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PubMed2001

Individual and group-based parenting programmes for improving psychosocial outcomes for teenage parents and their children.

BACKGROUND: Rates of births to teenage parents are high and there is also a high incidence of poor outcomes among the children of teenage parents including developmental and learning problems, and child maltreatment. Parenting programmes may have an important role to play in improving outcomes for both teenage parents and their children. OBJECTIVES: The aim of this review was to examine the effectiveness of individual and/or group based parenting programmes in improving psychosocial and developmental outcomes in teenage mothers and their children. SEARCH STRATEGY: A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychLIT, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library including SPECTR, CENTRAL, National Research Register (NRR) and ERIC. SELECTION CRITERIA: Only randomised controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being a waiting-list, no-treatment or a placebo control group. Studies had to include at least one standardised instrument measuring maternal psychosocial health or infant health and development. DATA COLLECTION AND ANALYSIS: The included studies were critically appraised using a number of criteria including the method of allocation concealment. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to produce an effect size. Due to the presence of significant heterogeneity it was not possible to combine the results in a meta-analysis. MAIN RESULTS: The results of the review are based on data from four studies. These showed that both individual and group-based parenting programmes produced results favouring the intervention group on a range of maternal and infant measures of outcome including mother-infant interaction, language development, parental attitudes, parental knowledge, maternal mealtime communication, maternal self-confidence and maternal identity. REVIEWER'S CONCLUSIONS: The conclusions which can be drawn from this review are limited due to the small number of included studies, and the use of a restricted number of outcomes measures. The conclusions are also limited by some of the methodological deficiencies of the included studies. Despite these problems the findings of the included studies suggest that parenting programmes may be effective in improving outcomes for both teenage mothers and their infants. There is, however, a need for further research into the effectiveness of parenting programmes for teenage parents.

Adolescent↗
PubMed2004

New approach to association testing in case-parent designs under informative parental missingness.

The transmission/disequilibrium test (TDT) and related methods using genotype data on diseased probands and their both parents (triads) have been popular for testing linkage or association between a disease and a candidate gene. The usefulness of the TDT-type approaches lies mainly in their robustness, in the sense that they are valid under population stratification, arbitrary parental genotype distribution, and "informative" parental missingness where the parental missingness may depend on parental genotypes. Recently, a variety of extended TDTs were developed to accommodate parental missingness and to allow for using incomplete triads, including single-offspring-single-parent families (dyads) and single offspring with no parents (monads). However, these methods usually do not preserve the full robustness of the original TDT. In this paper, we propose a new TDT-type approach based on the conditional likelihood of the proband's genotype given the number and, if any, genotypes of the available parents, as well as the proband's phenotype. This new proposal keeps the full robust property of the original TDT. In addition, the new method is very easy to implement, without the need to specify models on parental mating-type probabilities and on parental missingness.

Genetic Linkage↗
PubMed2001

The relationship between parental modeling, eating patterns, and dietary intake among African-American parents.

OBJECTIVE: This article examines the relationship between the frequency with which African-American parents report modeling healthful dietary behaviors for their children and parental dietary intake. DESIGN: Cross-sectional, baseline data from a community-based dietary change study to reduce fat intake and increase fruit and vegetable consumption among African-American parents was analyzed to identify role-modeling behaviors. SUBJECTS/SETTING: Subjects were 456 African-American parents who participated in a dietary change study as part of a national parent education group. Participants completed the Parental Dietary Modeling Scale, an eating patterns questionnaire and a food frequency questionnaire. STATISTICAL ANALYSES PERFORMED: Descriptive statistics and stepwise multiple linear regression analyses were conducted. RESULTS: Parental modeling of healthful dietary behavior was associated with the performance low-fat eating patterns (r = 0.48; P < .001), lower dietary fat intake (r = -0.30; P < .001), and higher consumption of fruits and vegetables (r = 0.18; P < .001). APPLICATIONS: The frequency with which parents model healthful dietary behaviors may be associated with parental dietary intake and may have long-term implications for the development of childhood eating patterns. Dietetics professionals need to carefully assess parents' current dietary modeling behaviors and inform parents about how performance of these general behaviors may affect their child's ultimate nutrition health.

Adult↗
PubMed2007

Parental personality as an inner resource that moderates the impact of ecological adversity on parenting.

Parents' personality was examined as a moderator of the impact of demographic risk on parenting in a longitudinal study (N=102 families). Parents' personality and demographic risk (i.e., education level, age, family income, and family size) were assessed when children were infants, and parents' power assertion, warmth, and positive affect were observed in naturalistic interactions 2.5 years later. Parents' personality moderated the adverse impact of demographic risk on parenting. For parents who had memories of unstable and unhappy childhood experiences and who reported low conventionality, higher risk was linked to more power assertion, but there was no such link for those parents who recalled happy childhood experiences and who embraced conventions. For both parents who lacked a sense of optimism and social trust, and for fathers who reported low conventionality, higher risk was linked to less affectively positive parenting, but there was no such link for parents who were optimistic and trusting or for fathers who were conventional. Higher risk was linked to more power assertion, but only for mothers low in Extraversion and for fathers high in Neuroticism.

Adaptation, Psychological↗
PubMed2000

Coping when a child has a disability: exploring the impact of parent-to-parent support.

AIM: To explore the impact of parent-to-parent support when a child is born with a disability. DESIGN: The research approach was qualitative. Data were collected retrospectively and were derived from in-depth interviews with parents. The audio-taped interviews were transcribed and then analysed using constant comparative procedures. SETTING: Scotland. PARTICIPANTS: The parents of 63 children born with a congenital upper limb deficiency. FINDINGS: The early weeks and months following the birth of their baby was a difficult and emotional time for most parents. Feelings of isolation were common and there was a lot of concern about what the future would hold. Although a certain amount of support was derived from contact with family, friends and health professionals, parents did not generally obtain the level of support that was required from these sources. Contact with other parents of limb-deficient children, however, clearly exerted a powerful stress-buffering influence, providing much needed emotional, social and practical support. CONCLUSIONS: This study suggests that parents of children with special needs are uniquely qualified to help each other. The challenge is to ensure that health professionals are aware of the potential benefits of parent-to-parent support and provide parents with information about appropriate local organizations/ contacts.

Adaptation, Psychological↗
PubMed2003

Effects of gender and level of parental involvement among parents in drug treatment.

Most studies of parents in drug treatment have focused exclusively on mothers, and few studies have examined the effects of parents' level of involvement with their children on the parents' drug use and psychological functioning, either before or after treatment. This study examined mothers and fathers (n = 331) who were parents of children under the age of 18; participants were sampled from 19 drug treatment programs across four types of treatment modalities in Los Angeles County. A majority of each group (57% of 214 mothers and 51% of 117 fathers) were classified as being highly involved with their children. At the baseline assessment, higher parental involvement was related to lower levels of addiction severity, psychological severity, and symptoms of psychological distress, and to higher levels of self-esteem and perception of parenting skills. In general, fathers had higher levels of alcohol and drug-use severity than did mothers, but fathers who were more involved with their children showed lower levels of addiction severity than fathers who were less involved. Parental involvement at baseline was unrelated to drug use at the 12-month follow-up, although parents who were less involved with their children reported experiencing more stressors. Given the association of parental involvement with lower levels of addiction severity and psychological distress at baseline, treatment protocols should build upon the positive relationships of parents with their children, and seek to improve those of less-involved parents.

Adult↗
PubMed1995

The parent-nurse relationship from the perspective of parents of children with cancer.

Research to date has overlooked the specific relationship between parents and nurses, particularly in the context of family-centered care for a hospitalized child with cancer. The purpose of this study was to describe how parents perceive the relationship with the pediatric staff nurse necessitated by the hospitalization of their child with cancer. Using a symbolic interactionist framework and a modified grounded theory methodology, this study explored the parent-nurse relationship when a child with cancer is hospitalized. A purposive, theoretical quota sampling method was used to recruit 16 parents. Both parents' and nurses' care were examined from the parents' perspectives; mothers and fathers were interviewed separately. Analysis of the data led to the development of a substantive theory describing parent care (Making it Better), nursing care (Going Through the Motions, Caring Incompletely and Caring Completely), and the parent-nurse relationship (Working Together). Conditions influencing the care provided by parents and nurses and in turn the parent-nurse relationship were also identified. This research describes strategies nurses use to enhance the family-centered care they provide and reveals the effect nursing care has on parents' hospital experiences. Recommendations are made for nursing research, practice, and education.

Adolescent↗
PubMed2006

Communication about prognosis between parents and physicians of children with cancer: parent preferences and the impact of prognostic information.

PURPOSE: Concerns about the harms of prognostic information, including distress and loss of hope, cause some physicians to avoid frank disclosure. We aimed to determine parent preferences for prognostic information about their children with cancer and the results of receiving such information. PATIENTS AND METHODS: We surveyed 194 parents of children with cancer (overall response rate, 70%), treated at the Dana-Farber Cancer Institute and Children's Hospital (Boston, MA) and the children's physicians. Our main outcome measure was parent rating of prognostic information as extremely or very upsetting. RESULTS: The majority of parents desired as much information about prognosis as possible (87%) and wanted it expressed numerically (85%). Although 36% of parents found information about prognosis to be extremely or very upsetting, those parents were more likely to want additional information about prognosis than those who were less upset (P = .01). Parents who found information upsetting were no less likely to say that knowing prognosis was important (P = .39), that knowing prognosis helped in decision making (P = .40), or that hope for a cure kept them going (P = .72). CONCLUSION: Although many parents find prognostic information about their children with cancer upsetting, parents who are upset by prognostic information are no less likely to want it. The upsetting nature of prognostic information does not diminish parents' desire for such information, its importance to decision making, or parents' sense of hope.

Adolescent↗
PubMed2003

The impact of late-afternoon stimulant dosing for children with ADHD on parent and parent-child domains.

Examined the impact of late-afternoon stimulant dosing on parent and parent-child domains. Twenty-one children with attention deficit hyperactivity disorder (ADHD) participated in a double-blind, placebo-controlled medication assessment comparing varying doses of methylphenidate (MPH) and Adderall in the context of an intensive treatment program. Children received varying doses of stimulant medication, including active medication or placebo at 3:30 p.m. daily. Parent ratings of their mood, pleasantness of parent-child interactions, and perceived parenting effectiveness and successfulness were obtained each evening. Effective medication doses had a beneficial impact on parent-child domains (e.g., parent-child interactions) but did not significantly affect non-child-related parent variables (e.g., negative affect [NA]). Findings suggested that doses with beneficial effects lasting into the evening improved parent reports of the pleasantness of parent-child interactions but were insufficient to produce positive changes in parent functioning.

Adult↗
PubMed2000

Influence of parental gender and self-reported health and illness on parent-reported child health.

BACKGROUND: Although there is clear evidence of the influence of parental factors on child health outcomes, the influence of parental perceptions of their health and illness on the reporting of child health remains primarily unknown. OBJECTIVES: To examine relationships between parents' reporting of their own health and illness with the reporting of their children's health and illness. METHOD: We surveyed parents of a representative population-based sample of children aged 5 to 18 years. One parent of each child completed a written questionnaire including the Child Health Questionnaire, a subjective measure of functional health and well-being, and an assessment of self-reported parental health and illness. Logistic regression models were used to examine relationships between parent and child health and illness. MAIN RESULTS: 5340 parents responded (86% mothers, 14% fathers). After adjusting for confounding effects, parents self-reporting poor health had increased odds of reporting their children with poor health (odds ratio: 7.5), although the effect was modified by parent gender. There were increased odds of mothers with self-reporting poor global health reporting their children with poor global health and illness (odds ratio: 9.0 and 2.5, respectively) that were not observed for fathers. CONCLUSIONS: A mother's self-reported health is strongly associated with her reporting of her child's health; this was not observed for fathers. These results suggest that parental gender should be considered as a mediating factor in the reporting of child health.

Adolescent↗
PubMed2001

The perceived effects of parent-led support groups for parents of children with disabilities.

Parent-led support groups for parents who have children with disabilities are voluntary organizations with goals to provide social support and information and to foster advocacy. The purpose of this study was to explore parents' perceptions of the effect of parent-led support groups in providing parents with support and knowledge and in improving parents' ability to deal with childhood disability issues. Qualitative methods were used to examine the experiences of members of nine parent-run support groups. From these groups, 20 parents were interviewed about the benefits and limitations of participation in support group. Information was also collected by observing support group meetings and reviewing group documents. Interview, observation, and document data were analysed to identify emerging themes. Results of the study indicated that the effects of belonging to a parent-led parent support group were substantial. Through these groups, parents gain increased skills, an increased sense of power and a sense of belonging. Participants are able to connect with each other and provide support and skills to deal with the day-to-day issues of raising a child with disabilities.

Adolescent↗
PubMed1987

Parent-to-parent teaching.

The effectiveness of using parents as interventionists for their children and other parents was examined. A multiple baseline design was employed to measure the effects of specific intervention techniques on teaching skills of three parents of toddler-aged children with Down syndrome. The first parent was trained by a professional interventionist on the use of the techniques. This parent then trained a second parent, who then trained a third parent. A fidelity-of-implementation measure indicated that the parents implemented the training procedures appropriately when training another parent. The effectiveness of the intervention techniques was measured through an observational code that assessed parent and child behavior during teaching sessions. Results suggest that training had a functional effect on the parents' use of the selected intervention techniques. The intervention also had a functional effect on the children's percentage of correct responding during the teaching session.

Adult↗
PubMed1993

Advising parents to stop smoking: pediatricians' and parents' attitudes.

Pediatricians are in a unique position to address the issues of smoking cessation with parents. Vermont pediatricians and parents of their patients were surveyed to assess attitudes about giving and receiving smoking cessation advice. A questionnaire was mailed to all pediatricians in Vermont, and 72 valid responses were received, for a response rate of 91%. Forty percent of pediatricians routinely took a smoking history from parents and 11% recorded this information in the child's chart. Most pediatricians (94%) reported advising at least 60% of smoking parents to quit, and they spent an average of 4.4 minutes doing this. Barriers to giving advice were lack of time (42%), feeling that parents did not expect advice (25%), and feeling ill at ease giving the advice (25%). Only 8.5% of pediatricians had received training in how to give smoking cessation advice, but 87% were willing to learn methods to give advice briefly. Six hundred seventy-six parents from randomly selected pediatric practices were interviewed. The average parental age was 32, and 84% were women; 49% had never smoked, 30% were former smokers, and 21% were current smokers. Current smokers were less likely to agree with statements about the adverse effects of passive smoke on children. Most parents (56%) felt that pediatricians should give quit-smoking advice to parents, and 52% of smoking parents reported that they would welcome advice. Only 30% of current smokers said advice would bother them somewhat, and 15% had more negative reactions. Parents and pediatricians agreed on the best opportunities to give quit-smoking advice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

Listening to parents. A national survey of parents with young children.

OBJECTIVE: To document the child-rearing needs and pediatric health care experiences of parents with children from birth to 3 years old. DESIGN: A nationally representatives sample of 2017 parents with children younger than 3 years using a 25-minute structured telephone questionnaire. Interviews were completed by 68% of the screened eligible respondents. The margin of sampling error for results at the 95% confidence level was +/- 3 percentage points. RESULTS: Seventy-six percent of children younger than 3 years were reported by parents to be in excellent health; 88% had a regular source of pediatric health care. Seventy-one percent of parents who received special pediatric services rated their child's physician as excellent in providing good health care. Seventy-nine percent of parents reported they could use more information in at least 1 of 6 areas of child rearing, and 53% wanted information in at least 3 areas. Forty-two percent had talked with their child's physician about "nonmedical" concerns; 39% of parents read to or looked at a picture book with their child on a daily basis; 51% of parents set daily routines for meals, naps, and bedtime. Breast-feeding and reading to the child on a daily basis were much more likely if a physician encouraged parents to do so. CONCLUSIONS: Most parents view the pediatric health care system as meeting the physical health needs of their young children. Parents want more information and support on child-rearing concerns, yet pediatric clinicians often fail to discuss nonmedical questions with them. The interventions of pediatric clinicians can positively affect parental behavior. Pediatric practices should consider creative ways to reconstitute and augment their current services and systems of care.

Adult↗
PubMed2003

Inner-city African American parental involvement in children's schooling: racial socialization and social support from the parent community.

Parents (n = 161) and teachers (n = 18) from an urban elementary school serving primarily African American children completed questionnaires regarding racial socialization, social support, and involvement in activities that support youth educational achievement at home and school. Parental reports of racism awareness, and contact with school staff were significantly correlated with parent reports of at-home involvement and at-school involvement. Parent reports of social support from the parent community were significantly related to at-home involvement only. Relative to teacher reports, parents reported more formal contacts with school staff, and higher levels of racism awareness, religiosity, and African American cultural pride. Teachers and parents agreed on school climate and parental levels of at-home and at-school involvement. The results suggest that racial socialization processes are related to parent involvement in children's schooling and that increased efforts are needed to bridge a cultural gap between parents and teachers in inner-city communities.

Black or African American↗
PubMed2003

Evaluating the parental fitness of psychiatrically diagnosed individuals: advocating a functional-contextual analysis of parenting.

The parental fitness of psychiatrically diagnosed individuals is often questioned in termination of parental rights cases. The goal of this article is to shift the focus from a predisposing bias of unfitness to a functional-contextual analysis of parenting behavior and competency. Three underlying biased assumptions are relevant for the courts' decision making: (a) that a diagnosis (past or present) predicts inadequate parenting and child risk, (b) that a diagnosis predicts unamenability to parenting interventions, and (c) that a diagnosis means the parent is forever unfit. Each assumption will be considered in light of empirical evidence, with major depression, schizophrenia, substance abuse, and mental retardation provided as examples of diagnostic labels often assumed to render a parent unfit. A research agenda to improve clinicians' ability to assess parental fitness and understanding of how parental mental illness, mental retardation, or substance abuse might compromise parenting capacities is discussed for forensic purposes.

Adult↗
PubMed2006

Childhood obesity treatment: targeting parents exclusively v. parents and children.

There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0.02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (P<0.05). A greater reduction in food stimuli in the home (P<0.05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

Anthropometry↗
PubMed1994

Associations between the mental health and social networks of children and parents in single-parent families. A comparison between a clinical group and a control group.

The parents and children in single-parent families were studied. A group of 39 children ages 9-16 years who had been patients at a child and adolescent psychiatric clinic and a control group with an equal number of children were interviewed together with their single parent regarding social network and mental health. The networks of children and parents in the control group were more similar to each other than the networks of parents and children in the patient group. The crosswise influence of parents' mental health, children's behavioral disturbances and social networks showed associations between parents' mental health and children's behavioural disturbances, between parents's social networks and children's behavioural disturbances and between parents' mental health and their social networks. There was, on the other hand, no association between parents' mental health and the social networks of their children.

Adolescent↗