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Dynamics of Parental Opioid Use and Children's Health and Well-Being: An Integrative Systems Mapping Approach.

ABSTRACT: The seemingly intractable opioid epidemic compels researchers, the media, and families to better understand the causes and effects of this complex and evolving public health crisis. The effects of this crisis on people using opioids, maternal prenatal opioid exposure, and neonatal abstinence syndrome are well-documented, but less is known about the impact of caregivers' opioid use on children's health and well-being. One challenge to understanding the effects of parental opioid use disorder (OUD) on child and adolescent outcomes is the numerous interrelated pathways in which a child's health and well-being can be impacted. To better understand these dynamic relationships, we applied a systems mapping approach to visualize complex patterns and interactions between pathways and potential leverage points for interventions. Specifically, we developed a causal loop diagram system map to elucidate the complex and interconnected relationships between parental OUD, social determinants of health at the family and socio-environmental levels, family strengths, social supports, and possible adverse impacts on children's physical and mental health and risks for future substance misuse. The goals of this research are to (1) identify factors and dynamics that contribute to the relationship between parental OUD and children's health and well-being and (2) illustrate how systems mapping as a tool can aid in understanding the complex factors and dynamics of the system(s) that influence the well-being of children and their parents or primary caregivers.

SUBMITTER: Smith JC

PROVIDER: S-EPMC8275850 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Research on children's quality of life and subjective well-being has advanced over the past decade largely as a result of developments in childhood theory, children's rights legislation, and the shift toward positive social science. However, in line with the uncertainty regarding the conceptualization of subjective well-being, the structural configuration of children's subjective well-being has not been considered in the literature. In the current study, we present and test a model of children's subjective well-being, which includes global (context-free items assessing overall and general well-being, without reference to a specific aspect of life) and specific (domain-based items assessing a specific aspect of life) cognitive components, and positive and negative affect. We further test the fit structure of a hierarchical structural (second-order) model of children's subjective well-being. Finally, we test the measurement invariance of the hierarchical model across age and gender. We use data from the third Wave of the Children's Worlds Survey. The data source includes a sample of 92,782 participants selected from 35 countries (girls = 49.7%) in two age groups (10- and 12-years-old). We found a good fit for the four-factor confirmatory factor model of children's subjective well-being. Correlations between the various latent factors were as anticipated-with positive correlations between the life satisfaction components and positive affect, and negative correlations with negative affect. We further found a good fit for the hierarchical structural model of children's subjective well-being. Finally, we found the tenability of measurement invariance across age and gender. The study extends the generalizability of the hierarchical structural configuration of the subjective well-being to child samples, and provides a viable model to explore correlates and predictors of children's subjective well-being using the full conceptual model. Finally, we propound the tenability of a quadripartite hierarchical conceptual model of children's subjective well-being.

Project description:Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Previous research indicates that UK parents would value an approach that facilitates meeting their infants' needs while supporting their own sleep-related well-being throughout their infant's first year. Six initial stakeholder meetings were held with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The Possums Sleep Program developed and delivered in Brisbane, Australia in a GP clinic setting, was chosen as an appropriate approach. Working collaboratively with a stakeholder group, we translated the Possums Sleep Program into an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Parent and practitioner views of the initial materials were obtained via feedback questionnaires and the tool was revised. The intervention was then field-tested by 164 practitioners who delivered it to at least 535 new parents and babies over 5 UK locations, to capture anonymous parent and practitioner views of the intervention concept, the materials, and their experiences with both. The intervention helps parents recalibrate their expectations of infant sleep development, encourages responsive parenting and experimentation to meet their infant's needs, offers parents strategies for supporting the development of their babies' biological sleep regulators and promote their own well-being, and teaches parents to manage negative thinking and anxiety that can impede sleep using the principles of Acceptance and Commitment Therapy. The 'Sleep, Baby & You' discussion tool, a 14 page illustrated booklet for parents, was field-tested and evaluated by practitioners and parents who offered enthusiastic feedback. Practitioners reported the 'Sleep, Baby & You' materials were easy for them to explain and for parents to understand, and were a good fit with the responsive parenting approaches they employed in other areas of their work. Parents who received the intervention postnatally understood the material and found the suggestions easy to follow. All parents who provided feedback had implemented one or more of the suggested changes, with the majority of changes (70%) being sustained for at least two weeks. Practitioners recommended development of digital and antenatal versions and offered feedback on circumstances that might challenge effective uptake of the intervention. 'Sleep, Baby & You' is a promising tool for promoting parental attitude and behaviour-change, that aims to adjust parental expectations and reduce negative thinking around infant sleep, promote responsive infant care in the face of infant-related sleep disruption and fatigue, and support parental well-being during the first year of parenthood. Initial field-testing provided insights useful for further development and subsequent testing via a randomised trial. Support exists for incorporating 'Sleep, Baby & You' into an anticipatory, universal intervention to support parents who may experience post-partum fatigue and infant sleep disruption.

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Dynamics of Parental Opioid Use and Children's Health and Well-Being: An Integrative Systems Mapping Approach.

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