were thematically analyzed. Ninety-two parent and 36 physician surveys were analyzed. Physicians reported parent input or participation was rarely sought in M&M review. Parents with direct experience of adverse events or death of their child reported providers discussed events with them in a timely manner and answered their questions; however, nearly half wished their healthcare team had done something differently during the disclosure. There was no statistical difference between groups regarding transparency (P = .37, .79); however, there was a significant difference in perspectives regarding parental involvement in the M&M review (P < .001). Common themes important to parents which emerged from the qualitative analysis were being adequately informed, feeling their perspectives were acknowledged and respected, having attentive and empathetic providers, and receiving consistent messaging. Although rarely included in current practice, parent participation in M&M could offer unique insight and increase accountability to proposed change elucidated by M&M review.
| S-EPMC9134398 | biostudies-literature
Project description:ImportanceParents of children with cancer value strong therapeutic relationships with oncology clinicians, but not every relationship is positive.ObjectiveTo identify the prevalence of challenging parent-clinician relationships in pediatric oncology and factors associated with these challenges from parent and clinician perspectives.Design, setting, and participantsThis survey was conducted among parents and oncology clinicians of children with cancer within 3 months of diagnosis from November 2015 to July 2019 at Dana-Farber Cancer Institute/Boston Children's Hospital and Texas Children's Hospital. Participants were 400 parents of children with cancer and 80 clinicians (ie, oncology physicians and nurse practitioners). Parents completed surveys about relationships with 1 to 2 primary oncology clinicians; clinicians completed surveys about relationships with parents. Data were analyzed from July 2020 to August 2021.ExposuresAt least 3 previous clinical visits between parent and clinician.Main outcomes and measuresThe Relationship Challenges Scale Parent Version and Clinician Version were developed and used to measure threats to the therapeutic alliance. For the Relationship Challenges Scale-Parent version, relationships were considered challenging if a parent responded to any single question in the 2 lowest of 4 possible categories. For the Relationship Challenges Scale-Clinician version, challenges were considered to be present if a clinician reported responses in the 3 lowest of 6 possible response categories to any question.ResultsAmong 400 parents, there were 298 [74.5%] women, 25 Asian individuals (6.3%), 28 Black individuals (7.0%), 97 Hispanic individuals (24.3%), 223 White individuals (55.8%), and 10 individuals (2.4%) with other race or ethnicity; race and ethnicity data were missing for 17 (4.3%) individuals. Among 80 clinicians, there were 57 (71.3%) women, 38 attending physicians (47.5%), 32 fellows (40.0%), and 10 nurse practitioners (12.5%). Parents identified 676 unique relationships with clinicians, and clinician reports were available for 338 relationships. Among 338 relationships with paired parent and clinician surveys, 81 relationships (24.0%) were considered challenging by parents, 127 relationships (37.6%) were considered challenging by clinicians, and 33 relationships (9.8%) were considered challenging by parent and clinician. Parents with Asian or other race or ethnicity (odds ratio [OR] vs White parents, 3.62; 95% CI, 1.59-8.26) or who had lower educational attainment (OR for ≤high school vs >high school, 3.03; 95% CI, 1.56-5.90) were more likely to experience relationships as challenging. Clinicians used a variety of strategies more frequently in 127 relationships in which they perceived challenges vs 211 relationships in which they did not perceive challenges, such as holding regular family meetings (22 relationships [17.3%] vs 13 relationships [6.2%]; P = .009) and offering extra time and attention (66 relationships [52%] vs 60 relationships [28.4%]; P < .001). However, these strategies were not used with increased frequency when parents experienced relationships as challenging vs when parents did not experience this.Conclusions and relevanceThis survey study found that nearly one-quarter of parents of children with cancer reported challenges in the therapeutic relationship with their oncologist and that clinicians used strategies to improve relationships more frequently when they experienced the relationship as challenging. These findings suggest that new strategies are needed to improve experiences for parents and to help clinicians recognize and attend to parents whose experiences are suboptimal.
| S-EPMC8600390 | biostudies-literature