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1.
West J Emerg Med ; 23(5): 678-683, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-20242722

ABSTRACT

INTRODUCTION: The pandemic has been difficult on physicians, with two fifths of doctors in one survey reporting that their mental health is now worse than before the pandemic. It is likely that a significant proportion of these physicians are parents of children necessitating childcare, as approximately 32% of the US workforce has someone in their household under the age of 14. We sought to study the impact of the coronavirus 2019 (COVID-19) pandemic on physician parents in academia. Our goal was to investigate the intersection of professional and personal challenges, as well as perceived impact on domestic life and professional development secondary to the COVID-19 pandemic. METHODS: Using Survey Monkey, we developed a 37-question survey to address the aim of this study. Questions were grouped into four categories: demographics; impact on childcare; impact on care; and impact on mental health/wellness. Most of the questions were multiple choice with a few fill-in-the-blank options to allow participants to provide additional information related to their experiences as physicians during the pandemic. A link to the survey was disseminated via email to physicians at our home institution, Rush University Medical Center (Chicago), via our own intra- and interdepartmental communications, We used private social media accounts such as Facebook physician groups to reach out to physicians at other academic medical centers. Survey responses were voluntary and collected anonymously over an eight-week period, without identifiable data. Inclusion criteria included any physician identifying themselves as working full or full or part time in an academic facility in the US and caregivers for children <18 years. RESULTS: Survey respondents were mostly female (83.2%), practicing in the Midwest (61.2%), and ranked as assistant professor (59.5%). The majority of respondents had two children (65.1%) who were <11 years in age (85.6%). Most respondents worked full time with 72.8% working over 50% clinically. Childcare was disrupted for 171 of 232 respondents (73.7%); 62.9% struggled with balancing work with childcare; 81.9% worried often or very often about fulfilling their responsibilities. A vast majority, 210 of 232 respondents (90.5%) had some degree of concern about feeling overburdened by their roles. More than half (57.3%) worried that their professional advancement was impacted by the pandemic, and 53.9% considered making adjustments to their clinical workload/. Over half (51.6%) thought that increased domestic responsibilities impacted their professional advancement. CONCLUSION: In the survey, which was completed primarily by early-career women physicians practicing in a variety of specialties and geographic regions, we noted that childcare disruption amidst the pandemic was extremely prevalent. The majority of respondents reported full-time equivalent work; thus, it is reasonable to assume that significant workloads and limitations in remote work in combination with childcare constraints resulted in significant burden. A large number felt the challenges were negatively impacting their professional development and felt overburdened by their various roles.


Subject(s)
COVID-19 , Physicians, Women , Physicians , COVID-19/epidemiology , Female , Humans , Male , Pandemics , Parenting/psychology , Surveys and Questionnaires
2.
BMC Public Health ; 23(1): 1099, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-20239982

ABSTRACT

BACKGROUND: The COVID-19 pandemic prompted rapid federal, state, and local government policymaking to buffer families from the health and economic harms of the pandemic. However, there has been little attention to families' perceptions of whether the pandemic safety net policy response was adequate, and what is needed to alleviate lasting effects on family well-being. This study examines the experiences and challenges of families with low incomes caring for young children during the pandemic. METHODS: Semi-structured qualitative interviews conducted from August 2020 to January 2021 with 34 parents of young children in California were analyzed using thematic analysis. RESULTS: We identified three key themes related to parents' experiences during the pandemic: (1) positive experiences with government support programs, (2) challenging experiences with government support programs, and (3) distress resulting from insufficient support for childcare disruptions. Participants reported that program expansions helped alleviate food insecurity, and those attending community colleges reported accessing a range of supports through supportive counselors. However, many reported gaps in support for childcare and distance learning, pre-existing housing instability, and parenting stressors. With insufficient supports, additional childcare and education workloads resulted in stress and exhaustion, guilt about competing demands, and stagnation of longer-term goals for economic and educational advancement. CONCLUSIONS: Families of young children, already facing housing and economic insecurity prior to the pandemic, experienced parental burnout. To support family well-being, participants endorsed policies to remove housing barriers, and expand childcare options to mitigate job loss and competing demands on parents. Policy responses that either alleviate stressors or bolster supports have the potential to prevent distress catalyzed by future disasters or the more common destabilizing experiences of economic insecurity.


Subject(s)
COVID-19 , Pandemics , Humans , Child , Child, Preschool , COVID-19/epidemiology , Parents , Parenting , Government
3.
BMC Psychiatry ; 23(1): 374, 2023 05 29.
Article in English | MEDLINE | ID: covidwho-20238920

ABSTRACT

BACKGROUND: Distinguishing whether and how pre-existing characteristics impact maternal responses to adversity is difficult: Does prior well-being decrease the likelihood of encountering stressful experiences? Does it protect against adversity's negative effects? We examine whether the interaction between relatively uniformly experienced adversity (due to COVID-19 experience) and individual variation in pre-existing (i.e., pre-pandemic onset) distress predicted mothers' pandemic levels of distress and insensitive caregiving within a country reporting low COVID-19 death rates, and strict nationwide regulations. METHOD: Fifty-one Singaporean mothers and their preschool-aged children provided data across two waves. Pre- pandemic onset maternal distress (i.e., psychological distress, anxiety, and parenting stress) was captured via self-reports and maternal sensitivity was coded from videos. Measures were repeated after the pandemic's onset along with questionnaires concerning perceived COVID-19 adversity (e.g., COVID-19's impact upon stress caring for children, housework, job demands, etc.) and pandemic-related objective experiences (e.g., income, COVID-19 diagnoses, etc.). Regression analyses (SPSS v28) considered pre-pandemic onset maternal distress, COVID-19 stress, and their interaction upon post-pandemic onset maternal distress. Models were re-run with appropriate covariates (e.g., objective experience) when significant findings were observed. To rule out alternative models, follow up analyses (PROCESS Model) considered whether COVID-19 stress mediated pre- and post-pandemic onset associations. Models involving maternal sensitivity followed a similar data analytic plan. RESULTS: Pre-pandemic maternal distress moderated the association between COVID-19 perceived stress and pandemic levels of maternal distress (ß = 0.22, p < 0.01) but not pandemic assessed maternal sensitivity. Perceived COVID-19 stress significantly contributed to post-pandemic onset maternal distress for mothers with pre-pandemic onset distress scores above (ß = 0.30, p = 0.05), but not below (ß = 0.25, p = 0.24), the median. Objective COVID-19 adversity did not account for findings. Post-hoc analyses did not suggest mediation via COVID-19 stress from pre-pandemic to pandemic maternal distress. CONCLUSIONS: Pre-existing risk may interact with subsequent perceptions of adversity to impact well-being. In combination with existing research, this small study suggests prevention programs should focus upon managing concurrent mental health and may highlight the importance of enhanced screening and proactive coping programs for people entering high stress fields and/or phases of life.


Subject(s)
COVID-19 , Female , Child , Child, Preschool , Humans , COVID-19/epidemiology , Parenting/psychology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Mothers/psychology , Adaptation, Psychological
4.
Pediatrics ; 151(Suppl 2)2023 05 01.
Article in English | MEDLINE | ID: covidwho-2319415

ABSTRACT

OBJECTIVES: To assess impact and implementation of remote delivery of a parenting program following suspension of in-person visits during the coronavirus disease 2019 pandemic. METHODS: Impact of remote delivery of the Reach Up parenting program on parenting practices was evaluated by randomized trial in Jamaica. Mothers with children aged 5 to 24 months who met 1 of 7 at-risk criteria were enrolled at health centers. Participants were randomly assigned to intervention or control using random number tables generated by a statistician. Intervention comprised a manual for parents with illustrated play activities, phone calls, and short message service messages. The control group received usual care. Parent practices were measured using an adapted Family Care Indicators telephone-administered questionnaire by interviewers unaware of group assignment. Qualitative interviews were conducted with staff and parents in Jamaica and Brazil and staff in Ecuador to identify facilitators and barriers to remote delivery of Reach Up. RESULTS: Two hundred forty-seven participants were assessed at endline (control n = 130; intervention n = 117). Intervention increased parent activities that support child development, effect size 0.34 SD (95% confidence interval 0.03-0.53), and use of praise, odds 2 times higher with intervention. There were no benefits to interactive language or play materials. Qualitative results showed parents appreciated program continuation and felt motivated to help their child, and methods were acceptable to staff. Barriers included poor mobile phone access, difficulty contacting parents, and feedback limitations without in-person contact. CONCLUSIONS: Remote delivery methods have potential to contribute to scaling of parenting programs.


Subject(s)
COVID-19 , Parenting , Child , Female , Humans , Parents , Mothers , Child Development
5.
J Pediatr Nurs ; 71: e104-e111, 2023.
Article in English | MEDLINE | ID: covidwho-2309030

ABSTRACT

PURPOSE: The purpose of this study was to understand the experiences of parents and caregivers of children with special healthcare needs during the COVID-19 pandemic. DESIGN AND METHODS: In this descriptive phenomenological study, the researchers used purposive and snowball sampling to recruit nineteen participants, ranging in age from 21 to 55 years of age until saturation was established. Colaizzi's method guided data analysis. Iterative examination of the interview transcripts, an audit trail, bracketing, and validation of findings with a subset of participants established trustworthiness. RESULTS: Navigating the COVID-19 Pandemic was the overarching theme. Four major themes emerged under Navigating the COVID-19 Pandemic as follows: Disruptions in Daily Life, Shifts in Daily Life, Innovations in Daily Life, and Surprising Silver Linings. CONCLUSION: This study elucidated an in-depth understanding of the positive and negative impacts of the pandemic on the lives of families living with a child with special needs. The COVID-19 pandemic profoundly affected families and parenting approaches. Parents of children with special healthcare needs in this study found day-to-day living especially difficult in similar and unique ways. For virtually all parents the pandemic added new challenges in meeting their child's physical, mental, social, and educational needs. Parents and caregivers revealed innovative ways of maintaining a sense of normalcy during the height of the pandemic. PRACTICE IMPLICATIONS: These findings demonstrate the importance of developing interventions and creating public health policies as we move beyond the current pandemic and plan for potential outbreaks in the future.


Subject(s)
COVID-19 , Pandemics , Child , Humans , Young Adult , Adult , Middle Aged , COVID-19/epidemiology , Parents , Parenting , Health Services Needs and Demand
7.
J Subst Abuse Treat ; 119: 108148, 2020 12.
Article in English | MEDLINE | ID: covidwho-2255237

ABSTRACT

Prior to COVID-19, options for parenting support while receiving substance use disorder (SUD) treatment were limited. The transition to using mobile technology for SUD treatment due to physical distancing during the pandemic may make parenting resources for people with SUDs even more limited. The rapid integration of parenting supports into telehealth and web-based treatment delivery is essential for improving long-term outcomes for families affected by substance use.


Subject(s)
Coronavirus Infections , Pandemics , Parenting , Pneumonia, Viral , Substance-Related Disorders/rehabilitation , COVID-19 , Humans , Internet , Telemedicine/methods
8.
Infant Ment Health J ; 44(2): 268-283, 2023 03.
Article in English | MEDLINE | ID: covidwho-2288354

ABSTRACT

Attachment security provides a well-documented protective developmental function for children exposed to individual- and community-level trauma, yet the effectiveness of prevention and intervention efforts targeting attachment during adolescence has been relatively underexplored. The Connecting and Reflecting Experience (CARE) program is a transdiagnostic, bi-generational, group-based, mentalizing-focused parenting intervention developed to dismantle the intergenerational transmission of trauma and support secure attachment relationships across the developmental spectrum within an under-resourced community. This exploratory study evaluated outcomes among caregiver-adolescent dyads (N = 32) in the CARE condition of a nonrandomized clinical trial at an outpatient mental health clinic within a diverse, urban U.S. community with disproportionate trauma exposure exacerbated by COVID-19. Caregivers predominantly identified as Black/African/African American (47%), Hispanic/Latina (38%), and/or White (19%). At pre- and post-intervention, caregivers completed questionnaires regarding parental mentalizing and their adolescents' psychosocial functioning. Adolescents completed scales regarding attachment and psychosocial functioning. Results showed a significant decrease in caregivers' prementalizing on the Parental Reflective Functioning Questionnaire, improvement in adolescent psychosocial functioning on the Youth Outcomes Questionnaire, and an increase in adolescents' reports of attachment security on the Security Scale. These preliminary findings suggest that mentalizing-focused parenting interventions may be effective in fostering improved attachment security and psychosocial functioning during adolescence.


La seguridad de la afectividad provee una bien documentada función protectora del desarrollo para niños expuestos al trauma individual y comunitario; aun así, la efectividad de los esfuerzos de prevención e intervención enfocados en la afectividad en la adolescencia ha sido relativamente poco explorada. El programa Conexión y Reflexión de la Experiencia (CARE) es una intervención de crianza transdiagnóstica, bigeneracional, con base en el grupo, enfocada en la mentalización, desarrollada para desarmar la transmisión intergeneracional de trauma y apoyar las relaciones de afectividad segura a lo largo del espectro del desarrollo dentro de una comunidad menos equipada con recursos. Este estudio exploratorio evaluó resultados entre díadas cuidador-adolescente (N = 32) bajo la condición CARE de un ensayo clínico no al azar en una clínica de salud mental ambulatoria dentro de una comunidad diversa y urbana en Estados Unidos, expuesta al trauma desproporcionadamente, lo cual fue exacerbado por COVID-19. A los cuidadores predominantemente se les identificó como negros/africanos/afroamericanos (47%), hispanos/latinas (38%), y/o blancos (19%). Antes y después de la intervención, los cuidadores completaron cuestionarios acerca de mentalización del progenitor y el funcionamiento sicosocial de sus adolescentes. Los adolescentes completaron escalas sobre la afectividad y el funcionamiento sicosocial. Los resultados mostraron una significativa disminución de la pre-mentalización en el Cuestionario del Funcionamiento con Reflexión del Progenitor, mejoras en el funcionamiento sicosocial de los adolescentes en el Cuestionario de Resultados de la Juventud, y un aumento en los reportes de los adolescentes sobre la seguridad de la afectividad en la Escala de Seguridad. Estos preliminares resultados sugieren que las intervenciones de crianza enfocadas en la mentalización pudieran ser efectivas para fomentar la mejorada seguridad de la afectividad y el funcionamiento sicosocial durante la adolescencia.


La sécurité de l'attachement offre une fonction protectrice au développement qui est bien prouvée pour les enfants exposés à un trauma individuel et communautaire. Cependant l'efficacité de la prévention et des efforts d'intervention ciblant l'attachement durant l'adolescence a été relativement peu exploré. Le programme de Connecting and Reflecting Experience (CARE, soit Expérience de Lien et de Réflexion) est une intervention de parentage transdiagnostique, bi-générationnel, basée sur un groupe, et ciblé sur la mentalisation développé afin de démonter la transmission intergénérationnelle du trauma et de soutenir des relations d'attachement sécure au travers du spectre développemental au soin d'une communauté manquant de moyens. Cette étude exploratoire a évalué les résultats chez des dyades personne prenant soin de l'adolescent-adolescent (N = 32) dans la condition CARE d'un essai clinique non-randomisé dans une clinique de santé mentale en consultation externe au soin d'une communauté américaine urbaine et diverse avec une exposition au trauma disproportionnée exacerbée par le COVID-19. Les personnes prenant soin des adolescents se sont en grande partie identifiés comme étant Noirs/Africains/Noir Américains (47%), Hispaniques/Latina (38%), et/ou Blanches (19%). Avant et après l'intervention les personnes prenant soin des adolescents ont rempli des questionnaires concernant la mentalisation parentale et le fonctionnement psychosocial de leurs adolescents. Les adolescents ont rempli des échelles concernant l'attachement et le fonctionnement psychosocial. Les résultats montrent une baisse importante de la pré-mentalisation des personnes prenant soin des adolescents concernant le Questionnaire de Fonctionnement de Réflexion Parental, une amélioration du fonctionnement psychosocial de l'adolescent au travers du Questionnaire des Résultats de Jeunesse (Youth Outcomes Questionnaire en anglais) et une augmentation dans les rapports de sécurité d'attachement faits par les adolescents au travers de l'échelle Security Scale. Ces résultats préliminaires suggèrent que les interventions de parentage focalisées sur la mentalisation peuvent être efficaces pour favoriser une sécurité de l'attachement améliorée et le fonctionnement psychosocial durant l'adolescence.


Subject(s)
COVID-19 , Mental Health , Child , Adolescent , Humans , Parent-Child Relations , Parents/psychology , Parenting/psychology
9.
Matern Child Health J ; 27(4): 632-640, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2287354

ABSTRACT

This cross-sectional study explores the relationship between maternal feelings, maternal parenting styles, and mothers' worry about COVID-19's detrimental consequences on preschool children's health and well-being. The study is among the first to concentrate on this reference specific group, whose characteristics might be particularly vulnerable to COVID-19's adversities. One hundred and four mothers of at least one preschool-age child completed an online questionnaire battery, which included the Parental Feelings Inventory, the Parenting Styles and Dimensions Questionnaire (PSDQ), and the parental worry about COVID-19 scale. Negative maternal feelings (i.e., anger, anxiety/sadness) were associated with authoritarian and indulgent parenting practices, especially verbal hostility, while maternal happiness was associated with more authoritative practices, especially warmth and support. The hierarchical multiple regression model explained about 42% of variance of the overall maternal worry about COVID-19 from maternal negative feelings and parenting styles, with maternal authoritative parenting and maternal anxiety/sadness as the significant predictors that uniquely explain maternal worry about COVID-19. These results are discussed in terms of positive and negative maternal worry, which partially reflect the differences between overprotective and authoritative parenting in early childhood.


Subject(s)
COVID-19 , Mothers , Female , Child, Preschool , Humans , Parenting , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology , Parents , Emotions , Anxiety/epidemiology
10.
Child Adolesc Psychiatr Clin N Am ; 32(3): 485-510, 2023 07.
Article in English | MEDLINE | ID: covidwho-2286337

ABSTRACT

This review summarizes risk factors for developing anxiety disorders in children and adolescents. A surfeit of risk factors, including temperament, family environment (eg, parenting style), environmental exposures (eg, particulate matter), and cognitive factors (eg, threat bias), increases the risk of anxiety in children. These risk factors can significantly impact the trajectory of pediatric anxiety disorders. The impact of severe acute respiratory syndrome coronavirus 2 infection on anxiety disorders in children is discussed in addition to its public health implications. Identifying risk factors for pediatric anxiety disorders creates a scaffold for the development of prevention strategies and for reducing anxiety-related disability.


Subject(s)
COVID-19 , Adolescent , Humans , Child , COVID-19/complications , Anxiety Disorders/epidemiology , Anxiety Disorders/etiology , Anxiety/psychology , Parenting/psychology , Risk Factors
11.
BMC Prim Care ; 24(1): 38, 2023 02 01.
Article in English | MEDLINE | ID: covidwho-2262055

ABSTRACT

BACKGROUND: Parenting is essential for children's development and preventing child abuse and neglect. Providing parenting services within the primary health care settings demonstrated effectiveness in improving parenting quality. However, little is known about the status of parenting and parenting resources in rural areas and whether they differ between rural and urban areas in Mainland China. OBJECTIVE: This study aimed to examine the rural-urban differences in parenting and availability of, utilization of, and need for parenting resources among Chinese parents with children under three years of age. PARTICIPANTS AND SETTING: A total of 425 parents of children under three years of age participated in an online survey between March and May 2020. METHODS: The Parenting and Family Adjustment Scale and Child Adjustment and Parenting Efficacy Scale were used to assess parenting, family adjustment, and parenting efficacy. The availability of, utilization of, and need for parenting resources were measured using self-developed questions based on literature. Chi-square tests, t tests, and Wilcoxon rank-sum test were used to examine the differences in responses between parents in rural and urban areas. RESULTS: Compared with their urban counterparts, rural parents reported a higher level of negative parenting and more limited parenting resources. Both rural and urban parents reported low availability and utilization of parenting resources as well as a great need for parenting support services. CONCLUSIONS: Rural parents faced more parenting challenges and limited parenting resources compared with urban parents. Both rural and urban parents with children under three years of age reported great needs for parenting resources. These findings highlight the potential of delivering accessible, sustainable, and cost-effective parenting programs via the primary health care system for public welfare in both urban and rural areas, with more attention paid to rural parents to help them improve their parenting.


Subject(s)
Child Abuse , Parenting , Humans , Child , Child, Preschool , East Asian People , Parents , Child Abuse/prevention & control , Surveys and Questionnaires
12.
BMJ Lead ; 7(1): 38-44, 2023 03.
Article in English | MEDLINE | ID: covidwho-2268486

ABSTRACT

BACKGROUND: In March 2020, academic research centres in Colorado were closed to prevent the spread of COVID-19. Scientists and research staff were required to continue their work remotely with little time to prepare for the transition. METHODS: This survey study used an explanatory sequential mixed-method design to explore clinical and translational researcher and staff experiences of the transition to remote work during the first 6 weeks of the COVID-19 pandemic. Participants indicated the level of interference with their research and shared their experiences of remote work, how they were impacted, how they were adapting and coping, and any short-term or long-term concerns. RESULTS: Most participants indicated that remote work interfered with their research to a moderate or great degree. Participant stories illuminated the differences of remote work prior to and during COVID-19. They described both challenges and silver linings. Three themes that highlight the challenges of transitioning to remote work during a pandemic were: (1) Leadership communication: 'Leadership needs to revisit their communication strategy'; (2) Parenting demands: Parents are 'multitasked to death' every day and (3) Mental health challenges: The COVID-19 experience is 'psychologically taxing'. CONCLUSIONS: The study findings can be used to guide leaders in building community, resiliency and support productivity during current and future crises. Potential approaches to address these issues are proposed.


Subject(s)
COVID-19 , Mental Health , Humans , Parenting , Leadership , Pandemics/prevention & control , COVID-19/epidemiology , Communication
13.
Nat Rev Chem ; 7(2): 67-68, 2023 02.
Article in English | MEDLINE | ID: covidwho-2268409
14.
PLoS One ; 18(2): e0282330, 2023.
Article in English | MEDLINE | ID: covidwho-2265939

ABSTRACT

Perinatal distress affects approximately 10% of fathers, but little is known about how gay fathers experience the challenges surrounding childbirth and early parenting of a child. This study explored gay fathers' experiences of having a baby via transnational surrogacy, raising that baby as a gay parent, and the context of the COVID-19 pandemic. In-depth qualitative interviews were conducted with 15 Israeli men to understand their experiences of surrogacy and early parenthood, focusing on the impact on their mental health and the relational factors involved. Secondary narrative analysis revealed that fathers constructed surrogacy as a perilous quest that required strong intentionality to undertake. The first year of parenthood was conceptualised alternately as a joyful experience and/or one that challenged fathers' identities and mental health. A relational framework was applied to better conceptualise the fathers' narratives, revealing that actual connections-and the potentials for links-considerably shaped experiences of surrogacy, perinatal distress and recovery. Implications for research and policy are discussed.


Subject(s)
COVID-19 , Sexual and Gender Minorities , Male , Pregnancy , Infant , Child , Female , Humans , Fathers/psychology , Mental Health , Israel , Pandemics , Surrogate Mothers/psychology , Parenting/psychology
15.
Int J Environ Res Public Health ; 20(5)2023 03 02.
Article in English | MEDLINE | ID: covidwho-2277933

ABSTRACT

Little is known about digital health interventions used to support treatment for pregnant and early parenting women (PEPW) with substance use disorders (SUD). METHODS: Guided by the Arksey and O'Malley's Scoping Review Framework, empirical studies were identified within the CINAHL, PsycInfo, PubMed, and ProQuest databases using subject headings and free-text keywords. Studies were selected based on a priori inclusion/exclusion criteria, and data extraction and descriptive analysis were performed. RESULTS: A total of 27 original studies and 30 articles were included. Varying study designs were used, including several feasibility and acceptability studies. However, efficacious findings on abstinence and other clinically important outcomes were reported in several studies. Most studies focused on digital interventions for pregnant women (89.7%), suggesting a dearth of research on how digital technologies may support early parenting women with SUD. No studies included PEPW family members or involved PEPW women in the intervention design. CONCLUSIONS: The science of digital interventions to support treatment for PEPW is in an early stage, but feasibility and efficacy results are promising. Future research should explore community-based participatory partnerships with PEPW to develop or tailor digital interventions and include family or external support systems to engage in the intervention alongside PEPW.


Subject(s)
Digital Technology , Substance-Related Disorders , Humans , Female , Pregnancy , Parenting , Substance-Related Disorders/therapy , PubMed
16.
Int J Environ Res Public Health ; 20(5)2023 02 22.
Article in English | MEDLINE | ID: covidwho-2275784

ABSTRACT

INTRODUCTION: Few studies have focused on the long-term effects of the COVID-19 pandemic on mental health. The objective of our work was to evaluate the changes in emotional and behavioral symptoms in patients with neuropsychiatric disorders and the impact on parenting stress 1 year after the first national lockdown. METHODS: We enrolled 369 patients aged 1.5-18 years of age referred to the Child and Adolescent Neuropsychiatry Unit of the University Hospital of Salerno (Italy) by their parents. We asked their parents to complete two standardized questionnaires for the assessment of emotional/behavioral symptoms (Child Behavior CheckList, CBCL) and parental stress (Parenting Stress Index, PSI) prior to the pandemic (Time 0), during the first national lockdown (Time 1) and after 1 year (Time 2), and we monitored the changes in symptoms over time. RESULTS: After 1 year from the start of the first national lockdown, we found a significant increase of internalizing problems, anxiety, depression, somatization, and social and oppositional-defiant problems in older children (6-18 years), and a significant increase of somatization, anxiety problems, and sleep problems in younger children (1.5-5 years). We also observed a significant relationship between emotional/behavioral symptoms and parental stress. CONCLUSION: Our study showed that parental stress levels increased compared to the pre-pandemic months and continues to persist over time, while internalizing symptoms of children and adolescents showed a significant worsening during 1 year follow-up from the first COVID-19 lockdown.


Subject(s)
COVID-19 , Humans , Child , Adolescent , Infant , Child, Preschool , Pandemics , Follow-Up Studies , Communicable Disease Control , Parenting/psychology
17.
J Prev (2022) ; 44(3): 341-357, 2023 06.
Article in English | MEDLINE | ID: covidwho-2255504

ABSTRACT

This study evaluated the effects of an enhanced version of the Family Check-Up Online (FCU-O), adapted to address parent and family functioning in response to the COVID-19 pandemic. In order to increase accessibility, the FCU-O was delivered as a web-based application coupled with online coaching support, a service delivery model that is consistent with pandemic-related limitations for in-person intervention, as well as the limited staffing and resources available in many schools and health care settings despite the increased need for mental health services driven by the pandemic. This registered clinical trial (blinded) tested the effects of the intervention on parental mental health, parenting behaviors, and family functioning from pre-treatment to 2-month follow-up. Families were randomly assigned to receive the FCU-O (N = 74) or to a wait-list control condition (N = 87). Random assignment to the FCU-O was associated with significant improvements in parental well-being, including reduced anxiety, depression, and perceived stress. Further, the FCU-O predicted significant improvements in adaptive parenting skills (e.g. less negative/coercive parenting, greater proactive parenting), and enhancements in family-relational functioning (e.g. improved coparenting). Effect sizes were small to moderate in magnitude (partial eta squared values between 0.03 and 0.11). The results indicate that online delivery of a family-centered intervention may represent a promising approach for addressing pandemic-related impacts on parent and family functioning.


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Mental Health , Parents/psychology , Parenting/psychology
18.
Attach Hum Dev ; 25(2): 223-239, 2023 04.
Article in English | MEDLINE | ID: covidwho-2285168

ABSTRACT

During the COVID-19 pandemic lockdowns made it impossible for parenting coaches to reach the families without digital means of communication. Several studies were initiated to transform existing parenting interventions into hybrid or fully online versions and to examine their feasibility, acceptability and efficacy. We present one such transformation in detail, the Virtual-VIPP which is based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). Furthermore, we report a systematic review of 17 published trials with online versions of parenting programs. Overall, online parenting interventions seem feasible to implement, are well-received by most families, and to show equivalent effects to face-to-face approaches. Careful preparation of technicalities and monitoring of fidelity are prerequisites. Advantages of online parenting interventions are their potentially broader reach, more detailed process documentation, and better cost-utility balance. We expect that online parenting interventions are here to stay, but their efficacy needs to be rigorously tested.


Subject(s)
COVID-19 , Parents , Humans , Parent-Child Relations , Pandemics , Video Recording , Feedback, Psychological , Object Attachment , Communicable Disease Control , Parenting
19.
Int J Environ Res Public Health ; 20(5)2023 03 02.
Article in English | MEDLINE | ID: covidwho-2282682

ABSTRACT

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.


Subject(s)
COVID-19 , Mental Disorders , Mental Health , Adolescent , Adult , Humans , Mental Disorders/epidemiology , Mental Health/statistics & numerical data , Pandemics , Parenting/psychology , Child , Parents/psychology
20.
Int J Environ Res Public Health ; 19(24)2022 12 17.
Article in English | MEDLINE | ID: covidwho-2282529

ABSTRACT

Child maltreatment impacts many young people involved in the child welfare system, and it is important that the resource parents supporting these youth have knowledge and skills in trauma-informed care. The current study is a preliminary evaluation of the Resource Parent Curriculum (RPC), an in-service, 8-module, group-based parenting program developed by the National Child Traumatic Stress Network. Youth and caregiver outcomes were examined by way of a quasi-experimental design that included 22 resource parents in the experimental group and 21 in the waitlist control group and involved baseline, post-program, and 2-month follow-up assessments. For learning outcomes, RPC resulted in improvements in resource parents' knowledge and beliefs about trauma-informed parenting. While not statistically significant, potential effects included improvements in resource parents' tolerance of challenging youth behaviors and parenting self-efficacy. For behavioral outcomes, several non-significant potential effects were noted, including improvements in resource parents' attachment relationships with their youth and increased social supports. This study was the first to evaluate RPC using a quasi-experimental design within a Canadian context and through a virtual delivery. Findings highlighted several benefits of the program and resource parents' ongoing training needs.


Subject(s)
Child Abuse , Parenting , Child , Adolescent , Humans , Canada , Child Welfare , Curriculum , Program Evaluation , Parent-Child Relations
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