Heterogeneity among adolescent mothers and home visiting program outcomes

Despite the challenges of early parenting, many adolescents navigate motherhood successfully, underscoring an overlooked heterogeneity among adolescent mothers. The present study used Latent Class Analysis (LCA) to identify subgroups of adolescent mothers (n = 704) enrolled in a randomized controlled trial (RCT) evaluation of a home visiting program for young parents. The model incorporated demographic and background characteristics, as well as indicators of psychological vulnerability. Analyses revealed four distinct subgroups: (a) non-Hispanic high vulnerability (n = 209, 30%); (b) Hispanic high vulnerability (n = 98, 14%); (c) non-Hispanic moderate vulnerability (n = 241, 34%); and (d) Hispanic moderate vulnerability (n = 156, 22%). Mothers in the two high vulnerability subgroups exhibited the poorest personal and parenting functioning outcomes measured approximately two years postpartum, particularly in terms of child maltreatment (non-Hispanic high vulnerability) and depressive symptoms (Hispanic high vulnerability). Analyses revealed positive effects of the home visiting program within specific latent classes on such outcomes as healthy baby at birth, high school or GED attainment, and repeat birth.     

Parenting and emotional well-being of adoptive school-aged children: The mediating role of attachment

This study focuses on the processes of adoptive parenting that affect children's emotional well-being. It aims to analyze the role of children's attachment as a mediator of the relationship between both parenting styles and parenting stress and children's positive and negative affect in adoptive families of school-aged children. The study included 322 Portuguese participants, divided into one group of adoptive parents (n = 135) and one comparison group of non-adoptive parents (n = 187); target-children were aged between 6 and 12 years. Self-report questionnaires were used to analyze the dimensions under study (parenting styles, parenting stress, children's attachment and children's emotional well-being). After conducting a preliminary analysis to identify potential differences between the adoptive and the non-adoptive parents, a mediation model was tested using the path analysis procedure. A baseline model was established, followed by a multi-group analysis in order to explore the model's invariance across the groups. Children's attachment mediated the relationship between parenting (styles and stress) and children's positive and negative affect. The multi-group analysis revealed that, for the adoptive group, both secure and anxious/ambivalent attachment mediated the association between parenting stress and negative affect; for the non-adoptive group, secure attachment was found to mediate the link between emotional warmth and positive affect. For both groups, the relationship between parenting stress and positive affect was mediated by secure attachment. Results pointed to the relevance of children's attachment in the association of parenting styles and parenting stress with children's emotional well-being. Moreover, differences concerning the mediation model emerged across the two groups, revealing that children's negative outcomes were better explained in the adoptive group. The results reinforce the importance of supporting adoptive parents after the adoption process.     

Exploration of factors predictive of at-risk fathers' participation in a pilot study of an augmented evidence-based parent training program: A mixed methods approach

There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers (M_age = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs.     

Empowering children with safety-skills: An evaluation of the Kidpower Everyday Safety-Skills Program

Changes in child safety knowledge concerning bullying, boundary-setting, and help-seeking were evaluated after participation in the Kidpower Everyday Safety Skills Program (ESSP), a workshop designed to increase children's knowledge of safe choices. The program consisted of an in-school workshop, weekly follow-up sessions, and homework assignments over 10 weeks and included skills-training, parental involvement, and opportunities to practice safety skills. Third-grade students (n = 128) participated in pre- and post-tests of safety skills, and were compared to a comparison group (n = 110) that did not participate in the program. Findings indicate that students who participated had increases in safety knowledge (maintained over 3 months) greater than the comparison group. Additional assessments indicate that the program was implemented with high fidelity and both teachers and students found the program successful. Children's understanding of the competency areas boundary-setting, stranger safety, help-seeking, and maintaining calmness and confidence improved.     

Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation

IntroductionThe Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50–65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN.MethodsData were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n = 163); qualitative data via face-to-face exit interviews with intervention program completers (n = 10) and non-completers (n = 10), and brief post education session discussions.ResultsMost participants (87%–96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy.ConclusionThe evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.     

Reducing hostile parenting through computer-mediated parenting education

ObjectiveThe present study evaluated a computer-mediated parent education program aimed at improving parents' self-concept and dysfunctional parenting practices.DesignEmployer-based parent education services were offered as part of a corporation's employee wellness program. Participants (N = 247) were asked to complete pre- and post-test surveys including surveys of demographic information, parental self-concept, and dysfunctional parenting behaviors.ResultsParticipants reported clinically significant levels of dysfunctional parenting practices at baseline. Results from the single-dose intervention indicated a significant decrease in hostile parenting from pre-test to post-test, which was likely predicted by parents' sense of competence at baseline.ConclusionComputer-mediated parent education workshops were efficacious in improving parents' self-concept and reducing parents' use of hostile parenting tactics. The study provides an important contribution to the extant literature by documenting the effectiveness of computer-mediated parenting programs, particularly those offered through the workplace.     

A parent's place: Parents', mentors' and program staff members' expectations for and experiences of parental involvement in community-based youth mentoring relationships

Youth mentoring has been conceptualized largely as a dyadic relationship between a mentor and mentee, with less attention paid to the role of parents. This study contributes to an emerging body of research on parent involvement by examining expectations for parents' roles in the mentoring process held by program staff, mentors, and parents themselves. In-depth interviews with mentoring program staff (n = 12), mentors (n = 30), and a parent or guardian of the youth being mentored (n = 30) were analyzed to identify these participants' views on the role of parents. Findings indicate that mentors and program staff were more aligned in their views and tended to be more focused on the ways that parents could potentially interfere with or otherwise disrupt the mentor–youth relationship. Parents' views were more varied and rooted in differences in both their individual values and beliefs about the role of a mentor in their child's life, their parenting styles and ways they expected adults outside of the family who were interacting with their child to engage with them. Implications for future research on parent involvement and for mentoring program practices are discussed.     

Parents' persistence and certification in a two-generation education and training program

Two-generation programs provide education and training services for parents while their children attend early childhood education programs. This study examines the rates of persistence and certification of parents in one of the only two-generation interventions in the country under study, CareerAdvance®, which offers training in the healthcare sector to parents while their children attend Head Start (n = 92). Results indicate that 16 months after enrolling in CareerAdvance®, 76% of participants attained at least one workforce-applicable certificate of the program and 59% were still in the program. The majority of parents who left the program during the 16 months had attained a certificate (68%). Parents with high levels of material hardship were more likely to attain a certificate and stay enrolled in the program, and parents with higher levels of psychological distress were less likely to attain a certificate in the same time period. Implications for future two-generation programming are discussed.     

Cost effectiveness of a school readiness intervention for foster children

ObjectiveMany young children in foster care suffer from emotional and behavior problems due to neglect and abuse. These problems can lead to difficulties in school, and functioning in school is linked to long-term health and development. Early intervention to reduce emotional and behavioral issues can help children successfully transition to school, which can improve long-term outcomes. However, communities need information on relative costs and benefits associated with programs to make informed choices. The objective of this study was to assess cost effectiveness, over 12 months, of the Kids in Transition to School (KITS) intervention compared to usual services available to children in a foster care control group (FCC).MethodRandomized controlled trial of 192 children in foster care entering kindergarten who were randomized to KITS (n = 102) or FCC (n = 90). KITS includes school readiness groups and parent training over 4 months. Main outcomes were days free from internalizing symptoms (IFD), days free from externalizing behavior (EFD), intervention costs, public agency costs, and incremental cost effectiveness.ResultsKITS significantly increased IFD and EFD compared to FCC. Average total cost of the intervention was $932 per family. The intervention did not significantly impact usual services. Average incremental cost effectiveness was $64 per IFD and $63 per EFD.ConclusionsThe cost of KITS is comparable to, or less than, similar programs, and the intervention is likely to provide significant emotional and behavioral benefit and improvement in school readiness for young children in foster care.     

The reasons why children work on the streets: A sample from Turkey

The phenomenon of children working on the streets is a societal issue in all underdeveloped or developing countries just as it is in Turkey. The purpose of this research was to examine the reasons that children work on the street by conducting individual in-depth interviews with working children and their mothers, choosing individuals from similar socioeconomic demographic backgrounds and making a comparison of their acceptance or rejection of working, the perception of social support received by the mothers, and their problem-solving skills. The research was a mixed study that used both qualitative and quantitative techniques. The research was conducted in two stages. In the first stage, quantitative comparisons were made of the problem-solving skills of and social support received by the mothers of children working on the streets (n = 37) and non-working children (n = 35) and of the parental acceptance or rejection/control status of working children (n = 41) and non-working children (n = 41). In the second stage, the reasons children were working on the streets were evaluated qualitatively with seven children who were working on the streets and nine mothers. The Child/Adolescent Parental Acceptance–Rejection/Control Questionnaire, the Multidimensional Scale of Perceived Social Support, the Problem-Solving Inventory, and individual interview questionnaires were used as data collection tools. The social support and problem solving skills of the mothers with children working on the streets were lower than those of the mothers whose children were not working. The main themes and sub-themes that stood out at the end of the research were socioeconomic and political factors, environmental factors, cultural factors and family factors.     

Factors that influence parent recruitment into prevention programs in early childhood: A concept map of parents', practitioners', and administrators' points of view

Given that parents are the main carriers of change in their child, their participation in programs for preventing behavior problems in early childhood represents a key element in ensuring the success of the intervention. That said, although at-risk families benefit the most from this type of program, they are identified as being hard to reach. This study aims at identifying the factors that influence parent recruitment based on the points of view of the actors concerned. To this end, a concept mapping operation was performed, which involved parents (n = 19), practitioners (n = 19), and administrators (n = 13) from community and public organizations. The participants generated 131 statements to complete the following sentence: In your opinion, parents would enroll more in prevention activities for their child if…. These 131 statements were classified into 12 groups representing the factors that influence parent recruitment, all of which were considered relatively important (between 3.51 and 4.42 on 5). The participants also agree on an understanding of recruitment that tends toward an ecological model. This study shows that parent recruitment into prevention programs targeting behavior problems in early childhood is complex and multifactorial (including factors that concern parents, practitioners, services, organizations, and policies). Because the map shows that the influencing factors in recruitment appear to be interrelated, they should all be considered to increase the chances of reaching at-risk families.     

The Parent University Program: Factors predicting change in responsive parenting behaviors

Few evidence-based parenting programs exist for children under the age of three and even fewer have been rigorously evaluated in comparison to parenting programs for older children. The Parent University Program (PUP), was developed to serve parents with children birth through three who lived in southwest Baltimore. Parent-child dyads (N = 86) participated in the parenting program with the goal of increasing responsive parenting skills.Participants of the PUP showed a significant increase in responsive parenting behaviors. Participants in this open trial study who completed pre-test, post-test, and follow-up assessments showed a significant change from clinical to non-clinical status after attending the PUP. Neither the type of facilitator nor the number of hours attended showed an association with changing parenting behaviors. The age of the child was associated with the change in responsive parenting. Parents of older children in the birth to three age range had higher scores at pre-test and showed less change over time. The results of this study suggest that the Parent University Program was associated with positive change in responsive parenting behaviors for parents with children birth through three years of age.     

Effectiveness of an empowerment program for adolescent second generation migrants: A cluster randomized controlled trial

Dutch adolescent second generation migrants are at increased risk of becoming marginalized and developing problem behavior. We tested the effectiveness of the Dutch multi-component empowerment program POWER that aims to prevent such problems. We hypothesized a positive intervention effect on participants' sense of mastery, coping skills, activities, conduct problems, and prosocial behavior. We conducted a cluster randomized controlled trial including a pretest and posttest with an intervention condition (n = 132) and a waitlist control condition (n = 116). Analyses showed that POWER was only effective in influencing the youngsters' participation in activities like sport, hobbies, and casual work. When implemented with high fidelity, POWER also influenced the level of conduct problems as well as their coping style. However, a more accurate registration of the implementation process would have been helpful and the program can potentially be further improved by clearly specifying which components of the program can be adapted and which must be delivered as intended.     

A comparison of outcomes for children and youth in foster and residential group care across agencies

Working collaboratively with two state associations and their member (nonprofit) agencies providing out-of-home care to children and youth, University researchers conducted a multi-site project to examine whether there were any differences in individual child-level outcomes between children placed in residential group care and those placed in foster. The study employed a quasi-experimental repeated measures design, with data collected at a minimum of two intervals (at intake and 3-month follow-up) and at subsequent intervals of 6 and 12 months for children remaining in care. Samples for analyses were drawn from 1082 youth in either residential group care (n = 903) or foster care (n = 179), in one of 37 agency sites across two southeastern states, who participated in a broader evaluation project. The average ages of participating youth in residential and foster care were 13.97 (SD = 2.43) and 13.65 (SD = 2.73), respectively. Based on his or her score on the Children's Global Assessment Scale (CGAS) at intake, each participant was also assigned to the low functioning group (n = 526; 53.1%), the borderline group (n = 232; 23.4%), or the high functioning group (n = 232; 23.4%). Analyses confirmed that youth in foster care tended to have higher levels of general functioning at baseline than did youth placed in group care. However, the degree to which youth progressed in care on measures of general functioning and mental and behavioral health problems did not differ based on placement setting; youth in residential group care settings progressed at the same rate as youth in community-based settings, regardless of their level of functioning at intake. The only exception to this pattern was in regard to anxiety; there was an observable, but non-significant trend of youth in foster care reporting decreases in anxiety levels, while those in group care reported increased anxiety.     

Program records as a source for program implementation assessment and youth outcomes predictors during residential care

This study used point card information from a residential program to generate treatment fidelity metrics and determine if the metrics predicted youth outcomes after six months in care. Youth outcomes included staff (n = 52) and youth (n = 143) ratings, youth conduct records kept by the residential program's teaching-family homes and school records. Treatment fidelity metrics included the program components: (a) percentage of positive interactions, (b) number of privileges earned, and (c) a skills taught to interactions ratio. The percentage of positive interactions averaged 90% per youth; 76% of the point cards indicated that privileges were earned; and a variety of life skills were typically taught to the youth (skills ratio = .61). The data from the treatment fidelity metrics supported that the program was implemented consistent with program expectations. The range of implementation quality for each measured component was then used to predict youth outcomes. Increased percent of positive interactions predicted significantly decreased externalizing behaviors as reported by staff (β = − 0.31, p < .001) and youth (β = − 0.30, p < .001), and significantly fewer incidents of non-compliance (Exp(b) = 0.93, p < .001) and school problems (Exp(b) = 0.91, p < .001) as indicated on the program records. The skills ratio indicated similar trends across outcomes, although non-significant at the p < .01 level. Permanent products may be helpful to develop program treatment fidelity metrics, which may be useful for monitoring implementation and may be associated with improved youth outcomes.     

A program based on Social Cognitive Theory and Smith's model of health and illness and its effect on maternal self-efficacy and child behavior

PurposeThis study was conducted in order to determine the effect of a program based on Social Cognitive Theory and Smith's Model of Health and Illness on the self-efficacy, self-esteem and attitudes of mothers and on the emotional and behavioral problems and competence levels of their children.MethodThis quasi-experimental study used a control group and a pretest-posttest design. The sample was composed of 77 mothers (experimental group, n = 39; control group, n = 38) who had low self-efficacy and self-esteem and whose children had problematic behavior. The mothers in the experimental group underwent a 10-session program over a period of 10 weeks. This program included activities to help them build trust in themselves and their surroundings, induce positive thinking, increase their childcare knowledge and skills, establish an effective interaction with their children, set realistic and positive goals, cope with stress, experience the feeling of success and become motivated. Data were collected by using the Demographic Information Form, the self-efficacy for Parenting Task Index-Toddler Scale, the Rosenberg Self-Esteem Scale, the Parent Attitude Scale and the Brief Infant-Toddler Social & Emotional Assessment. Data were collected before the start of the program, immediately after its completion and three months afterwards.ResultsIt was found that, at the end of the program and after the following three months, the self-efficacy, self-esteem and democratic attitude scores of the experimental group mothers and the competency scores of their children had significantly increased compared to their pre-program scores. The problem domain scores of their children had decreased and a statistically significant difference was detected in favor of the experimental group. In both the experimental and the control group, a weak negative correlation was found between the self-efficacy and democratic attitude scores of the mothers and the problem domain scores of their children.ConclusionThe total 12-hour program created a positive change, even among the mothers with low self-efficacy, low self-esteem and low education and income levels who had problematic children. Therefore, healthcare professionals may find it beneficial to offer this program to all mothers having 2- and 3-year-old children.     

Computer-mediated parenting education: Digital family service provision

Computer-mediated family service provision holds the promise of equal efficacy, lower cost, and higher accessibility than traditional parent education groups that require parents to travel to a service venue, thereby alleviating often-cited pragmatic barriers to participation in parenting programs. Hence, examinations of which populations are attracted to particular service modalities are a necessary step in building a reliable evidence base. The scant computer-mediated parent education literature indicates that online parenting programs are beneficial to indicated or secondary prevention programs seeking to bolster specific parent, child, or dyadic outcomes; it is reasonable to ask, then, if this service provision mechanism would be equally effective for all parents, outside of targeted intervention designs. The current paper describes the provision of computer-mediated parenting services to a large sample of parents (N = 192, 89.6% female, average age 40 years; 27% racial/ethnic minority) with no shared prevention indicator through an employer-based program. Our research questions on service provision and utilization include: Who is served by primary prevention programs like this? Do participants report satisfaction with computer-mediated services commensurate with traditional face-to face services? In addition to significant differences in perceived social support by gender, marital status, and number of children younger than 18 living in the home, results from three measures of parenting attitudes and behaviors (e.g., discipline style, sense of competence, and locus of control), indicate that this sample has some confidence in their general abilities as parents, but struggle to feel an internal sense of control over their children's behavior, with the greatest number of parents tending towards overreactive discipline. Associations between these indicate a consistent pattern such that dysfunctional parenting practices tend to co-occur, and parents who do employ dysfunctional strategies feel less competent as parents. Participants report high satisfaction with these services, at equal or better rates than reported in the parent education literature. This work provides evidence that computer-mediated parenting services can attract and exceed expectations of participants with clinical and subclinical but moderate parenting needs, indicating that this service delivery mode has the potential to reach a wide number of individuals ideally situated for prevention services.     

Development of an innovative process evaluation approach for the Families Improving Together (FIT) for weight loss trial in African American adolescents

This study demonstrates how a multi-theoretical, multilevel process evaluation was used to assess implementation of the Families Improving Together (FIT) for weight loss intervention. FIT is a randomized controlled trial evaluating a culturally tailored, motivational plus family-based program on weight loss in African American adolescents and their parents. Social Cognitive, Self Determination, Family Systems theories and cultural tailoring principles guided the conceptualization of essential elements across individual/family, facilitator, and group levels. Data collection included an observational rating tool, attendance records, and a validated psychosocial measure.ResultsAttendance records (0 = absent, 1 = present, criteria = ≥70%) indicated that 71.5% of families attended each session. The survey (1 = false, 6 = true, criteria = ≥4.5) indicated that participants perceived a positive group climate (M = 5.16, SD = 0.69). A trained evaluator reported that facilitator dose delivered (0 = no, 1 = yes, criteria = ≥75%) was high (99.6%), and fidelity (1 = none to 4 = all, criteria = ≥3) was adequate at facilitator (M = 3.63, SD = 0.41) and group levels (M = 3.35, SD = 0.49). Five cultural topics were raised by participants related to eating (n = 3) and physical activity (n = 2) behaviors and were integrated as part of the final curriculum.DiscussionResults identify areas for program improvement related to delivery of multi-theoretical and cultural tailoring elements. Findings may inform future strategies for implementing effective weight loss programs for ethnic minority families.     

A randomized controlled trial of the effectiveness of the youth crime prevention program ‘New Perspectives’ (NP): Post-treatment changes and moderator effects

ObjectivesNew Perspectives (NP) aims to prevent that youth at onset of a criminal career will develop a more persistent criminal behavior pattern. The study aim was to examine whether NP was effective relative to care as usual in preventing and reducing (persistent) delinquency. Moreover, we examined improvements in secondary outcomes (e.g., peer and parent relationships and cognitive distortions) and other outcomes (e.g., substance use and self-esteem).MethodsAt-risk youth (N = 101) aged 12 to 19 years were randomly assigned to the intervention group (NP, n = 47) or control group (‘care as usual’, n = 54). The effects of the NP intensive phase (3 months after program start) and aftercare phase (6 months after program start) were analyzed.ResultsNP and care as usual did not differ on any of the outcome measures at both post-test occasions. The effects of NP were the same for boys and girls, different age groups, and ethnic groups.ConclusionsThe overall null-effects are discussed, including implications for further research, policy, and practice.