Parental Buffering in the Context of Poverty: Positive Parenting Behaviors Differentiate Young Children\u27s Stress Reactivity Profiles

Experiencing poverty increases vulnerability for dysregulated hypothalamic–pituitary–adrenal (HPA) axis functioning and compromises long-term health. Positive parenting buffers children from HPA axis reactivity, yet this has primarily been documented among families not experiencing poverty. We tested the theorized power of positive parenting in 124 parent–child dyads recruited from Early Head Start (Mage = 25.21 months) by examining child cortisol trajectories using five samples collected across a standardized stress paradigm. Piecewise latent growth models revealed that positive parenting buffered children\u27s stress responses when controlling for time of day, last stress task completed, and demographics. Positive parenting also interacted with income such that positive parenting was especially protective for cortisol reactivity in families experiencing greater poverty. Findings suggest that positive parenting behaviors are important for protecting children in families experiencing low income from heightened or prolonged physiologic stress reactivity to an acute stressor

What Works for Whom in Family Support Programs: Leveraging Administrative Data to Improve Precision Matching

Family support programs (FSPs) are designed to stabilize and strengthen families on a range of outcomes to promote well-being. Paradoxically, families with the greatest need are more likely to drop out or experience reduced benefit on average. This study examines patterns of differential benefit for families experiencing elevated stress through a cross-program evaluation of “what works for whom” in FSPs. Family Resource Center Family Development Services (FDSs), Colorado Community Response (CCR), Promoting Safe and Stable Families (PSSF), Head Start (HS), and SafeCare Case Management Pilot (Safe CMP) contributed data on 15,771 participants enrolled in services from 2014-2020. Program samples were weighted to correct for dropout. Improvements in self-sufficiency, health, and family protective factors were measured using ANCOVA. Main effects and interactions between program and predictors were examined, including cumulative stress score, single-parenthood, poverty, household size, fatherhood, primary language, parent age, race, and ethnicity. Importantly, the study design is pre-post assessments without randomization to program or reference to a comparison group. Thus, pre-post change could not be calibrated against change that would have occurred without program participation. Dropout ranged from a low of 20% in HS to a high of 75% in PSSF. Latinx caregivers and families with higher stress varied in their pattern of attrition by program. Families enrolled in HS, a center-based model, and CCR, a community-based model, showed the greatest number of differential pre-post improvements. ESL families exhibited greater improvements in their health and child education across program participation. BIPOC families showed greater gains in child education and fewer improvements in family functioning and resilience than white families across program participation. Families with higher stress exhibited greater improvements in maintaining control when disciplining, but fewer pre-post gains in substance abuse, family functioning, child education, and beliefs about the intent of child misbehavior. Homevisiting and community-based programs were linked with the greatest number of differential subgroup benefits. Families with higher stress had the greatest variation in differential benefits by program. This study suggests that no single approach benefited all subgroups equivalently. Findings from this project may increase the equity with which families are supported in FSPs

Revealing personal professional theories

Personal professional theories, Knowledge development, Professional development, Vocational education and training, Concept mapping, Stimulated recall,

Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study

BACKGROUND AND AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. DESIGN: Delphi approach with two sequential phases: survey development and iterative surveying of experts. SETTING: Online study. PARTICIPANTS: During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n=54) identified via recommendations from the Steering Committee and a systematic review. MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients, and modes of delivery. FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions, and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training, and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias-modification, goal setting, strategy learning, and meta-awareness as active ingredients; and (iv) both addiction treatment workforce and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation, and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options

Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study.

AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. DESIGN, SETTING AND PARTICIPANTS: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review. MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery. FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options