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PubMed2006

The joint influence of parental modeling and positive parental concern on cigarette smoking in middle and high school students.

The purpose of the study was to examine the interaction between parental smoking status and parental attitudes, as measured by positive parental concern, on the risk of adolescent cigarette smoking. Parental smoking and parental concern about smoking were measured in a cross-sectional study of 37,244 students, a random sample of Maryland middle and high school students, who were current or never smokers. Parental concern was classified into 3 levels: strict, moderate, and minimal. The likelihood of youths being current smokers was positively associated with both parental smoking (both versus neither parent smokes: odds ratio [OR] 3.4, 95% confidence interval [CI] 3.1-3.7) and parental concern about smoking (minimal versus strict concern: OR 2.3, 95% CI 2.1-2.4). Youths with parents who did not smoke and with strict concern had the lowest likelihood of smoking. In comparison to this group, after adjustment for other social influences the likelihood of being a current smoker was more than 5 times greater among boys (OR 5.8, 95% CI 4.5-7.4) and girls (OR 5.2, 95% CI 4.1-6.5) whose parents both smoked and were minimally concerned about smoking. Current smoking in youths was independently associated with both parental smoking and less parental concern. When these 2 factors were jointly considered, the prevalence of current smoking in youths increased both with exposure to parental modeling and reduced parental concern about smoking. The results indicate that minimal parental concern about smoking worsens the risk due to parental modeling. Parental modeling and parental attitudes act synergistically to exacerbate the likelihood of smoking.

Adolescent↗
PubMed2001

Association of maladaptive parental behavior with psychiatric disorder among parents and their offspring.

BACKGROUND: A longitudinal study was conducted to investigate the role of maladaptive parental behavior in the association between parent and offspring psychiatric disorder. METHODS: Psychosocial and psychiatric interviews were administered to a representative community sample of 593 biological parents and their offspring from 2 counties in the state of New York in 1975, 1983, 1985 to 1986, and 1991 to 1993. In 1975, the offspring were a mean age of 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985 to 1986. Parent and offspring psychiatric symptoms were assessed in 1983, 1985 to 1986, and 1991 to 1993. RESULTS: Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. CONCLUSIONS: Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms.

Adolescent↗
PubMedDate not supplied

Do children know their parent's HIV status? Parental reports of child awareness in a nationally representative sample.

OBJECTIVE: To determine the rates and predictors of child awareness of parental human immunodeficiency virus (HIV) status and the effect of that knowledge on children. METHODS: Interviews were conducted with 274 parents from a nationally representative sample of HIV-infected adults receiving health care for HIV. The outcome measures were parental report of child's awareness of parental HIV status, how others reacted to child's parent having HIV, and reasons for nondisclosure. RESULTS: HIV-infected parents reported that 44% of their children (5-17 years old) were aware of their parent's HIV status, and parents had discussed with 90% of those children the possibility that HIV or acquired immunodeficiency syndrome (AIDS) might lead to their parent's death. Multivariate analyses revealed that parents with higher income, with an HIV risk group of heterosexual intercourse, with higher CD4 counts, with greater social isolation, and with younger children were less likely than others to report that their child knew the parent was HIV positive. Parents reported that 11% of children worried they could catch HIV from their parent. Reasons children did not know their parent's HIV status included that the parent was worried about the emotional consequences of disclosure (67%), was worried the child would tell other people (36%), and did not know how to tell their child (28%). CONCLUSIONS: HIV-infected parents often worry about the emotional consequences of disclosure to their children and that their children may tell others. More than a quarter of parents reported not knowing how to tell their children. Clinicians may be able to support and guide HIV-infected parents in deciding whether, when, and how to disclose their infection to their children.

Adolescent↗
PubMed2005

The quality of communication between parents and adolescent children in the case of parental cancer.

BACKGROUND: This study was designed to investigate: (i) parent-adolescent communication in families of cancer patients; (ii) relationships between parent-adolescent communication and posttraumatic stress symptoms (PTSS) in adolescent children; and (iii) associations between parents' illness characteristics and parent-adolescent communication. PATIENTS AND METHODS: A total of 212 adolescents completed the Impact of Event Scale and Parent-Adolescent Communication Scale. RESULTS: Adolescents communicated less openly with mothers with cancer than controls with mothers; this was the only significant difference with the reference group. Daughters communicated more openly with ill parents than with healthy parents. More open communication with healthy parents was related to fewer PTSS in daughters. More problem communication with both parents was related to more PTSS in both sons and daughters. Sons reported more problems in communication with ill parents in case of more intensive treatment or recurrent disease. Daughters experienced less open communication with both parents when ill parents received more intensive treatment. Time since diagnosis was not related to parent-adolescent communication. Multivariate analyses showed that communication patterns specifically affected PTSS of daughters. Problem communication with the healthy parent was the strongest predictor of intrusion while problem communication with the ill parents was the strongest predictor of avoidance. CONCLUSIONS: Parent-adolescent communication in families of cancer patients differs little from that in families not confronted with parental cancer. Problem communication outweighed lack of openness with respect to development of PTSS. Recurrent disease and intensive treatment regimens affected parent-adolescent communication negatively.

Adolescent↗
PubMed2002

[Maladaptative parenting and the association between parental and offspring psychiatric disorders].

A longitudinal study was conducted to investigate the role of maladaptive parental behavior and the association between parent and offspring psychiatric disorders. Psychosocial and psychiatric interviews were carried out in a representative community sample of 593 biological parents and their offspring from two counties in the state of New York in 1975, 1983, 1985-86, and 1991-93. In 1975, the mean age of offspring was 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985-86. Parent and offspring psychiatric symptoms were assessed in 1983, 1985-86, and 1991-93. Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, independent of whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms.

Adolescent↗
PubMed2001

Parent, child, and social correlates of parental discipline style: a retrospective, multi-informant investigation with female twins.

BACKGROUND: The type of parental discipline used in families appears to be related to parental characteristics, child temperament, and aspects of the social context. Within these three areas, we examine specific correlates of parental discipline (namely, limit setting and physical discipline) using a multiple informant model. METHOD: Using interview data from 2003 female twins from a population-based twin registry and 1472 of their parents, we examined retrospective reports of parental discipline from three perspectives. First, father and mother reporting separately on the type of discipline they provided for their offspring; second, each twin reporting on the type of discipline they received from their parents; and third, each parent reporting on the discipline provided by their spouse. Using a mixed model regression, we examined the impact on parental discipline of 25 potential predictor variables, as reported by parents, from three domains: social context, parental factors, and childhood vulnerability factors. RESULTS: There was a great deal of overlap between the independent variables for the two types of discipline in the areas of child vulnerability factors and family relationships, with similar effect sizes for child disobedience, teenage rebelliousness, and family discord. However, the profiles of parental characteristics associated with each type of discipline were quite different. Greater use of physical discipline was associated with less parental warmth, a higher incidence of parental lifetime generalised anxiety disorder, and more frequent religious attendance. Greater use of limit setting was associated with more years of parental education, younger age, and greater parental extroversion and authoritarianism. CONCLUSIONS: Parental characteristics, child temperament, and social context may all contribute to the frequency of discipline used in families, but parental characteristics may be most influential in determining the type of discipline used.

Adult↗
PubMed1998

Parent-adolescent conflict and stress when parents are living with AIDS.

Parental perceptions of conflict and stress with their adolescent children are described, and their associations with demographic factors, physical health, and lifestyle are examined. Adolescent-parent conflicts, parenting stress, and parents' health, substance use, and sexual lifestyle were assessed among 151 parents living with AIDS. Parents living with AIDS reported a mean of 3.3 (SD = 1.3) areas of conflict with their adolescents and 1.5 (SD = 1.7) stressful parenting events over the previous 3 months. The parents were very ill, with many physical symptoms and diseases. Simultaneously, substance use was common (17% used daily), but not injection drug use (3.3%). Half had a sexual partner (63% protected their partners by using condoms consistently). Regression analysis revealed that parent-adolescent conflict was significantly associated with high parental drug use; stressful parenting events were significantly related to the lifestyle (high drug use and frequent sex acts) of Latino and African American parents, but not of white parents. Results of the analysis indicate that, in contrast to parents with other illnesses, parent-adolescent conflict and stressful parenting events were not influenced by parents' health status, but were significantly influenced by substance use and sexual lifestyles.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Parent and adolescent perceived need for parental consent involving research with minors.

OBJECTIVE: To assess parents' and adolescents' perceived need for parental consent for minor adolescents to participate in minimal risk research studies based on procedural invasiveness (anonymous surveys, interviews, and blood or urine testing) and sensitivity of the topics (sexuality, drug and alcohol use, and sexually transmitted diseases and human immunodeficiency virus [HIV]). METHODS: An anonymous self-report questionnaire was administered to 100 adolescent-parent pairs at 2 clinical sites (urban and suburban) of Children's Hospital of Michigan in Detroit. RESULTS: By invasiveness of the research procedure, the proportions of parents and adolescents who perceived a need for parental consent were as follows: face-to-face interviews, 62% vs 48%; telephone interviews, 72% vs 46%; blood or urine testing, 77% vs 62%; and blood testing for HIV status, 78% vs 59%. These differences were only significant for telephone interviews and HIV blood testing. For anonymous surveys, a minority of parents (33%) and adolescents (26%) reported that parental consent was needed. Based on sensitivity of the research topics, the proportions of parents and adolescents who perceived a need for parental consent were as follows: sexuality, 60% vs 34%; drug and alcohol use, 56% vs 44%; contraception, 62% vs 46%; and sexually transmitted diseases and HIV testing, 56% vs 52%. These differences were only significant for sexuality. Parents with higher education believed that teens could give their own consent (P < .05). Fifty-seven percent of parents and their teens agreed that parental consent for anonymous surveys was not necessary. For more invasive procedures and more sensitive topics, the percentage of disagreement ranged from 28% to 55.5%. CONCLUSIONS: There is a greater perceived need for parental consent to adolescent participation in research studies among parents than among teens for more invasive procedures and more sensitive topics. These results suggest the need for sensitivity to differing adolescent and parental perceived need for parental consent for a minor adolescent to participate in such studies. Further studies with larger samples are needed to determine what factors influence diverse parent and adolescent opinions.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Parent interaction course in order to enhance communication skills between parents and children following pediatric cochlear implantation.

OBJECTIVE: To assess the effect of a parent interaction training course on the communication skills of parents of young implanted children. The training course was designed to help parents to be less controlling in their interactions with their deaf children and to facilitate the development of spoken language. STUDY DESIGN: Prospective study comparing the communication skills of parents of deaf children fitted with cochlear implants before and after a parent interaction training course. SETTING: Pediatric tertiary referral center for cochlear implantation. METHODS: Video samples were taken of parents interacting with their children 1 month before the course (ranging from 15 days to 2 months) and after the course (ranging from 15 days to 1 month). Video samples were then transcribed orthographically and parents' turns in the interaction were assigned to one of two categories: (a) initiations--the parent initiates conversation or introduces a new topic and (b) responses--the parent responds to the child's previous turn. 12 months after completion of the course, the process was repeated in order to establish the relative permanence of changes in behavior. HYPOTHESIS: The parents' turns would shift from a predominance of initiations to a predominance of responses as a result of attendance on the course. This would demonstrate that the parents were less controlling of their children in communication and were exhibiting more contingent behavior--responding to their child's initiations rather than expecting the child to respond to theirs. PATIENTS: The study involved 17 parents of 11 implanted children. The mean age at implantation was 4 years (range: 2.2-6.3 years). The implant experience of the children ranged from 2 to 23 months at the time of the study. All children used total communication. RESULTS: The post-course initiations were half those of the pre-course ones (median from 14 decreased to 7) and the responses were almost double following the course (median from 8 increased to 14). Both differences were statistically significant (P < 0.05). 12 months after the course, the responses score remained high with a median score of 16.5. However, a slight but significant increase in the initiation scores was also noted (median from 7 to 8.5). Parental satisfaction of the course was found to be high as no families failed to attend on any of the occasions despite the great distances some of them had to travel. CONCLUSION: The format of the parent interaction training course was found to be highly acceptable to the parents and the components covered proved to be effective in promoting positive changes in parental communication behavior. Clinicians need to provide a responsive environment for implanted deaf children and help others to do the same. The training course provided a very useful forum to share insights and skills and to evaluate ways of enhancing the communication between parents and children following cochlear implantation.

Child↗
PubMed2006

Parent-child agreement regarding children's acute stress: the role of parent acute stress reactions.

OBJECTIVE: We examined parent-child agreement regarding child acute stress disorder (ASD) and the relationship between parent ASD symptoms and parent ratings of child ASD. METHOD: Parent-child dyads (N = 219; child age 8-17 years) were assessed within 1 month of child injury. Parent-child agreement was examined regarding child ASD presence, severity, and specific symptoms. Relationships among parent ASD and parent- and child-reported child ASD were examined using regression analysis and generalized estimating equations (GEE). RESULTS: Parent-child agreement was low for presence of child ASD (kappa = 0.22) and for individual symptoms. Parent and child ratings of child ASD severity were moderately correlated (r = 0.35). Parent ASD was independently associated with parent-rated child ASD, after accounting for child self-rating (beta =.65). Generalized estimating equations indicated that parents with ASD overestimated child ASD and parents without ASD underestimated child ASD, compared to the child's self-rating. CONCLUSIONS: Parents' own responses to a potentially traumatic event appear to influence their assessment of child symptoms. Clinicians should obtain child self-report of ASD whenever possible and take parent symptoms into account when interpreting parent reports. Helping parents to assess a child's needs following a potentially traumatic event may be a relevant target for clinical attention.

Adolescent↗
PubMed2006

Parenting children with diabetes and Belsky's Determinants of Parenting Model: literature review.

AIM: This paper provides a critical appraisal of the parenting literature as related to children with diabetes and proposes an adapted model of Belsky's Determinants of Parenting. BACKGROUND: Diabetes is the leading endocrine disease in school-aged children. As primary healthcare providers, parents assume responsibility for the daily management of their children's diabetes. It is therefore inevitable that parenting becomes a crucial variable in determining diabetes control. However, the literature examining parenting children with a chronic illness such as diabetes is limited. METHOD: A literature search was conducted using the CINAHL, EMBASE, PsychINFO, and Social Science Index databases and the terms 'parenting', 'determinants of parenting', 'Belsky's Determinants of Parenting' and combined with 'children' and 'type 1 diabetes'. Parenting and nursing literature from 1984 to 2004 was included if it was related to parenting determinants and diabetes control in children. The literature retrieved was critically appraised and synthesized in relation to Belsky's Determinants of Parenting Model. FINDINGS: By incorporating new knowledge, an adapted Determinants of Parenting Model is proposed. The adapted model reflects a bi-directional relationship between parenting and child characteristics. Specifically, suggestions for future research on the adapted model and the bi-directional relationship between parenting and child characteristics are also discussed. CONCLUSION: Recommendations are presented for use of the adapted Determinants of Parenting Model for future nursing research. Future research will need to focus on establishing causal links between the determinants, identifying the extent to which each determinant influences parenting, and parenting determinants questionnaire development.

Child↗
PubMed2005

Parenting stress in mothers of children with an intellectual disability: the effects of parental cognitions in relation to child characteristics and family support.

BACKGROUND: Recent theories of stress and coping in parents of children with intellectual disabilities (ID) emphasize the importance of cognitive appraisals in influencing parents' levels of stress and their adaptations to difficulties presented by the children. This study investigated the relationships between parental cognitions, child characteristics, family support and parenting stress. The aspects of cognitions studied were: parenting self-esteem (including efficacy and satisfaction) and parental locus of control. METHODS: The group studied consisted of 46 mothers of children with ID. The Vineland Adaptive Behavior Scales and Maladaptive Behavior Domain were administered by interview. Mothers also completed four questionnaires: the Family Support Scale, the Parenting Sense of Competence Scale, a shortened form of the Parental Locus of Control Scale and the Parenting Stress Index (Short Form). RESULTS: Data were analysed using Pearson's correlation coefficients, partial correlations and a regression analysis. The results indicated that most of the variance in parenting stress was explained by parental locus of control, parenting satisfaction and child behaviour difficulties. Whilst there was also a strong correlation between family support and parenting stress, this was mediated by parental locus of control. CONCLUSIONS: The results demonstrate the potential importance of parental cognitions in influencing parental stress levels. It is argued that these results have implications for clinical interventions for promoting parents' coping strategies in managing children with ID and behavioural difficulties.

Adult↗
PubMed2003

Why do physicians think parents expect antibiotics? What parents report vs what physicians believe.

OBJECTIVE: To examine the relation between parent expectations for antibiotics, parent communication behaviors, and physicians' perceptions of parent expectations for antibiotics. STUDY DESIGN: A nested cross-sectional study with parallel measures of parents presenting children for acute respiratory infections (previsit) and physicians (postvisit) and audiotaping of the encounters. POPULATION: Ten physicians in 2 private pediatric practices (1 community-based and 1 university-based) and a consecutive sample of 306 eligible parents (response rate, 86%) who were attending sick visits for their children between October 1996 and March 1997. OUTCOMES MEASURED: Communication behaviors used by parents expecting antibiotics and physicians' perceptions of parents' expectations. RESULTS: Parents' use of "candidate diagnoses" during problem presentation increased the likelihood that physicians would perceive parents as expecting antibiotics (from 29% to 47%; P=.04), as did parents' use of "resistance to the diagnosis" (an increase from 7% to 20%). In the multivariate model, parents' use of candidate diagnoses increased the odds that a doctor would perceive a parental expectation for antibiotics by more than 5 times (odds ratio, 5.23; 95% confidence interval, 3.74-7.31; Plt.001), and parents' use of resistance to a viral diagnosis increased these odds by nearly 3 times (odds ratio, 2.73; 95% confidence interval, 1.97-3.79; Plt.001). CONCLUSIONS: Parents perceived as expecting antibiotics may be seeking reassurance that their child is not seriously ill or that they were correct to obtain medical care. Physicians were significantly more likely to perceive parents as expecting antibiotics if they used certain communication behaviors. This study revealed an incongruity between parents' reported expectations, their communication behaviors, and physicians' perceptions of parents' expectations.

Anti-Bacterial Agents↗
PubMed2005

Parents' perceptions of the value of the Webster-Stratton Parenting Programme: a qualitative study of a general practice based initiative.

BACKGROUND: Parenting styles and parent-child relationships are a determinant of emotional and behavioural problems in children. Controlled trials of parenting programmes have been shown to be effective in helping parents of children with clinical levels of behaviour problems, but there is little research on the impact of such programmes in families where children's development falls in the 'normal' range. Also, such trials do not shed light on why or how programmes do, or do not, work, or how they might be improved. METHODS: A qualitative study of the impact of the Webster-Stratton 'Parents and Children Series' programme on participants in a controlled trial of this programme, whose children's behaviour was below average, but, for the majority, in the normal range. Data were gathered in interviews, open-ended questions on a questionnaire and tape recordings of group leader supervision sessions. RESULTS: Parents reported increased confidence, better relationships with their children, successful use of new behaviour management techniques and improvements in their children's behaviour as a result of the programme. One parent found the programme unsuitable because she was already using the techniques that were taught, and another parent felt the programme was designed for parents of younger children. Many parents reported that additional sessions would have been useful to consolidate what they had learnt, and some parents felt the course would have been more effective if their partners had attended. CONCLUSIONS: The Webster-Stratton Parenting Programme is useful for parents of 'normal' children as well as for parents of children whose behaviour is in the clinical range. Follow-up sessions and attendance by both parents might increase effectiveness. The findings of this study suggest greater benefits to parents and children than were apparent in the controlled trial.

Adaptation, Psychological↗
PubMed2005

Parent or nurse? The experience of being the parent of a technology-dependent child.

AIMS: This paper reports a study exploring parents' experiences of caring for a child who is dependent on medical technology, and in particular of performing clinical procedures on their own children. BACKGROUND: A group of children with a continuing need for the support of medical technology have emerged in community settings as a result of medical advances and government policies. Caring for these children has a significant social and emotional impact on parents, because of their specialized and intensive care needs. Obtaining appropriate and coordinated home support services is problematic. METHODS: Grounded theory techniques were used, and in-depth interviews were conducted with the parents of 24 children. FINDINGS: Parents' accounts revealed that their constructions of parenting were shaped by the nature of their role in caring for their child and by the transformation of their homes by medical equipment and personnel. They described themselves as having a role that had both parenting and nursing dimensions. Parents managed this tension and defined their role and relationship to their child to be primarily one of parenting by differentiating parental care-giving and its underpinning knowledge from that of professionals, particularly nurses. CONCLUSIONS: Parenting a technology-dependent child alters the meaning of parenting. Professionals need to recognize that providing care has a substantial emotional dimension for parents, and that they need opportunities to discuss their feelings about caregiving and what it means for their parenting identity and their relationship with their child. A key professional nursing role will be giving emotional support and supporting parents' coping strategies. Parents' perceptions of nurses raise questions about whether nurses' caregiving is individualized to the needs of the child and family, and whether parental expertise is recognized.

Adolescent↗
PubMed1997

Comparing child-rearing practices in parents of children with cancer and parents of healthy children.

This nonexperimental, descriptive study identified parenting behaviors and differences in the reported child-rearing practices between parents of children diagnosed with cancer and parents of healthy children. Two groups of parents were included: 58 parents of children diagnosed with cancer at a large urban children's cancer center and 58 parents of healthy children. The total group of parents ranged from 22 to 58 years with 35.7 and 35.9 years as the mean ages of the two groups. A variety of races were included among the parents and educational backgrounds ranged from high school and vocational to graduate/ doctoral degrees. Each child with cancer selected a healthy friend of the same age, sex, and race who served as their healthy counterpart for this study. Each of these child's parents were then involved in the data collection process. Data were collected over a 2-month period using the Child-Rearing Practices Report (CRPR) in the Q-sort format, in which the parent sorted 91 cards containing 91 items dealing with child-rearing. Items were compared between the two groups using two-tailed t-tests. Using a significance level of alpha = .02, 11 significant differences were found between the two groups in the domains of parental expectations, discipline, expression of emotion, parental concern/worry, and overprotectiveness. In conclusion, the primary types of items that shared or demonstrated significant differences between the two groups of parents were those dealing with discipline and overprotectiveness issues. The items responded to most significantly different were, "I tend to spoil my child" and "I worry about the health of my child," with the parents of children with cancer consistently rating these as more descriptive of them than the parents of healthy children did. Finally, this study suggested that the time of the child's diagnosis with cancer also affected the parents' reported child-rearing practices.

Adolescent↗
PubMed2007

Parental smoking and adolescent smoking stages: the role of parents' current and former smoking, and family structure.

This study examined the role of parents' current and former smoking in predicting adolescent smoking acquisition stages. Participants were 7,426 students from 33 schools in the Netherlands. Participants' survey data were gathered at baseline and at two-year follow-up. Logistic regression models showed that parental smoking status was not only predictive of transitions from never smoking to trying smoking, monthly smoking, or daily smoking, but also of the progression from trying smoking to daily smoking. Further, although parental former smoking was weaker associated with progressive adolescent smoking transitions than current parental smoking, however absence of parental smoking history was most preventive. Compared to the situation in which both parents had never smoked, cessation of parental smoking after the child was born was associated with an increased risk for children to smoke. Adolescents living in a single-parent family were at greater risk of smoking than adolescents living in an intact family with both mother and father. In sum, the role of parental smoking is not restricted to smoking onset and is present throughout different phases of the acquisition process. Results support the delayed modeling hypothesis that parental smoking affects the likelihood for children to smoke even when parents quit many years before. Children living in single-parent families are only exposed to the behaviour of one parent; in two-parent families the behaviour from one parent may magnify or buffer the behaviour of the other parent.

Adolescent↗
PubMed2002

Parent report of mealtime behavior and parenting stress in young children with type 1 diabetes and in healthy control subjects.

OBJECTIVE: This study assessed parent report of mealtime behavior and parenting stress in preschoolers with type 1 diabetes. It was hypothesized that children with type 1 diabetes would be seen as exhibiting more mealtime behavior problems and that their parents would evidence greater parenting stress when compared with healthy subjects. It was also hypothesized that report of mealtime behavior problems would be positively correlated with parenting stress. RESEARCH DESIGN AND METHODS: A total of 40 children (aged 1-6 years) with type 1 diabetes were recruited from a pediatric hospital. Another 40 children matched for age, sex, marital status, and socioeconomic status were used as control subjects. Reliable and valid parent report measures, such as the Behavioral Pediatrics Feeding Assessment Scale and the Parenting Stress Index, were used for data collection. RESULTS: Parents of children with type 1 diabetes reported more behavioral feeding problems than parents of healthy control subjects. Additionally, parents of children with type 1 diabetes reported higher frequencies of parenting behaviors associated with poor nutritional intake and a greater number of parenting problems concerning mealtimes when compared with parents of healthy control subjects. Parents of children with type 1 diabetes also reported higher stress levels than parents of control subjects. A moderate relationship between mealtime behavior problems and general parenting stress was observed for families coping with type 1 diabetes. CONCLUSIONS: Mealtime problems reported in preschool children with type 1 diabetes are appropriate targets for behavioral intervention. Behavioral observation techniques and training in child behavior management skills should be used in future research aimed at assessing and treating barriers to effective nutrition management in young children with type 1 diabetes.

Adult↗