Online programs as tools to improve parenting: A meta-analytic review

Background

A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions is lacking.

Method

A systematic review was undertaken of studies (n = 19), published between 2000 and 2010, that describe parenting programs of which the primary components were delivered online. Seven programs were adaptations of traditional, mostly evidence-based, parenting interventions, using the unique opportunities of internet technology. Twelve studies (with in total 54 outcomes, N_tot parents = 1615 and N_tot children = 740) were included in a meta-analysis.

Results

The meta-analysis showed a statistically significant medium effect across parents outcomes (ES = 0.67; se = 0.25) and child outcomes (ES = 0.42; se = 0.15).

Conclusions

The results of this review show that web-based parenting programs with new technologies offer opportunities for sharing social support, consulting professionals and training parental competencies. The meta-analytic results show that guided and self-guided online interventions can make a significant positive contribution for parents and children. The relation with other meta-analyses in the domains of parent education and web-based interventions is discussed.     

Risk-taking behavior and academic self-efficacy as variables accounting for problematic internet use in adolescent university students

Objective

This study investigated the relationship between risk-taking behavior and academic self-efficacy and problematic internet use in adolescent university students and whether problematic internet use varies according to the variables of gender, possession of a computer and living with the family.

Methods

The study was performed with 556 students from the Karadeniz Technical University Fatih Faculty of Education in Turkey. The Problematic Internet Use Scale, the Adolescent Risk-Taking Questionnaire, the Academic Self-Efficacy Scale and Personal Information Collection Form were used in the collection of data.

Results

Pearson correlation analysis revealed a significant positive correlation between problematic internet use and risk-taking behavior (r = .37, p < .01) and a significant negative correlation between problematic internet use and academic self-efficacy (r = − .12, p < .05). Multiple regression analysis revealed that risk-taking behavior and academic self-efficacy accounted for 14% of total problematic internet use variance (F_(2,553) = 46.11, p < .05). The individual contribution to the model of risk-taking (β = .37) and academic self-efficacy (β = − .09) is significant. Our results also showed that university adolescents' problematic internet use scores vary by gender (t = − 4.90, p < .05) and possession or otherwise of a computer (t = 3.10, p < .05), but not on the basis of whether they live with their families (t = − .13, p > .05).

Conclusions

Risk-taking behavior and academic self-efficacy emerged as significant predictors of problematic internet use.     

Is program structure related to stigma and community acceptance of justice-involved adolescents?

Objective

The aim of the study is to examine the impact of diversion program characteristics on social stigma of delinquent adolescents in Jordan.

Method

A street survey of adults was conducted in Amman, Jordan. Respondents were randomly assigned to read one of four vignettes involving a delinquent adolescent who participated successfully in one of four types of juvenile justice interventions: detention center placement; diversion with counseling; diversion with counseling plus victim apology and restitution; and diversion with counseling plus family-based apology and restitution. Respondents reported their willingness to accept the adolescent as a member of their child's school, as a friend of their child, as a spouse for their child, and as a future employee. Seventy seven percent of adults approached participated (N = 137).

Results

Respondents reported greater willingness to accept the adolescent when he participated in any of the three diversion programs compared to the detention center condition (β = .80, p < .05). However, there were no differences among the diversion program types (i.e., counseling only, counseling plus individual restorative justice, counseling plus tribal restorative justice) in acceptance levels. Regardless of intervention type, the perception that the adolescent had ‘learned his lesson’ was associated with greater acceptance and with heightened expectations of future success.

Conclusion

Intervention characteristics can influence public stigma in the Middle East. For justice involved youths, interventions that increase perceptions that youth have learned their lesson is a crucial ingredient to stigma reduction efforts. Social work interventions with delinquent adolescents and their families need to incorporate stigma management strategies that convey lesson-learning as a key intervention outcome.     

Predictors of out-of-home placement following residential treatment

Objective

There is a lack of research examining predictors of out-of-home placement (OOHP) following residential treatment (RT). The current study examined how various child and family factors predict OOHP at discharge and 6-months post-discharge for a RT sample.

Methods

Three hundred and eighty-three children (11.92 years, SD = 2.63, 293 boys) with serious mental health disorders were assessed using the Brief Child and Family Phone Interview (BCFPI) and placement information forms at admission, discharge, and 6-months post-discharge from RT.

Results

OOHP at discharge was predicted by older age, OOHP at admission, child welfare involvement, deliberate self-harm, a history of physical abuse, neglect, witnessed domestic violence, and a poor family situation (p < .05). At 6-months post-discharge, OOHP was predicted by dual diagnosis, OOHP at admission, child welfare involvement, neglect, and witnessed domestic violence (p < .05).

Conclusions

Pre-treatment factors are predictive of OOHP following RT. Identifying these key predictors and developing permanency planning options for children to promote stability and consistency is essential. A systemic evidence-based approach is imperative in promoting resilience for children at risk of OOHP, including family intervention and collaboration with the community.     

Delinquent and aggressive behaviors in early-adopted adolescents: Longitudinal predictions from child temperament and maternal sensitivity

Background

160 early-adopted children were followed from infancy to adolescence. Central question was whether early and concurrent parenting and child temperament predicted adolescent delinquent and aggressive behaviors.

Methods

Structural equation modeling was used to test the relations between early and concurrent observed maternal sensitivity, mother reported effortful control and teacher reported delinquent and aggressive behaviors.

Results

This longitudinal adoption study showed that lower effortful control, concurrent as well as 7 years earlier, predicted higher levels of delinquency in adolescence and aggression in middle childhood and in adolescence. Lower levels of effortful control in infancy predicted higher levels of maternal sensitivity in adolescence which in its turn predicted less adolescent delinquent behavior.

Conclusions

The findings suggest that effortful control is an important predictor of both aggressive and delinquent behaviors. Maternal sensitivity also plays a role in the development of delinquent behavior, buffering a lack of effortful control, but is not related to aggression at age 14. It is important to note that these relations were found in a sample of parents and their genetically unrelated adopted children.     

Are maternal and community risk factors associated with the presence of asthma among children placed in foster care?

Objective

The occurrence of pediatric asthma has been associated with exposure to chronic stress. This study examined the relationship between maternal and community risk factors and asthma in a sample of maltreated children in foster care.

Method

Interviews were conducted with 365 maltreated children in foster care. Measures included youth/caregiver reports of asthma, an index of maternal risk based on data abstracted from child welfare records and community violence exposure.

Results

After controlling for demographic variables, maternal risk was associated with the presence of asthma (OR = 1.314, 95% CI = 1.09–1.58). Community violence exposure, however, was not related to the presence of asthma.

Conclusion

Maternal risk factors were significantly associated with the presence of asthma in a foster care population. Physicians who care for maltreated children in foster care should be particularly attuned to the presence of these additional risk factors that may place high-risk children at increased risk for chronic health problems.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.     

Evaluating the effectiveness of combining Home-Start and Triple P parenting support in the Netherlands

The effects of Home-Start compared to Home-Start extended with Triple P group training were studied. The underlying theoretical models of change of both programs complement each other and therefore it was assumed that combined support leads to increased positive outcomes. Outcomes related to parental wellbeing, parenting behaviour and child behaviour were included. One hundred forty four parents, all mothers, were randomly assigned to either the Home-Start program or the combined support of Home-Start and Triple P group level 4. Parents reported on wellbeing, parenting behaviour, and child behaviour at baseline, post-program and at 6-month follow-up. Based on intention to treat analyses, families in the combined intervention condition showed similar effects on the majority of primary and secondary outcomes as the only receiving Home-Start condition. A negative effect on parental depression and on two subscales of the Child Behavioral Checklist (anxiety and oppositional defiant behaviour) was found for families in the combined Home Start and Triple-P condition. The hypothesized stronger positive effect of combining Home-Start and Triple P support on selected outcome measures was not confirmed. Combining promising evidence-based parenting programs with complementary underlying theoretical frameworks does not necessarily lead to better results.     

The relationship between problematic internet use and interpersonal cognitive distortions and life satisfaction in university students

Objective

The aim of the study was to analyze the relationship between problematic internet use by college students and interpersonal cognitive distortions and life satisfaction.

Methods

A total of 418 students, 260 females and 158 males, studying in different departments of the Fatih Faculty of Education, Karadeniz Technical University, participated. The Online Cognition Scale, Interpersonal Cognitive Distortions Scale, Life Satisfaction Scale and Personal Information Form were used as instruments.

Results

A significant positive correlation was determined between problematic internet use and interpersonal cognitive distortions (r = .33, p < .01), and a negative one with life satisfaction (r = − .21, p < .01). Interpersonal cognitive distortions, life satisfaction and gender account for 21% of total variance (F₍₃₄₁₃₎ = 37.30, p < .05). Findings revealed that males exhibit more problematic internet use than females, which subjects with a pessimistic perception of events have a higher level of problematic internet use than those with an optimistic perception and that subjects who always feel lonely exhibit greater problematic internet use than those who never or only sometimes experience feelings of loneliness.

Conclusions

Interpersonal cognitive distortions, life satisfaction and gender were significant predictors of problematic internet use. Problematic internet use exhibits significant variations according to gender, perception of events and feelings of loneliness.     

The relationship of placement experience to school absenteeism and changing schools in young,school-aged children in foster care

Background

Chronic school absenteeism and frequent school changes, particularly among younger children, may be antecedents for the high rates of school failure and subsequent dropout among youth in foster care. However, the relationship of foster care experience to absenteeism and school change has not been well studied.

Objective

This study examined the association of placement experience with absenteeism and changing schools among 209 urban children in foster care enrolled in public elementary schools.

Methods

A cohort of children aged 5 to 8 years who entered non-relative or kinship foster care from 2006–2008 were followed longitudinally for 2 years from entry into foster care. Children residing in foster care were categorized at the end of the study as early stable, late stable, or unstable, if they achieved a permanent placement prior to 45 days, between 45 days and 9 months, or failed to do so within 9 months, respectively. Children who reunified home were classified as a fourth category. Poisson regression, controlling for baseline factors, was used to compare days absent and number of schools attended across categories of placement experience.

Results

Among the 209 children, 51% were male, 79% were African American, and 55% were initially placed with kin. One third of children reunified home; among children who did not reunify, one half was early stable, and a third was unstable. Adjusted rates of school absenteeism increased in stepwise fashion as children's placements became more unstable; children with unstable placements were 37% more likely to be absent than those with early placement stability (p = 0.029). Children who reunified during the study demonstrated the highest rates of absenteeism; however, there was no significant difference in absenteeism before or after reunification. Number of schools attended increased as stability worsened, with the standardized rate of schools attended reaching 3.6 schools (95% CI 3.1–4.1) over a two year period among children in unstable placements.

Conclusions

The relationship between placement experience and school absenteeism and school change illustrates the need to better coordinate the educational experience of high-risk children in foster care. The secondary finding of high absenteeism among children in the process of returning home illustrates that educational challenges for youth may be equally if not more concerning among the greater majority of youth in child welfare who remain home with birth parents.     

Support for basic psychological needs in the context of HIV disclosure for older youth

Purpose

This study utilized Self-Determination Theory's sub-theory Basic Needs Theory (Deci & Ryan, 2000) to understand older youths' perceptions of support for their basic needs of autonomy, relatedness, and competence in the context of disclosing their HIV status.

Methods

Semi-structured interviews lasting 10–60 min each were conducted with nine youth aged 17–19 (4 women and 5 men) and two adult staff at a one-week residential program in a large southern city. Participant observations of disclosure-related conversations and experiences were conducted and recorded throughout the program. Reliability and validity assurances were met in multiple ways. Analysis of the content of interviews and observations indicated consistent themes that converged on the research questions.

Results

When participants perceived more support for their basic psychological needs for autonomy, relatedness, and competence, they reported more self-determined motivation to disclose their status and better satisfaction with their decisions. The results of this study indicate that Basic Needs Theory is useful for understanding how the basic psychological needs of autonomy, relatedness, and competence are satisfied or thwarted in the context of HIV disclosure for older youth.

Conclusions

Programs and people working with older youth with HIV/AIDS can use BNT to help youth identify, create, and adapt contexts to be supportive of their basic needs for autonomy, relatedness, and competence, and provide guidance and support accordingly. Providers can utilize this information to support youth in strategizing about their disclosure decisions and goals for their well-being.     

Establishing a mental health service for young children in out-of-home care: The Gumnut Clinic for 0 to 5 year olds in Western Sydney

Objective

Children aged 0 to 5 years in out-of-home care represent a vulnerable population at high risk of social, emotional and developmental problems, yet there are few services specifically addressing their psychological needs. This paper is the first of two concerning the establishment of The Gumnut Clinic, a specialist mental health assessment clinic in Western Sydney for this population. The current paper provides the rationale for the development of the clinic and detail of the referral and assessment processes.

Method

The paper describes the establishment of The Gumnut Clinic at Redbank House in Sydney, Australia, the approach to assessment of these young children and their carers, and the challenges encountered.

Conclusions

Young children are overrepresented in child protection and out-of-home care services. Their social, emotional and developmental needs are under-recognized. Development of a specialist mental health service is a step towards improving health outcomes for these children.     

Temporal stability of entries and predictors for entry into out-of-home care before the third birthday: A Danish population-based study of entries from 1981 to 2008

Objective

Placing a child in out-of-home care is one of the most radical measures a child protection system can decide to take. There is an essential interest in understanding the probability of entering care and what circumstances are related to the decision to place a child in out-of-home care. This study investigates the temporal stability of rates and predictors for entry into care.

Method

Data were obtained by linking several registration systems. The study population was defined as all children entering care before their third birthday from birth cohorts 1981–2008 (N = 11,034). Furthermore, a control population consisting of a randomly assigned quarter of the Danish child population from the same birth cohorts was used (N = 515,773). Rates of entry and Cox regression models from six periods from 1981 to 2008 were used to model co-variates associated with entry into out-of-home care.

Results

The overall likelihood for entering care is found to be decreasing over time. Furthermore, results reveal two trends: relative rates of entry are significantly decreasing for children whose mother has a psychiatric history prior to the child's birth; relative rates are significantly increasing for children whose mother or father was unemployed in the year prior to the child's birth.     

Social supports preferred by the teachers when facing school violence

Objectives

This study aims at examining whether the social support sources of teachers differ depending on the variables of gender and seniority when they encounter violence at school and investigating their opinions on precautions against school violence.

Methods

Data was collected via a questionnaire from a sample of 179 female and 166 male Turkish teachers. Chi-square and Mann-Whitney U tests were used for data analysis.Results: Male and female teachers preferred to share the experience of exposure to verbal (χ² (5) = 22.81, p < .01), physical (χ² (5) = 36.64, p < .01), emotional (χ² (5) = 26.13, p < .01) and sexual violence (χ² (5) = 37.43, p < .01) at school with different social support sources. Male teachers preferred their colleagues as social support sources whereas female teachers preferred their spouses/families. Social support sources which teachers prefer when they face any type of violence other than sexual violence differ due to the length of teaching experience. School administrators and counselors are not among the social support sources of teachers when they were exposed to violence.

Conclusions

Turkish teachers' preferences related to their victimization experiences indicate a need for prevention program encompassing teachers, school counselors and administrators.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Actuarial risk assessment in child protective services: Construction methodology and performance criteria

Purpose

To prevent the recurrence of child maltreatment, actuarial risk assessment can help child protective services (CPS) workers make more accurate and consistent decisions. However, there are few published articles describing construction methodologies and performance criteria to evaluate how well actuarial risk assessments perform in CPS. This article describes methodology to construct and revise an actuarial risk assessment, reviews criteria to evaluate the performance of actuarial tools, and applies a methodology and performance criteria in one state.

Methods

The sample included 6832 families who were followed for two years to determine whether they were re-reported and re-substantiated for maltreatment.

Results

Both the adopted and the revised tools had adequate separation and good predictive accuracy for all families and for the state's three largest ethnic/racial groups (White, Latino, and African American). The adopted tool classified relatively few families in the low-risk category; the revised tool distributed families across risk categories.

Conclusions

The revised tool classified more families as low-risk, allowing CPS to allocate more resources to higher-risk families, but at the cost of more false negatives.     

Parental substance misuse and compliance as factors determining child removal: A sample from the Victorian Children's Court in Australia

Purpose

The current study explores the role of parental substance misuse in child protection cases and examines its impact as a factor in decisions on child removal in court orders.

Methods

A cohort of 273 child protection cases from the Victorian Children's Court was reviewed. This sample consisted of cases where children have been removed (Custody to Secretary Order, n = 142 cases) or remained with parents (Supervision Order, n = 131 cases). Data was extracted on parental substance misuse in single and two parent households as well as compliance with court-based and child protection directives.

Principle results

Parental substance misuse (PSM) was present in 51% of child protection cases sampled and among those, poly-substance abuse was common (67%). PSM was associated with Indigenous status; younger age of child at court appearance; having a court-proven case of emotional abuse, less compliance with child protection services and a longer time between notification to authorities and final court decision. In one parent households, only parental compliance is the primary factor underlying decisions of child removal. In two parent households, the decision to remove a child from the family home was ultimately driven by parental compliance, and to a lesser extent by PSM of illicit drugs and the number of parents misusing drugs.

Conclusion

PSM and non-compliance appear to be significant factors in delaying stability for the child through the granting of court orders which may involve child removal. There is a need, by child protection professionals, for prompt recognition of PSM and associated compliance/engagement issues in order to refer appropriate cases for further assessment and treatment in specialist drug treatment services. Early involvement with specialist drug treatment services provides the Court with an indication of compliance which is an important factor for making decisions that assist with achieving stability for the child.     

Intention to leave in social workers and educators employed in voluntary child welfare agencies

Introduction

Individuals employed in child welfare settings can have a profound impact on children in care. Research shows that direct care staff can have an effect on emotional and physical outcomes for children with whom they work. This paper seeks to expand knowledge of the child welfare workforce by studying educators employed in child welfare settings and comparing their job satisfaction and intent to leave with that of prevention workers employed in similar settings.

Materials and methods

Data for prevention workers (n = 538) were obtained from workers employed at all preventive service programs under contract with a large municipality. Data for educators were obtained from voluntary agencies located elsewhere in the state (n = 139). The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included various aspects of job satisfaction, intention to leave, and whether workers regretted taking their jobs. Data were analyzed using bivariate analysis and structural equation modeling (SEM).

Results

While both educators and prevention workers varied on different domains of job satisfaction, their overall satisfaction did not differ nor did their intention to leave their jobs. Satisfaction with contingent rewards, the nature of the work and opportunities for promotion along with not regretting taking one's job were predictive of thinking about leaving one's job. Thinking about leaving was predictive of taking concrete steps towards actual leaving.

Discussion

While people both prevention workers and educators report different levels of job satisfaction and work conditions in their agencies, job title itself has less to do with a worker's intention to leave, as measured by both thinking about leaving and taking steps towards actively looking for a new job, than other factors. Larger contextual factors may be at play in workers' decisions to stay employed. Suggestions are made for reducing turnover intentions along with suggestions for further study to clarify the role of organizational factors in workers' intention to leave.     

Youth Substance Use in a Context of Family Homelessness

Objective

This study examines the relationship between family processes and youth substance use debuts among a sample of youth residing in urban family homeless shelters.

Method

Data regarding shelter experiences, youth and family characteristics, and the use of three substances (i.e., cigarettes, alcohol, and marijuana) were gathered from a sample of youth (11-14 years) and their respective parents residing in an urban family homeless shelter system. Multinomial logistic regression analysis was used to examine the influences on youth substance use.

Results

Of the 198 youth included in the statistical analysis, 72% (n = 143) reported no substance use debuts, while 18% (n = 35) indicated one and 10% (n = 20) indicated two to three substance use debuts. Within the final model, greater substance use debut was associated with being older (13-14 vs. 11-12; OR = 7.5; 95% CI = 1.8-30.9) and stressors exposure (OR = 4.8; 95% CI = 1.5-14.7). Furthermore, youth of adult caretakers that reported low levels of the three family processes considered were almost four and a half more likely (OR = 4.4; 95% CI = 1.2-16.5) to have made two to three substance use debuts.

Conclusions

Family processes may be a particularly important intervention target toward reducing the rate of substance use among youth residing in urban family homeless shelters.     

Examining the equivalence of fidelity over two generations of KEEP implementation: A preliminary analysis

Problem

In order to obtain and maintain positive outcomes garnered from evidence-based practice (EBP) models, it is necessary to implement them effectively in “real world” settings, to continually monitor intervention fidelity to prevent drift, and to train new staff due to turnover. The fidelity monitoring processes that are commonly employed in research settings are labor intensive and probably unrealistic to employ in community agencies given the additional burden and cost that they represent over and above the cost of implementing the EBP. Efficient strategies for implementing fidelity monitoring and staff training procedures within the inner context of agency settings are needed to promote agency self-sufficiency and program sustainability.

Method

A cascading implementation model was used whereby agencies who achieved proficiency in KEEP, an EBP designed to prevent placement disruptions in foster and kinship child welfare homes, were trained to take on fidelity management roles to improve the likelihood of program sustainability. Agency staff were trained to self-monitor fidelity and to train internal staff to achieve model fidelity. A web-based system for conducting fidelity assessments and for onsite/internal and remote program quality monitoring was utilized.

Results

Scores on fidelity ratings from streamed observations of intervention sessions showed no differences for foster parents treated by first generation interventionists trained by model developers compared to a second generation of interventionists trained by the first generation.

Conclusion and relevance to child welfare

Development of the local intra-agency capacity to manage quality intervention delivery is an important feature of successful EBP implementation. Use of the cascading implementation model appears to support the development of methods for effective monitoring of fidelity of the KEEP intervention, for training new staff, and ultimately for the development of internal methods for maintaining program sustainability and effectiveness.