Graphic Paper: Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package.

Background: Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit. Aims: To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and healthcare workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict. Methods: The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum. Results: High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults' well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP. Conclusions: Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.

Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package.

Background: Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit. Aims: To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and health care workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict. Methods: The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum. Results: High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults' well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP. Conclusions: Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.

A Mixed-Methods Feasibility Study of Breastfeeding Attitudes among Southern African Americans.

We assessed the feasibility and acceptability of examining breast/chest feeding attitudes among African Americans in South Carolina using an explanatory sequential, mixed methods approach. We surveyed 50 pregnant African American women during their ob-gyn appointment (Phase I), followed by qualitative interviews with four African American couples (N = 8) (Phase II), and integrating quantitative-qualitative data through joint display (Phase III). Phase I supported the feasibility of recruiting pregnant African American women for our study. However, for Phase II, more research is needed to support the feasibility of recruiting couples from the quantitative phase. The Iowa Infant Feeding Attitude Scale demonstrated moderate reliability (α = 0.68). Participants intending to exclusively breastfeed (M = 65, SD = 5.79) had higher scores than those intending to exclusively use formula (M = 50, SD = 4.37, p < .001). The six qualitative themes (Phase II) and data integration (Phase III) identified cultural considerations for future research.

Enrolling Caregivers in Obesity Interventions to Improve Obesity-Related Outcomes in Children.

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children's change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver's percent of time spent in MVPA/ST and changes in their child's percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers' MVPA was strongly associated with the change in children's MVPA (ß = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (ß = 0.24 [-2.16, 2.64]). Changes in caregivers' ST was strongly associated with changes in children's ST (ß = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (ß = 0.35 [-0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves.

Perinatal Navigator Approach to Smoking Cessation for Women With Prevalent Opioid Dependence.

Women who smoke during pregnancy face psychosocial barriers to cessation, and women with opioid use disorder (OUD) face amplified barriers. We pilot tested a Perinatal Wellness Navigator (PWN) program for a group of high-risk perinatal women (N = 50; n = 42 with OUD) that consisted of (a) one-on-one tobacco treatment, (b) comprehensive assessment of cessation barriers, and (c) linkage to clinical/social services. Outcome measures were assessed at baseline and postintervention. Participants smoked 10 fewer cigarettes per day (p = .05) at postintervention and were less dependent on nicotine (p < .01). Mean postnatal depression scores (p = .03) and perceived stress (p = .03) decreased postintervention. Participants received at least one referral at baseline (n = 106 total), and 10 participants received an additional 18 referrals at postintervention to address cessation barriers. The PWN program was minimally effective in promoting total tobacco abstinence in a high-risk group of perinatal women, but participants experienced reductions in cigarettes smoked per day, nicotine dependence, stress, and depression.

Social Support, Parenting Competence, and Parenting Satisfaction Among Adolescent, African American, Mothers.

This secondary analysis explored how social support changed during the first 6 months postpartum and examined the relationships among social support, parenting competence, and parenting role satisfaction. Single, low-income, adolescent, new mothers ( N = 34) completed measures of perceived parenting competence, parenting role satisfaction, and four types of received social support (emotional, informational, tangible, problematic) from the entire social network at 1 week, 6 weeks, 3 months, and 6 months postpartum. Results indicated that social support did not change over time. Emotional, informational, and tangible social support were significantly correlated, concurrently and predictively, with perceived competence and satisfaction at most data collection points. Future social support intervention studies using social support as a modifiable variable with this high-risk group of African American adolescent new mothers are advocated. Health care professionals are encouraged to examine existing social support within these mothers' identified family units.

When Are Caregivers More Likely to Offer Sugary Drinks and Snacks to Infants? A Qualitative Thematic Synthesis.

Many children consume more sugar than is recommended, and caregivers often find it difficult to change this habit once established. This thematic synthesis aims to identify the "critical situations" where caregivers may be more likely to offer infants sugary drinks and snacks. This thematic synthesis is reported in accordance with the statement for enhancing transparency in reporting the synthesis of qualitative research (ENTREQ). Our confidence in the findings of our synthesis was assessed using the CERQual (Confidence in the Evidence From Reviews of Qualitative Research Approach). We included 16 studies from the United States, the United Kingdom, Australia, and Denmark. We identified eight "critical situations" when caregivers may be more likely to offer sugary drinks and snacks to infants. Interventions that seek to reduce sugar intake for caries prevention in infants and young children may be more successful if they provide caregivers with practical parenting strategies to replace the nonnutritive functions of sugary foods and drinks, as opposed to taking an information-giving approach.

Somali Families' Experiences of Parenting in the United States.

The purpose of this study was to gain an understanding of first-generation Somali families' experiences of parenting in the United States to discover potential barriers to effective parenting with the goal to design supportive interventions. Using descriptive phenomenological design, 20 Somali families in Seattle, Washington, were interviewed. Interview transcripts were then analyzed using steps outlined by Colaizzi. The overarching theme that emerged was "Parenting: A Balancing Act," which represents Somali parents trying to balance traditional cultural values and parenting traditions with dominant cultural expectations. Participants expressed fear of losing their children to American lifestyle choices, such as drugs or gangs, and misuse of the American system to turn on their parents. Parents also acknowledged the benefits of access to education and health care for children. To cope with the stressors of their new life, participants sought to preserve traditional cultural and religious values, thus strengthening their Somali community.

Birthing and Parenting a Premature Infant in a Cultural Context.

The purpose of this longitudinal qualitative descriptive study was to explore American Indian mothers' perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 American Indian mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of American Indian culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that health care providers deliver culturally appropriate care that fully supports American Indian mothers and their premature infants.

Effects of a Brief, Prevention-Focused Parenting Education Program for New Mothers.

We evaluated the effects of a parenting program, Baby and You, on parenting knowledge, parenting morale, and social support using a single-group, pre-test, and post-test design with 159 Canadian mothers of infants aged 2 to 9 months old. Baby and You is a prevention-focused parenting program (PFPP) to improve maternal and infant health through education and social support. The 4-week curriculum focuses on infant development and safety, parent-child relationships, maternal self-care, and community resources. We computed repeated-measures ANOVAs separately for scores on Parenting Knowledge Scale, Parenting Moral Index, and Family Support Scale. We found a significant increase between pre-test and post-test on parenting knowledge, but not parenting morale or social support. Parenting morale may be a stable construct that shows little change over time. It may take more than 4 weeks of programming for mothers to identify and integrate new sources of social support.

Teenage pregnancy in adolescents with an incarcerated household member.

This study examines the association between the incarceration of a household member and adolescent pregnancy, and evaluates whether this association extends beyond that of other variables associated with sexual health. We used data from 12 waves of the National Longitudinal Survey of Youth: Child and Young Adult. After eliminating males and individuals who did not respond to key questions, a sample of 1,229 girls (ages 14-19) was analyzed. Girls who experienced the incarceration of a household member faced more demographic and family environment risk factors than those who did not. Regression analyses demonstrated that the addition of a household incarceration variable afforded superior prediction of teenage pregnancy relative to the prediction based on demographic and family features alone. Programs that are directed toward reducing teen pregnancy will benefit from attention to the home situation of the at-risk girl, particularly the experience of household member incarceration and related family dynamics.

Exploration of the short-term and long-term effects of parental illness on children's educational and behavioral functioning using a large Taiwanese sample.

This study used data from Waves I and II of the Taiwan Educational Panel Survey (TEPS) to explore the potential short-term and long-term effects of parental illness and health condition on children's behavioral and educational functioning. A sample of 11,018 junior high school students and their parents and teachers in Taiwan were included in this present study. The results supported previous work that parental illness may place children at slight risk for poor psychosocial adjustment and behavioral problems. Parental illness was associated with lower adaptive skills and more behavioral problems in children. Children of ill parents showed resilience in their educational functioning in the event of parental illness as children's academic achievement and learning skills were not related to parental illness/health condition.