The agreement between parent-reported and directly measured child language and parenting behaviors

Parenting behaviors are commonly targeted in early interventions to improve children\u27s language development. Accurate measurement of both parenting behaviors and children\u27s language outcomes is thus crucial for sensitive assessment of intervention outcomes. To date, only a small number of studies have compared parent-reported and directly measured behaviors, and these have been hampered by small sample sizes and inaccurate statistical techniques, such as correlations. The Bland-Altman Method and Reduced Major Axis regression represent more reliable alternatives because they allow us to quantify fixed and proportional bias between measures. In this study, we draw on data from two Australian early childhood cohorts (N = 201 parents and slow-to-talk toddlers aged 24 months; and N = 218 parents and children aged 6-36 months experiencing social adversity) to (1) examine agreement and quantify bias between parent-reported and direct measures, and (2) to determine socio-demographic predictors of the differences between parent-reported and direct measures. Measures of child language and parenting behaviors were collected from parents and their children. Our findings support the utility of the Bland-Altman Method and Reduced Major Axis regression in comparing measurement methods. Results indicated stronger agreement between parent-reported and directly measured child language, and poorer agreement between measures of parenting behaviors. Child age was associated with difference scores for child language; however, the direction varied for each cohort. Parents who rated their child\u27s temperament as more difficult tended to report lower language scores on the parent questionnaire, compared to the directly measured scores. Older parents tended to report lower parenting responsiveness on the parent questionnaire, compared to directly measured scores. Finally, speaking a language other than English was associated with less responsive parenting behaviors on the videotaped observation compared to the parent questionnaire. Variation in patterns of agreement across the distribution of scores highlighted the importance of assessing agreement comprehensively, providing strong evidence that simple correlations are grossly insufficient for method comparisons. We discuss implications for researchers and clinicians, including guidance for measurement selection, and the potential to reduce financial and time-related expenses and improve data quality. Further research is required to determine whether findings described here are reflected in more representative populations

Improving mental health of adolescents with Type 1 diabetes: protocol for a randomized controlled trial of the nothing ventured nothing gained online adolescent and parenting support intervention

Management of Type 1 diabetes comes with substantial personal and psychological demands particularly during adolescence, placing young people at significant risk for mental health problems. Supportive parenting can mitigate these risks, however the challenges associated with parenting a child with a chronic illness can interfere with a parent’s capacity to parent effectively. Interventions that provide support for both the adolescent and their parents are needed to prevent mental health problems in adolescents; to support positive parent-adolescent relationships; and to empower young people to better self-manage their illness. This paper presents the research protocol for a study evaluating the efficacy of the Nothing Ventured Nothing Gained online adolescent and parenting intervention which aims to improve the mental health outcomes of adolescents with Type 1 diabetes

What influences parental engagement in early intervention? Parent, program and community predictors of enrolment, retention and involvement

Poor participant engagement undermines individual and public health benefits of early intervention programs. This study assessed the extent to which three types of engagement (participant enrolment, retention and involvement) were influenced by individual, program and contextual factors. Data were from a cluster randomised controlled trial (N = 1447) of a community-based parenting program, delivered at two levels of intensity (group sessions with and without individualised home coaching) conducted in Victoria, Australia. Individual (parent and family) factors and program factors were assessed by parent report and administrative records, and contextual factors by area-level population statistics. Data were analysed using multilevel logistic or linear regression models. Individual and contextual factors predicted enrolment, while family and program factors were more influential on program retention and parents’ active involvement. Provision of individualised support was important to all forms of engagement, particularly for families experiencing the greatest barriers to participation. These findings indicate that different strategies are required to effectively support families in the processes of enrolling, continuing to attend and actively participating in early intervention program

Early Home Learning Study: Overview and outcomes. Final Report to the Victorian Government Department of Education and Early Child Development

This report presents findings from the Early Home Learning Study (EHLS), a cluster randomised controlled trial (RCT) conducted by the Parenting Research Centre (PRC) between 2009 and 2012. The study was commissioned by the Department of Education and Early Childhood Development (DEECD) in recognition that children from families experiencing high levels of disadvantage are vulnerable to poorer developmental outcomes in the early years of life, particularly in relation to language and communication skills. To improve support for these children, the PRC was engaged to design, implement and evaluate a program to enhance children’s early learning at home, with an emphasis on parenting and children’s language and communication skills. The EHLS had three broad goals: 1. To improve the early learning and development foundations of babies (6 to 12 months) and toddlers (12 to 36 months) in vulnerable circumstances in up to 2,000 families. 2. To build the capacity of the existing Victorian service system to support parents in creating positive home learning experiences for their children. 3. In the Victorian context, to develop scientific knowledge of how best to support parents to create enriched home learning environments in the early years. The ‘smalltalk’ programs were community-based programs designed for parents experiencing vulnerable circumstances with children aged 6 months to 3 years. To ensure acceptability and accessibility, and for ease of implementation, smalltalk was developed for two existing service platforms: - a six-week parenting group program delivered in the Maternal and Child Health (MCH) platform for parents of children aged 6 to 12 months, and - a ten-week playgroup and parenting program delivered through the supported playgroup (SPG) platform for parents of children aged 12 to 36 months. Two models of intervention intensity were trialled in each platform: the parent group or supported playgroup alone (‘smalltalk’) or the parent group/supported playgroup supplemented by an additional six home-based, individual coaching sessions (‘smalltalk plus’)

Development and application of a methodology for the evaluation of a health complaints process

The aim of the current study was to develop and test a methodology that could be applied to the evaluation of the complaints processes of regulatory bodies of health professionals in Australia including mental health regulatory bodies such as the board that the Council of Australian Governments (COAG) are planning to set up to regulate the psychology profession. The methodology was applied to the evaluation of the complaints process at the Office of the Health Services Commissioner of Victoria (HSC). There were four main research questions. The first research question related to the extent to which the methodology was able to determine how well the HSC was performing in their role of resolving health complaints. The second research question explored the implications of the findings of the evaluation of the HSC complaints process for the management of health complaints in general. The third research question related to the strengths and limitations of the methodology when applied in a practical setting and the final research question related to further improvement of the methodology for future applications. Questionnaires and telephone interviews were used to examine the experiences of 133 providers and 150 complainants whose complaints had been reviewed and closed in one year. The methodology proved successful in assessing the performance of the complaints process at the HSC. The findings of the evaluation indicated that complainants and providers were generally satisfied with the process by which their complaints were managed. However, they were in general less satisfied with the outcome. In particular the evaluation highlighted the unintended negative consequences that complaints processes can have on the complainants and respondents. It was concluded that these maladaptive behavioural responses to complaints most probably have their origins in the negative emotional overlay attached to health complaints which has the potential to lead to unrealistic expectations of the process and outcomes on the part of complainants, and maladaptive post-complaint practices for health service providers. The findings highlight the importance of providing advocacy and support for the parties involved in health complaints as a means of minimising these maladaptive responses. Finally, it is acknowledged that these findings are specific to Australian health regulatory systems

A model for the evaluation of a health complaints service

Abstract not available

Type 1 diabetes as a risk factor for depression and other adverse outcomes in adolescents and young adults from rural Victoria

There is growing evidence to support strong links between Type 1 diabetes and poor psychological health, such as depression and anxiety. Preliminary evidence suggested that regional youth with Type 1 diabetes potentially face poorer mental health outcomes than their urban counterparts. The study examined the relationship between disease concerns and depression, anxiety, quality of life and the availability of social support. Comparisons were made between levels reported among participants living in rural and urban areas. Data collection comprised interviews, online focus groups and questionnaires to ascertain self-reported concerns from participants about their disease, their levels of depression and anxiety related to the disease, their quality of life and their levels of social support. The study attracted 123 volunteer adolescents and young adults with Type 1 diabetes (50 males and 73 females aged 13 to 25). Of the participants, 73 lived in rural or regional Victoria and 50 in urban settings. Parents of participants who were under the age of 18 were also invited to participate, and 76 did so. Findings were to be used to develop a website to educate and support adolescents with diabetes living in rural areas

A co-designed website (FindWays) to improve mental health literacy of parents of children with mental health problems: Protocol for a pilot randomised controlled trial.

BackgroundMental health problems, such as behavioural and emotional problems, are prevalent in children. These problems can have long lasting, detrimental effects on the child, their parents and society. Most children with a mental health problem do not receive professional help. Those that do get help can face long wait times. While waiting, parents want to learn how they can help their child. To address this need, we co-designed a new website to help parents find ways of helping their child's mental health problem while waiting to get specialist help.ObjectivesTo assess the acceptability and feasibility of a new co-designed website, FindWays, through a pilot randomised controlled trial. The protocol is registered with ISRCTN (ISRCTN64605513).MethodsThis study will recruit up to 60 parents of children aged two-twelve years old referred to a paediatrician for behavioural and/or emotional problems. Participants will be randomly allocated by computer generated number sequence to either the intervention or control group. Intervention group participants will receive access to the FindWays website to help them manage their child's mental health problem while they wait to see the paediatrician. Acceptability and feasibility will be assessed over the 4-month intervention through mixed methods including: recruitment, adherence, retention, net promoter score (quantitative measures) and semi-structured interviews to gain an in-depth understanding of parents' experience and potential adverse effects (qualitative measure). Secondary outcomes measured by parent survey at 4-months post randomisation include child mental health, parent mental health, impact of the child's mental health problem on their functioning and family, and health service use and associated costs.ResultsRecruitment commenced June 2022 with publication expected in October 2023.ConclusionThis study will provide novel data on the acceptability and feasibility of a new website co-designed with parents to help them find ways of managing their child's behaviour and emotions

The influence of depression and anxiety on outcomes after an intervention for prediabetes

Objectives: To conduct initial analyses and examine ways in which depression and anxiety are associated with outcomes after participation in the Healthy Living Course (HLC), an early-intervention diabetes prevention program for adults with prediabetes. Design: Randomised controlled study using pre-intervention and postintervention measures to examine relationships between depression, anxiety and diabetes-related program outcomes. Participants and setting: 185 adults from urban and rural Victoria with prediabetes who had completed the HLC program and for whom postintervention measure data were available. Data were collected between 15 June 2006 and 15 June 2008. Main outcome measures: Baseline and postintervention scores on mood (anxiety, depression), biochemical (fasting plasma glucose, oral glucose tolerance), anthropometric (body mass index [BMI], waist circumference), cognitive (self-efficacy, diabetes knowledge) and behavioural (healthy eating, physical activity) measures; correlations between these measures. Results: The intervention alleviated depression, and improved eating patterns and scores on cognitive, anthropometric and biochemical measures. Cultural group and sex did not influence most results. Baseline mood was not associated with anthropometric or biochemical outcomes; however, more positive baseline mood factors were associated with activity changes, and with greater subsequent activity rates, self-efficacy and diabetes knowledge. In turn, baseline self-efficacy was associated with postintervention healthy eating. Changes towards healthier eating correlated with anthropometric and biochemical changes, while baseline cognitive measures were also associated with physiological outcomes. As expected, reductions in BMI and waist circumference were related to biochemical changes. Conclusion: Our findings highlight the importance of assessing mood factors in prediabetes, and the need to develop theoretical models of change mechanisms for mood in health outcomes

Can the onset of Type 2 diabetes be delayed by a group-based lifestyle intervention? A randomised control trial

This study was a randomised control trial with a waiting control group. It was designed to evaluate the effectiveness of a 6-month, group-based diabetes prevention programme, The Healthy Living Course and assess whether participation in the programme led to changes in modifiable risk factors for type 2 diabetes among an already at-risk pre-diabetic population. Individuals designated at risk for diabetes by their general practitioners (GPs) were screened using an Oral Glucose Tolerance Test. Volunteers (N¼307) with pre-diabetes were assigned to an intervention or wait-control group in the ratio of approximately 2 : 1. The sample was pre-tested on biochemical, anthropometric and self-report behavioural, cognitive and mood variables and post-tested either at the end of the educational/support-based lifestyle programme or the end of the wait period. The intervention group significantly improved their diabetes knowledge, motivation to change, positive affect, healthy eating and activity levels and showed significantly greater reductions in weight, body mass index, waist circumference, diastolic blood pressure and fasting plasma glucose in comparison with controls. The intervention group also changed their diagnostic status from pre-diabetes to non-diabetes at a greater rate than the wait group (43% vs. 26%) who received standard care from their GPs