Parenting young children during COVID-19: Parenting stress trajectories, parental mental health, and child problem behaviors.

Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children (Mage = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The roles of child temperament, parent stress, and parenting style in family mealtimes.

Family mealtimes are associated with benefits for children, including healthy eating, fewer behavior problems, and healthy psychological well-being. However, the interactions during family mealtimes, and the parent and child characteristics, which may affect both the family mealtime environment and the associated benefits in children are not fully understood. The goal of this study was to examine the role of child and parent characteristics on the family mealtime environment. We tested several mediation models to explain how child temperament (negative affectivity), parent stress, and the dimensions of parent feeding style (responsiveness and demandingness) interact and influence each other to impact the structure and quality of the mealtime environment. Parents (68 mothers; 82 fathers) of children between 2 and 6 years completed an online survey. Measures included the Children's Behavior Questionnaire, Perceived Stress Scale, Caregiver's Feeding Styles Questionnaire, and The Meals in Our Household Questionnaire. Child negative affectivity was associated with poorer mealtime quality and structure. These associations were mediated through parent responsiveness, but not demandingness. The role of demandingness in family mealtimes may depend on parent responsiveness. When examined together in a serial mediation model, child negative affectivity increased parent stress, which reduced responsiveness, and led to poorer mealtime quality and structure. These results emphasize the complex relationships between child temperament, parent stress, and the dimensions of parenting styles that occur within the mealtime context. This line of research is essential for understanding family mealtime dynamics and informing future studies aimed at creating positive interactions between parents and children during mealtimes.

The Preventing Alzheimer's with Cognitive Training (PACT) randomized clinical trial.

BACKGROUND: To address the rising prevalence of Alzheimer's disease and related dementias, effective interventions that can be widely disseminated are warranted. The Preventing Alzheimer's with Cognitive Training study (PACT) investigates a commercially available computerized cognitive training program targeting improved Useful Field of View Training (UFOVT) performance. The primary goal is to test the effectiveness of UFOVT to reduce incidence of clinically defined mild cognitive impairment (MCI) or dementia with a secondary objective to examine if effects are moderated by plasma ß-amyloid level or apolipoprotein E e4 (APOE e4) allele status. METHODS/DESIGN: This multisite study utilizes a randomized, controlled experimental design with blinded assessors and investigators. Individuals who are 65 years of age and older are recruited from the community. Eligible participants who demonstrate intact cognitive status (Montreal Cognitive Assessment score > 25) are randomized and asked to complete 45 sessions of either a commercially available computerized-cognitive training program (UFOVT) or computerized games across 2.5 years. After three years, participants are screened for cognitive decline. For those demonstrating decline or who are part of a random subsample, a comprehensive neuropsychological assessment is completed. Those who perform below a pre-specified level are asked to complete a clinical evaluation, including an MRI, to ascertain clinical diagnosis of normal cognition, MCI, or dementia. Participants are asked to provide blood samples for analyses of Alzheimer's disease related biomarkers. DISCUSSION: The PACT study addresses the rapidly increasing prevalence of dementia. Computerized cognitive training may provide a non-pharmaceutical option for reducing incidence of MCI or dementia to improve public health. REGISTRATION: The PACT study is registered at http://Clinicaltrials.govNCT03848312.

Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families.

The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.

Applying the Health Belief Model to Quantify and Investigate Expectations for Computerized Cognitive Training.

Despite the demonstrated benefits of computerized cognitive training for older adults, little is known about the determinants of training behavior. We developed and tested scales to quantify expectations about such training, examine whether expectations predicted training adherence, and explore if training expectations changed from pre- to post-training. Participants (N=219) were healthy older adults aged 55-96 years (M=75.36, SD=9.39), enrolled in four studies investigating Dakim, Insight, or Posit Science Brain Fitness computerized cognitive training programs. Instruments were adapted from existing health behavior scales: Self Efficacy for Cognitive Training, Outcome Expectations for Cognitive Training, Perceived Susceptibility to Cognitive Decline, Dementia or Alzheimer's Disease, and Perceived Severity of Cognitive Decline, Dementia or Alzheimer's Disease. Participants completed scales at baseline (N=219) and post-training (n=173). Eight composites were derived from factor analyses. Adherence rates were high (M=81%), but none of the composites predicted training adherence. There was an overall significant effect of time, Wilks' λ=.843, F(8, 114)=2.65, p=.010, partial η 2 =.157, a significant overall effect of training group, Wilks' λ=.770, F(16, 228)=1.99, p=.015, partial η 2 =.123, and an overall significant group x time interaction, Wilks' λ=.728, F(16, 226)=2.44, p=.002, partial η 2 =.147. Significant effects of time were found for expected psychological outcomes and self-efficacy. Post-training, participants more strongly agreed that training was enjoyable and increased their sense of accomplishment. Changes in self-efficacy for cognitive training varied by program, improvingfor Dakim- and declining for the more challenging Brain Fitness- and InSight participants. These newly devised scales may be useful for examining cognitive training behaviors. However, more work is needed to understand factors that influence older adults' enrollment in and adherence to cognitive training.

Ability to Categorize Food Predicts Hypothetical Food Choices in Head Start Preschoolers.

OBJECTIVE: To investigate whether preschoolers are able to identify and categorize foods, and whether their ability to classify food as healthy predicts their hypothetical food choice. DESIGN: Structured interviews and body measurements with preschoolers, and teacher reports of classroom performance. SETTING: Six Head Start centers in a large southeastern region. PARTICIPANTS: A total of 235 preschoolers (mean age [SD], 4.73 [0.63] years; 45.4% girls). INTERVENTION(S): Teachers implemented a nutrition education intervention across the 2014-2015 school year in which children were taught to identify and categorize food as sometimes (ie, unhealthy) and anytime (ie, healthy). MAIN OUTCOME MEASURES: Preschooler responses to a hypothetical snack naming, classifying, and selection scenario. ANALYSIS: Hierarchical regression analyses to examine predictors of child hypothetical food selection. RESULTS: While controlling for child characteristics and cognitive functioning, preschoolers who were better at categorizing food as healthy or unhealthy were more likely to say they would choose the healthy food. Low-contrast food pairs in which food had to be classified based on multiple dimensions were outside the cognitive abilities of the preschoolers. CONCLUSIONS AND IMPLICATIONS: Nutrition interventions may be more effective in helping children make healthy food choices if developmental limitations in preschoolers' abilities to categorize food is addressed in their curriculum. Classification of food into evaluative categories is challenging for this age group. Categorizing on multiple dimensions is difficult, and dichotomous labeling of food as good or bad is not always accurate in directing children toward making food choices. Future research could evaluate further preschoolers' developmental potential for food categorization and nutrition decision making and consider factors that influence healthy food choices at both snack and mealtime.

Validation and Assessment of Pediatric Lead Screener Questions for Primary Prevention of Lead Exposure.

OBJECTIVE: Pediatric lead screener questions have previously been evaluated for their ability to identify children whose blood lead levels (BLLs) are greater than 10 µg/dL. Based on recent policy changes stressing that there is no safe BLL for children, the current study reevaluates the screener questions for their ability to identify children with BLLs less than 2 µg/dL and the validity of the questions in positively identifying those at greater risk for exposure. METHOD: A total of 202 parents of children enrolled in Head Start programs were administered the pediatric lead screener, questions to validate the screener questions, and children's BLLs were collected in Summer 2013. Pediatric screener questions were validated against children's BLL and the more comprehensive questions on lead risk. RESULTS: In predicting BLL greater than 2 µg/dL, the pediatrician screener tool had a sensitivity of 26.3% and specificity of 72.2%. Each of the screener questions had low sensitivities for identifying children with BLLs above 2 µg/dL. The screener questions did not demonstrate adequate validity when compared against a more comprehensive battery of lead exposure risk indicators. The validation questions improved sensitivity to detect children with BLL >2 µg/dL and reduced the number of false positives. CONCLUSION: The pediatrician screener questions in their current format are not a useful primary prevention tool in identifying children at greater risk for lead exposure and in need of secondary prevention through the receipt of a blood lead test. A revision to the protocol for identifying children at risk could result in better primary and secondary prevention efforts.

Differential social evaluation of pregnant teens, teen mothers and teen fathers by university students.

Youth may be particularly attuned to social evaluation during the teen years with implications for physical and mental health. Negative attitudes and stereotypes constitute an important type of social evaluative threat. Pregnant and parenting teens not only encounter challenges associated with their early transition to parenthood, but also are confronted with unfavourable attitudes of others. A university sample of 255 men and women responded to surveys targeting their feelings and beliefs about pregnant teens, teen mothers and teen fathers. Teen mothers were generally perceived more positively than pregnant teens who were perceived more positively compared to teen fathers. Social evaluations were generally unrelated to respondents' sex or race, but respondents who had contact with a friend or family member who had experienced a teen pregnancy were selectively more positive, as were freshmen compared to seniors. Risks attributed to early childbearing may be exacerbated by negative social evaluations.

Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction.

INTRODUCTION: The current study examined home and full (i.e., home plus car) smoking ban adoption as secondary outcomes to a randomized controlled trial targeting reduced secondhand smoke exposure (SHSe) for children under treatment for cancer. METHODS: Families with at least 1 adult smoker who reported SHSe for their children (n = 119) were randomized to control or intervention conditions and followed for 1 year with 5 assessments. Both groups were advised of the negative health outcomes associated with SHSe; the intervention group provided more in-depth counseling from baseline to 3 months. Parents reported on household and car smoking behavior, demographic, psychosocial, and medical/treatment-related information. RESULTS: Regardless of group assignment, there was an increase in home (odds ration [OR] = 1.16, p = .074) and full (OR = 1.37, p = .001) smoking ban adoption across time. Families in the intervention group were more likely to adopt a full ban by 3 months, but this difference was nonsignificant by 12 months. Married parents (OR = 2.33, p = .006) and those with higher self-efficacy for controlling children's SHSe (OR = 1.11, p = .023) were more likely to have a home smoking ban; parents who reported smoking fewer cigarettes were more likely to adopt a home (OR = 1.62, p < .0001) or full (OR = 7.32, p = .038) ban. CONCLUSIONS: Smoking bans are in-line with Healthy People 2020's tobacco objectives and may be more feasible for parents with medically compromised children for immediate SHSe reduction. Furthermore, interventions targeting full smoking bans may be a more effective for comprehensive elimination of SHSe.

Tobacco use and exposure among youth undergoing cancer treatment.

INTRODUCTION: Adolescents with cancer are susceptible to the health consequences associated with secondhand smoke exposure (SHSE) and tobacco use. The present study compared tobacco use, exposure, and risk factors between patients and population peers. METHOD: Self-reported data on tobacco use, SHSE, and tobacco-related risk factors were drawn from a pediatric oncology hospital and the National Youth Tobacco Survey. Conditional logistic regression was used to estimate odds ratios for patients and control subjects. RESULTS: Patients were as likely to have tried tobacco and report home SHSE as control subjects. Patients were more likely to report car SHSE, less likely to report that SHSE is harmful, and less likely to report home smoking bans. DISCUSSION: Patients experienced SHSE, tobacco use, and tobacco-related risk factors at rates greater than or equal to control subjects. These results provide support for consideration of intervention targets, health status, and delivery mechanisms, particularly by health care providers, when developing comprehensive tobacco control strategies.

Accuracy and Concordance in Reporting for Secondhand Smoke Exposure among Adolescents Undergoing Treatment for Cancer and Their Parents.

Few studies have examined adolescent reporting accuracy for secondhand smoke exposure (SHSe), and never for youth with cancer. SHSe reporting from adolescents being treated for cancer (Mage=14.92 years, SD=1.67) was examined against parent/guardian reports and urine cotinine among 42 adolescent-parent dyads. Number of days in hospital-based lodgings prior to assessment emerged as the strongest predictor of urine cotinine (ß=-0.46, p=0.003) and adolescent SHSe reporting significantly predicted urine cotinine (ß=0.37, p=0.011) beyond relevant demographic and contextual variables (overall R2=0.40, F(6, 35)=3.90, p=0.004). Findings support adolescents as accurate reporters of discrete SHSe occurrences.

Effective intervention programming: improving maternal adjustment through parent education.

This study assessed the secondary effects of a parent training intervention program on maternal adjustment, with a focus on understanding ways in which program efficacy differed for participants as a function of whether or not their children had behavior problems. Mothers (N = 99) of toddlers (2-3 years of age) were randomly assigned to receive one of three levels of intervention: (1) informational booklet (2) booklet + face-to-face parent training sessions, or (3) booklet + web-based parent training sessions. Findings indicated that all levels of intervention were associated with increases in maternal well-being for participants with typically developing children. Mothers of toddlers with behavior problems, however, did not benefit from receiving only the booklet but significantly benefitted from receiving either the face-to-face or web-based interventions. Findings are discussed in terms of efficient and efficacious program dissemination and the resulting implications for public policy.

Parental psychosocial predictors of secondhand smoke exposure (SHSe) for children with cancer.

Children with cancer are at greater risk for the negative consequences of secondhand smoke exposure, making the identification of predictors of exposure critical. The current study investigated the impact of parents' psychosocial variables (perceived stress and vulnerability, self-efficacy), as well as health-related and demographic variables, on children's current exposure levels. Data were from 135 families whose children (M = 8.6 years old) lived with a smoker and were being treated for cancer. Self-efficacy was the consistent significant psychosocial predictor of exposure and the time since a child's diagnosis was indicative of lower exposure when limiting the sample to only smoking parents (n = 95). Both predictors of exposure have implications on motivation for behavioral change and may be suggestive of a teachable moment. Interventions may profit from tailoring programs to families based on these predictors of exposure, in particular for tobacco-based interventions for parents of medically compromised children, such as children with cancer.

Maternal depressive symptomatology and child behavior: transactional relationship with simultaneous bidirectional coupling.

The present study investigated reciprocal relationships between adolescent mothers and their children's well-being through an analysis of the coupling relationship of mothers' depressive symptomatology and children's internalizing and externalizing behaviors. Unlike studies using discrete time analyses, the present study used dynamical systems to model time continuously, which allowed for the study of dynamic, transactional effects between members of each dyad. Findings provided evidence of coupling between maternal depressive symptoms and children's behaviors. The most robust finding was that as maternal depressive symptoms became more or less severe, children's behavior problems increased or decreased in a reciprocal manner. Results from this study extended upon theoretical contributions of such authors as Richters (1997) and Granic and Hollenstein (2003), providing empirical validation from a longitudinal study for understanding the ongoing, dynamic relationships between at-risk mothers and their children.