The effect of COVID-19 lockdowns on maternal mental health and parenting practices moderated by urban green space

Stress generates difficulties in parenting, which affects child development. We aimed to understand the impact of COVID-19 lockdowns on maternal mental health and parenting practices. We also explored to what extent green space is a protective factor in the aforementioned relationship. We explored heterogeneous lockdown effects using longitudinal georeferenced data for 985 families (mothers and 24- to 30-month-olds) and exploiting localized lockdowns in Chile. Controlling for observed and unobserved fixed characteristics, on average, we did not find an association between lockdown duration and maternal mental health or parenting practices. However, the previous nonsignificant association is heterogeneous across access to green space. Although lockdown duration increased dysfunctional interactions with children for mothers with little access to green space, we did not see the previous effect on mothers who live close to green space. Mothers who do not comply with the lockdown mandate are the ones who drive this heterogeneous effect. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review.

BACKGROUND: In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status. AIMS: This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. METHODS: Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. RESULTS: The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. CONCLUSIONS: Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.

Results from the Strong Families Start at Home/Familias Fuertes Comienzan en Casa: feasibility randomised control trial to improve the diet quality of low-income, predominantly Hispanic/Latinx children.

OBJECTIVE: To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. DESIGN: Pilot randomised controlled trial. SETTING: Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. PARTICIPANTS: Parents and their 2-5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. RESULTS: Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (-1·35, -0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (-1·52, -0·19)), using food as a reward (PE = -0·54, 95 % CI (-1·35, -0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). CONCLUSION: Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.

Evaluation of a cluster-randomized controlled trial: Communities for Healthy Living, family-centered obesity prevention program for Head Start parents and children.

BACKGROUND: This study reports the outcomes of Communities for Healthy Living (CHL), a cluster randomized obesity prevention trial implemented in partnership with Head Start, a federally-funded preschool program for low-income families. METHODS: Using a stepped wedge design, Head Start programs (n = 16; Boston, MA, USA) were randomly assigned to one of three intervention start times. CHL involved a media campaign and enhanced nutrition support. Parents were invited to join Parents Connect for Healthy Living (PConnect), a 10-week wellness program. At the beginning and end of each school year (2017-2019), data were collected on the primary outcome of child Body Mass Index z-score (BMIz) and modified BMIz, and secondary outcomes of child weight-related behaviors (diet, physical activity, sleep, media use) and parents' weight-related parenting practices and empowerment. Data from 2 years, rather than three, were utilized to evaluate CHL due to the COVID-19 pandemic. We used mixed effects linear regression to compare relative differences during intervention vs. control periods (n = 1274 vs. 2476 children) in (1) mean change in child BMIz and modified BMIz, (2) the odds of meeting child health behavior recommendations, (3) mean change in parenting practices, and (4) mean change in parent empowerment. We also compared outcomes among parents who chose post-randomization to participate in PConnect vs. not (n = 55 vs. 443). RESULTS: During intervention periods (vs. control), children experienced greater increases in BMIz and modified BMIz (b = 0.06, 95% CI = 0.02,0.10; b = 0.07, 95% CI = 0.03, 0.12), yet were more likely to meet recommendations related to three of eight measured behaviors: sugar-sweetened beverage consumption (i.e., rarely consume; Odds Ratio (OR) = 1.5, 95% CI = 1.2,2.3), water consumption (i.e., multiple times per day; OR = 1.6, 95% CI = 1.2,2.3), and screen time (i.e., ≤1 hour/day; OR = 1.4, 95% CI = 1.0,1.8). No statistically significant differences for intervention (vs. control) periods were observed in parent empowerment or parenting practices. However, parents who enrolled in PConnect (vs. not) demonstrated greater increases in empowerment (b = 0.17, 95% CI = 0.04,0.31). CONCLUSIONS: Interventions that emphasize parent engagement may increase parental empowerment. Intervention exposure was associated with statistically, but not clinically, significant increases in BMIz and increased odds of meeting recommendations for three child behaviors; premature trial suspension may explain mixed results. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03334669 , Registered October 2017.

Contributions of Work-to-Family Enrichment to Parental Food Monitoring and Satisfaction with Food-Related Life during the COVID-19 Pandemic in Dual-Earner Parents and Their Adolescent Children.

Evidence shows that numerous family-related variables influence parents' use of different food parenting practices (FPP), but less is known about the influence of parents' work-related variables on their use of FPP, and their own and their children's outcomes in the food domain. To fill this gap, the present study explored intra-individual and inter-individual effects between work-to-family enrichment (WtoFE), parents' monitoring practices, the adolescent's perception of their parents' monitoring practices, and the three family members' satisfaction with food-related life (SWFoL), in different-sex dual-earner parents with adolescent children. The mediating role of monitoring between WtoFE and SWFoL was also tested. A sample of 430 different-sex dual-earner parents and one of their adolescent children (average age 13.0 years, 53.7% female) were recruited in Rancagua, Chile, during March and June 2020. The three family members answered the monitoring dimension of the Compressive Feeding Practices Questionnaire and the Satisfaction with Food-Related Life Scale. Parents answered a measure of WtoFE based on the Work-Home Interaction Survey. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modelling. Results showed a positive association between WtoFE and SWFoL, directly (p < 0.001) and through monitoring in fathers (95% confidence interval [0.010, 0.097], actor effect). The father's (p = 0.042) and mother's (p = 0.006) WtoFE was positively associated with their adolescent's SWFoL (partner effects). The father's (p = 0.002) and mother's (p = 0.036) WtoFE were positively associated with their own monitoring (actor effect), while only the father's WtoFE (p = 0.014) was positively associated with the adolescent's perception of their parents' monitoring (partner effect). The father's (p = 0.018) and mother's (p = 0.003) monitoring, as well as the adolescents' perception of their parents' monitoring (p = 0.033), were positively associated with their own SWFoL (actor effects), while the mother's monitoring (p = 0.043) was also associated with the father's SWFoL (partner effects). Findings suggest that both parents' WtoFE improved their monitoring practices, which, in turn, improved their own SWFoL and their adolescent child's SWFoL. Policymakers and organizations must aim to promote the WtoFE of working parents.

How do Internet moms raise children? The reshaping of Chinese urban women's parenting psychology by COVID-19 online practices.

With the acceleration of social transformation and "mediatization," urban women's parenting practices have become an important factor affecting the demographic structure and national development. The global COVID-19 pandemic has further contributed to the networking of social life and the creation of "Internet moms" who rely on the Internet for parenting interactions. Using a mixed-methods design, this paper conducted participant observation and in-depth interviews with 90 mothers from various industries born after 1980/1990 across multiple geographies in China to examine the impact of urban women's Internet practices on the psychology and practice of parenting during the COVID-19 pandemic, as well as how they were empowered by media technologies to practice motherhood and complete their role socialization through the sharing of parenting information, experiences, and actions. The purpose of this qualitative study was to investigate the changing impact of Internet-based parenting practices on Chinese urban women's daily lives during the COVID-19 pandemic. Through the analysis of these influences, it was found that the whole society, including urban parenting groups, paid attention to self-expression and self-worth and further hoped to arouse society's recognition, face up to the identity of "mother" and "female," and give more attention and support to women. The study also found that, as interpersonal communication channels were hindered during the COVID-19 pandemic, the power of the Internet, represented by social media, has created a new platform for information empowerment, action mutual, and ideation of motherhood for urban women formerly bound to family and parenting matters. From individual, family, and individual parenting experiences to group, social, and shared scenarios, urban women are engaged in emotional and memory interactions, including motherhood-related expression, experiences, and collaboration. This shift from virtual to physical has reshaped their parenting view, helping them break through the confines of family experience and traditional customs in addition to providing psychological motivation to express their gender concepts, shape their self-image, construct gender power, and interpret intimate relationships, pushing them to become more reflective of the times, as well as more capable and authoritative.

Parents' Modeling During the COVID-19 Pandemic: Influences on Family Members' Diet Quality and Satisfaction With-Food-Related Life in Dual-Earner Parents With Adolescent Children.

Reciprocal family influences in the food domain have been little explored, particularly during the COVID-19 pandemic. To fill in this gap, this study explored actor and partner effects between parents' food modeling and parents' and their adolescent children's diet quality and satisfaction with food-related life (SWFoL); and the mediating role of diet quality between modeling and SWFoL. This study used a cross-sectional design. A sample of 430 different-sex dual-earner parents and one adolescent child were recruited in Rancagua, Chile, between March and June 2020. Parents answered the modeling dimension of the Comprehensive Feeding Practices Questionnaire. Parents and adolescents answered the Adapted Healthy Eating Index (AHEI) and the SWFoL Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modeling. Results showed that one parent's modeling enhanced diet quality for themselves, their partner, and the adolescents. Parents' modeling was associated with their own SWFoL, directly and via their own diet quality. There were positive associations between mothers' modeling and adolescents' SWFoL; between mothers' diet quality and fathers' SWFoL; and between mothers' modeling and fathers' SWFoL via the fathers' diet quality. Parents' modeling can improve the three family members' diet quality, while mothers' modeling and diet quality showed to improve fathers' and adolescents' SWFoL.

Feasibility and acceptability study of the online ACT-Raising Safe Kids program

This study aimed to examine the feasibility and acceptability of the online version of the ACT-Raising Safe Kids Parenting Program, and the effect of improving parenting practices in the coronavirus pandemic context. The sample comprised 20 mothers of two-to-six-year-old children. The mothers answered the ACT, PAFAS, and PSOC scales in the pre- and post-intervention assessments. In addition, the acceptability questionnaire and the ACE scale were administered at post-intervention. A within-group comparison analysis was performed. The results showed that the mothers reported a significant increase in emotional/behavioral regulation and parental sense of competence, and a decrease in coercive practices in the post-intervention period compared to the pre-intervention period. The mothers reported great acceptance of the ACT online version. In conclusion, the ACT online version was feasible, acceptable, and effective in improving parenting practices.

Associations between Children's Health-Related Characteristics, Self-Esteem, and Fathers' Parenting Practices and Media Addiction among Younger School-Aged Korean Children.

This study aimed to investigate the relationship between media addiction levels among early school-aged children and their health status, self-esteem, and their fathers' parenting practices. Therefore, we analyzed the data from a total of 1149 fathers and children from the 10th year (2017) survey of the Panel Study on Korean Children (PSKC), by the Korean Children's Panel Research Institute. Specifically, a multinomial logistic analysis was conducted to identify the factors affecting children's media addiction. The media addiction levels were 68.8%, 24.9%, and 6.3%, in general, high-risk, and potential-risk users, respectively. When media addiction levels were used as the reference group for general users, the pattern observed in the data revealed a direct positive association between media use time and the probability of becoming a potential-risk user (79.4%, OR = 1.79, 95% CI: 1.20, 2.68). Furthermore, when general users were used as the reference group, the male gender accounted for the majority of high-risk users, at 99% (OR = 1.99, 95% CI: 1.46, 2.71). Within this group, the children's body mass index (BMI) was high (5%, OR = 1.05, 95% CI: 1.00, 1.11), their media use time increased by 1 h a day (145%, OR = 2.45, 95% CI: 1.93, 3.11), their self-esteem decreased (32%, OR = 0.68, 95% CI: 0.49, 0.95), the fathers' authoritative parenting practices were low (37%, OR = 0.63, 95% CI: 0.43, 0.92), and the permissive parenting practices were high (92%, OR = 1.92, 95% CI: 1.09, 3.37). Therefore, the results of this study highlight children's media use time and the risk factors related to high BMIs in order to prevent media addiction among early school-aged children. Our findings also suggest appropriate parenting practices and highlight the need to strengthen children's self-esteem.

Evaluating an Evidence-Based Parenting Intervention Among Filipino Parents: Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND: Filipino Americans underuse mental health and preventive care services even though studies have indicated that Filipino youth experience high rates of suicidal ideation, substance abuse, and teen pregnancies, whereas adults experience immigration stress, discrimination, and depression. Evidence-based parenting interventions provided in early childhood have proven to be effective in preventing the onset and escalation of child mental health disorders. In a pilot randomized controlled trial, we found that participation in the Incredible Years Basic Parent Training Program (IY) improved parenting stress and positive parenting practices and decreased child internalizing and externalizing symptoms among Filipino families. A fully powered trial is needed to determine the efficacy of IY as a prevention program among Filipino families. OBJECTIVE: The aims of this study are to describe the design and rationale of a randomized controlled trial evaluating the effects of the web-based IY program among parents recruited from multiple community-based settings and its impact on parenting practices, parenting stress, and child problem behavior among Filipino Americans and describe the impact of COVID-19 on our study protocols. METHODS: This study uses a randomized controlled 2-arm individually randomized group treatment pretest-posttest design for 180 parent-child dyads. Individuals are eligible if they are ≥18 years, live in California, and have at least one Filipino child aged 8-12 years. Consenting participants are randomly allocated to receive either the 12-week IY parenting intervention (intervention arm) or American Academy of Pediatrics' Bright Future handouts and placed on a waitlist to receive IY posttrial (waitlist control arm). Primary outcomes include the Parent Practices Interview and the Parenting Stress Index. Secondary outcomes will be measured using the Child Behavior Checklist (completed by parent) and will include child internalizing and externalizing behaviors and total problems. Data are collected at baseline and 3- and 6-month follow-ups. RESULTS: Changes made to the protocol owing to COVID-19 include administration of surveys remotely and implementation of the intervention on the web. The pandemic has provided an opportunity to evaluate the effectiveness of a web-based version of IY that may improve access and increase use of the intervention. Recruitment and data collection procedures are still ongoing and are expected to be completed by December 2022. CONCLUSIONS: Our research will determine whether IY promotes positive parenting practices and prevents child internalizing and externalizing behaviors in healthy but high-risk populations such as Filipino families. It will also uplift cultural narratives and add to the evidence base for web-based parenting programs and their implementation in real-world settings. If found efficacious, IY has the potential to prevent behavioral health disparities in this understudied and high-risk Filipino population and can be scaled, adapted, and implemented in other at-risk racial and ethnic minority communities. TRIAL REGISTRATION: ClinicalTrials.gov NCT04031170; https://clinicaltrials.gov/ct2/show/NCT04031170. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21867.

Parenting practices, stressors and parental concerns during COVID-19 in Pakistan.

BACKGROUND: COVID-19 is a global crisis that has added fear, uncertainty, and stress to parents. Parents are going through several challenges related to school closure, financial insecurity and working remotely. These stressors are affecting the mental health of parents. OBJECTIVES: This study aimed to observe major stressors along with the impact of COVID-19 on parental concerns and practices during lockdown. PARTICIPANTS: Sample (N = 923) was selected through purposive sampling from parents attending Out Patients Departments of hospitals in three provincial capital cities of Pakistan having a high burden of COVID-19, i.e. Lahore, Karachi and Peshawar. Parents having at least one child younger than 18 years were included in the study. METHODS: A quantitative design was used using a COVID-19 Parenting Response Scale (α = 0.74). It was used as a self-administered tool for parents who knew how to read and write Urdu/English language, however it was conducted as a structured interview for those who could not read/write. Data was analyzed by applying descriptive statistics (frequency, mean, percentage), independent sample t-test and Pearson Product Moment Correlation. RESULTS: Findings of the current study showed several stressful factors for parents during COVID-19 pandemic, mainly financial burden, children's education, uncertainty of the situation, and many others. The study also suggests an association of parental concerns during COVID-19 with parenting practices. CONCLUSION: COVID-19 pandemic presents a global crisis not only of the health of the people but also on family relations and mental well-being. Findings of this research indicate the need for targeted and accessible interventions for mental health of parents especially during these challenging circumstances so that they can cope with the challenges in an effective way and be able to take care of their children better.

COVID-19 pandemic shifts in food-related parenting practices within an ethnically/racially and socioeconomically diverse sample of families of preschool-aged children.

This study aimed to evaluate the influence of the COVID-19 pandemic on food parenting practices used by parents of young children. Ecological Momentary Assessment (EMA) was used to evaluate parents' use of coercive, indulgent, structured, and autonomy supportive food parenting practices before and during the COVID-19 pandemic among a diverse racial/ethnic sample (n = 72) of parents of preschool-aged children. The impact of parent and child mood/behavior on use of specific food parenting practices was also evaluated during both time periods. Results revealed that most parents of preschoolers use a variety of food parenting practices, including coercive control, indulgence, structure, and autonomy support practices. The use of structured and autonomy supportive practices, however, decreased during the COVID-19 pandemic. Further, the types of practices used by parents were contextually associated with the mood of the parent as well as child mood. Parent negative mood during COVID-19 was associated with higher levels of coercive control and indulgence and lower levels of structure, whereas child positive child mood was associated with greater use of autonomy supportive practices. These findings suggest that effects of the COVID-19 pandemic on family dynamics around feeding young children include shifts away from theoretically supportive approaches to parenting and highlight the roles of parent and child mood/behavior as potentially important momentary influences on food parenting during this time. Public health practitioners and clinicians working with parents of young children during COVID-19, and in years to come, should consider the potential impact of parental mood and stress, as well as child mood and behaviors. Additional research is needed to better understand how to best help parents maintain supportive feeding practices in the face of challenging situations.

Maternal Work-Life Balance and Children's Social Adjustment: The Mediating Role of Perceived Stress and Parenting Practices.

The participation of women with young children in the Japanese labor force has increased dramatically in recent years, bringing growing potential for conflict between work and family roles amid inadequate social systems, such as childcare support. Thus, work-life balance (WLB) of mothers may influence their children's mental health and lifestyle. This study aims to clarify the relationship between parents' WLB and children's mental health, as well as the underlying factors of parental stress and nurturing attitude. The study is based on a questionnaire survey administered in 2019 to fifth-grade elementary school students and their caregivers in Aichi Prefecture, Japan. The regression results indicated that the higher the work-family negative spillover, the higher the child's externalizing and internalizing problems, and the higher the positive spillover, the lower the problems and the higher the prosocial behaviors. Path analysis indicates that maternal WLB is negatively and positively related to children's behavior through maternal stress and parenting practices. The study suggests that maternal WLB is related to children's emotional and behavioral problems. WLB may impact children's emotional and behavioral problems through parents' mental health and involvement with their children, particularly because of work arrangements changing with the COVID-19 pandemic.

Child eating behaviors, parental feeding practices and food shopping motivations during the COVID-19 lockdown in France: (How) did they change?

The COVID-19 pandemic caused France to impose a strict lockdown, affecting families' habits in many domains. This study evaluated possible changes in child eating behaviors, parental feeding practices, and parental motivations when buying food during the lockdown, compared to the period before the lockdown. Parents of 498 children aged 3-12 years (238 boys; M = 7.32; SD = 2.27) completed an online survey with items from validated questionnaires (e.g., CEDQ, CEBQ, HomeSTEAD). They reported on their (child's) current situation during the lockdown, and retrospectively on the period before the lockdown. Many parents reported changes in child eating behaviors, feeding practices, and food shopping motivations. When changes occurred, child appetite, food enjoyment, food responsiveness and emotional overeating significantly increased during the lockdown. Increased child boredom significantly predicted increased food responsiveness, emotional overeating and snack frequency in between meals. When parents changed their practices, they generally became more permissive: less rules, more soothing with food, more child autonomy. They bought pleasurable and sustainable foods more frequently, prepared more home-cooked meals and cooked more with the child. Level of education and increased stress level predicted changes in parental practices and motivations. This study provides insights in factors that can induce positive and negative changes in families' eating, feeding and cooking behaviors. This can stimulate future studies and interventions.

Relationship Between Parenting Practices and Children's Screen Time During the COVID-19 Pandemic in Turkey.

PURPOSE: This study investigates the relationship between parenting practices and children's screen time following the COVID-19 outbreak. DESIGN AND METHODS: The population of the present cross-sectional study was the parents of children studying in three randomly-selected schools in the western, eastern and central regions of Turkey. The study data were collected between May 15 and 31, 2020, using a descriptive questionnaire form and the Parenting Practices Scale applied to 1115 parents of children between 6 and 13 years of age. The data were analyzed using the SPSS 21.0 software package, and with descriptive, correlation and multiple regression analyses. RESULTS: It was noted that 68% of the mothers did not work, and 40.2% of the fathers had shifted to a flexible work arrangement as a result of the COVID-19 pandemic. The study revealed that 89.6% of the families had established ground rules related to screen time, and that the screen time of the children of 71.7% of the families had seen an increase, amounting to 6.42 ± 3.07 h/day. Gender, age, household income, mother's employment status, family's rules about screen time, and inconsistent parenting practices were defined as significant predictors in the children's screen time model created for the study. CONCLUSIONS: A vast majority of the participants stated that their children's screen time had increased during the COVID-19 pandemic. PRACTICE IMPLICATIONS: Screen time should be monitored, the necessary support should be provided to children, and parents should set ground rules for their children's screen times.