Relations between Positive Parenting Behavior during Play and Child Language Development at Early Ages.

Parental behavior in interactions with children has been related to child language development. Our study contributes to the literature about relations between the characteristics of parent-child interactions during play and a child's language development in typically developing children at early ages, with data from mothers and fathers from the same families in Spain. Our aim was to analyze the relation between positive parenting behaviors assessed with the Spanish version of the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and child language development assessed with the Bayley-III scales. We controlled for some sociodemographic variables. The participants were 90 children aged 15-31 months and their mothers and fathers. Bivariate analysis showed significant positive relations between mothers' responsive, encouraging and teaching behaviors and a child's language scores. Relations were found between fathers' encouraging and teaching behaviors and a child's language. Regression models indicate that maternal and paternal encouraging behaviors predicted 18% of the variability in the child's receptive language, and maternal responsive and teaching behaviors predicted 16% of the variability in the child's expressive language and total language scores. The study provides new data that support the relevance of positive parental behaviors to improve a child's linguistic development.

Parenting of Spanish mothers and fathers playing with their children at home.

The aims of this study were to compare the parenting behaviors of mothers and fathers when evaluated in a free play situation at home and to study how these behaviors were related to the sociodemographic variables of the family. The study included 155 mothers and 155 fathers from the same families in Spain. The children (90 boys and 65 girls) were typically developing and were aged between 10 and 47 months old. The parents completed a sociodemographic questionnaire, and parenting behaviors in four domains (Affection, Responsiveness, Encouragement, and Teaching) were assessed from self-recorded videotapes, in accordance with the Spanish version of the PICCOLO. Our results showed both commonalities and differences between the mothers and fathers. The mean scores for the four parenting domains followed a similar pattern in both mothers and fathers: the highest mean score was in the Responsiveness domain, followed by the Affection, Encouragement, and the Teaching domains. Regarding the second aim, no differences were observed in parenting according to the child's gender and the only domain related to the child's age was mother's Teaching. Mothers with a higher educational level scored higher on all parenting domains, except for Responsiveness. Family income was positively related to maternal Affection, Encouragement, and the total PICCOLO score, and to the father's score in the Teaching domain. This study provides evidence that Spanish mothers and fathers show very similar strengths for promoting children's development during interactions. These results are relevant to inform social public policies and family programs.

Demographic and Parental Factors Associated With Developmental Outcomes in Children With Intellectual Disabilities.

The aim of the study was to examine the relation between demographic variables, parental characteristics, and cognitive, language and motor skills development in children with intellectual disabilities (ID). A sample of 89 children with ID, aged 20-47 months, completed the Bayley Scales of Infant Development to measure cognitive, motor, and linguistic development. Parents were administered questionnaires about demographic information and parental anxiety, depression, parental stress, conjugality and familial functioning. Parenting behaviors (affection, responsiveness, encouragement, and teaching) were observed using the Spanish version of PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes). A bivariate analysis showed that cognitive development in infants was significantly related to the mother's and father's responsiveness, and to the father's teaching scores. Infant language development was related to a variety of maternal factors (educational level, anxiety, depression, maternal responsiveness) and to the father's teaching scores. None of the factors were statistically related to child motor development. A multivariate regression analysis indicated that children's cognitive development can be predicted by a linear combination of maternal responsiveness and paternal teaching scores. Language development can be predicted by a linear combination of maternal anxiety and responsiveness, and paternal teaching scores. The present study provides evidence of the importance of paternal involvement for cognitive and language development in children with intellectual disabilities, and contributes to the increasing literature about fathering. Gaining knowledge about parental contributions to children's development is relevant for improving positive parenting in early intervention programs.

Spanish Validation of the PICCOLO (Parenting Interactions With Children: Checklist of Observations Linked to Outcomes).

Background/Objective: The aim of this study was to explore the psychometric properties of the Spanish version of the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO; Roggman et al., 2013a). This observational measure is composed of 29 items that assess the quality of four domains of parenting interactions that promote child development: affection, responsiveness, encouragement, and teaching. Methods: The sample included 203 mother-child dyads who had been video-recorded playing together. Fifty-six percent of the children were male, and 44% were female, aged from 10 to 47 months. Video-recorded observations were rated using PICCOLO items. Results: Confirmatory factor analysis supported that the instrument has four first-order factors corresponding to the hypothesized domains of parenting behaviors, and a second-order factor corresponding to a general factor of positive parenting. Construct validation evidence was compiled by examining the relationship between PICCOLO scores and child age. As expected, teaching domain and total PICCOLO scores were positively correlated with child age. The Spanish PICCOLO also demonstrated good inter-rater reliability (ranging from 0.69 to 0.84) and internal consistency reliability (ranging from 0.59 to 0.88) for the four domain scores and the total parenting score. Concurrent criterion-related validity was examined via correlations between parenting scores and child cognitive, language and motor skills outcomes, measured using the Bayley Scales of Infant Development. Conclusion: The Spanish version of the PICCOLO meets the criteria for a reliable and valid observational measurement of parenting interactions with children. The psychometric properties of the instrument make it appropriate for general research purposes, but also for program evaluation of Early Intervention and other parenting-support interventions. This measure, focused on parent strengths, could be used to facilitate family-centered practices in early intervention and other programs that have parenting as an outcome.

Barriers to and discourses about breast cancer prevention among immigrant women in Spain: a qualitative study.

OBJECTIVES: To identify knowledge, barriers and discourses about breast cancer screening in Spain among female immigrants from low-income countries and native Spanish women from a low socioeconomic class. DESIGN: Qualitative interview study with thematic analysis interpreted using cultural mediators. SETTING: Mallorca, Spain. PARTICIPANTS: Thirty-six in-depth interviews, using cultural mediators, of immigrant women living in Mallorca who were 50-69 years old and were from Maghreb, Sub-Saharan Africa, Eastern Europe, Latin America, China or were native to Spain and from a low socioeconomic class. RESULTS: We analysed the interviews to assess breast cancer perceptions and beliefs, discourses about breast cancer prevention and barriers to accessing breast cancer prevention programmes. Although the women reported an association of breast cancer with death, they acknowledged the effectiveness of early detection. They also exhibited reluctance to talk about cancer. Discourses about cancer prevention tended to be proactive or fatalistic, depending on the woman's country of origin. For all women, fear of results and lack of time were barriers that limited participation in breast cancer prevention programmes. Language barriers, frequent changes of residence and fear due to status as an irregular (undocumented) immigrant were barriers specific to immigrant women. CONCLUSIONS: The culture of origin affects whether an immigrant has a fatalistic or proactive approach toward breast cancer screening. Immigrants from low-income countries and Spanish natives from a low socioeconomic class experience barriers in access to breast cancer screening. Frequently changing homes is also a barrier for immigrant women.

Correction to: Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial.

It has been highlighted the original article (1) contained a typesetting mistake in the authorship, and that author Caterine Vicens was omitted.

Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial.

BACKGROUND: Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS: This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION: EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION: ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.

Adult community health-promoting interventions in primary health care: A systematic review.

OBJECTIVE: To examine evidence on the effectiveness of health-promoting community interventions carried out in primary health care. METHODS: Systematic review of originals and systematic reviews of health-promoting community interventions with the participation of primary health care. A working definition of community activities was used in the inclusion criteria. Databases searched up to 2013: PUBMED, EMBASE, CINHAL, Web of SCIENCE, IBECS, IME, and PSICODOC. No restrictions on year of publication or design. Articles were reviewed by separate researchers to identify risks of bias. RESULTS: Fifty-one articles published between 1966 and 2013 were included: 11 systematic reviews and 40 originals that described 39 community interventions. There is evidence on the effectiveness of community interventions in reducing cardiovascular risk factors, encouraging physical exercise, preventing falls and improving self-care among chronic patients compared with usual individual care. The effectiveness of some interventions increases when the community is involved in their development. Most assessments show positive results despite design limitations. CONCLUSIONS: The community approach may be more effective than the individual in usual preventive interventions in primary care. There is a lack of evidence on many community interventions in primary care and further research is needed.

Efficacy of a brief multifactorial adherence-based intervention on reducing the blood pressure of patients with poor adherence: protocol for a randomized clinical trial.

BACKGROUND: Lowering of blood pressure by antihypertensive drugs reduces the risks of cardiovascular events, stroke, and total mortality. However, poor adherence to antihypertensive medications reduces their effectiveness and increases the risk of adverse events. In terms of relative risk reduction, an improvement in medication adherence could be as effective as the development of a new drug. METHODS/DESIGN: The proposed randomized controlled trial will include patients with a low adherence to medication and uncontrolled blood pressure. The intervention group will receive a multifactorial intervention during the first, third, and ninth months, to improve adherence. This intervention will include motivational interviews, pill reminders, family support, blood pressure self-recording, and simplification of the dosing regimen. MEASUREMENT: The primary outcome is systolic blood pressure. The secondary outcomes are diastolic blood pressure, proportion of patients with adequately controlled blood pressure, and total cost. DISCUSSION: The trial will evaluate the impact of a multifactorial adherence intervention in routine clinical practice. Ethical approval was given by the Ethical Committee on Human Research of Balearic islands, Spain (approval number IB 969/08 PI).