Une étude exploratoire. Interaction entre les dyades mère-nourrisson et père-nourrisson chez les couples à faible revenu

Vingt-neuf parents à faible revenu et leurs nourrissons ont participé à une recherche exploratoire portant sur les interactions parent-nourrisson et décrivant le niveau d'interactions, les similarités et les différences au sein des dyades mère-nourrisson et père-nourrisson. L'échelle de mesure Nursing Child Assessment Teaching Scale, un instrument d'observation standardisé de 73 items, a été utilisée pour mesurer les interactions. Les résultats ont montré que bien que la majorité (69%) des dyades parent-nourrisson n'ont pas démontré de comportements interactifs à risque, près de 31% de l'échantillon étaient désorganisés dans leurs interactions. De plus, les résultats ont démontré que bien que les deux parents étaient sensibles et répondaient aux signaux de leurs nourrissons, les mères étaient plus aptes que les pères à répondre à la détresse de leurs nourrissons alors que les nourrissons étaient plus clairs et répondaient mieux aux pères qu'aux mères. Avec cette information, les cliniciens et les chercheurs peuvent mieux comprendre les interactions au sein du contexte familial et renforcer les programmes d'intervention visant à maintenir et à améliorer les interactions parent-nourrisson.Interaction between low-income mother-infant and father-infant pairs: an exploratory study Twenty-nine low-income parents and their infants participated in an explanatory study about parent-infant interaction — describing the level of interaction and the similarities and differences in mother-infant and father infant pairs. The Nursing Child Assessment Teaching Scale, a 73-item standardized observation instrument, was used to measure interaction. Results showed that although the majority (69%) of parent-infant dyads did not demonstrate risky interactive behaviors, nearly 31% of the sample was disorganized in their interactions. Further, results showed that while both mothers and fathers were sensitive and responsive to their infants' cues, mothers were more apt to respond to their infants' distress than fathers, and infants were clearer and more responsive with their fathers than with their mothers. With this information clinicians and researchers can better understand interactions within a family context and strengthen intervention programs aimed at maintaining and improving parent-infant interactions.Una investigación exploratoria. Interacción entre los pares madre-niño lactante y padre-niño lactante en las parejas a ingreso modesto Veinte-nueve padres con ingreso modesto y sus niños lactantes participaron en una investigación exploratoria sobre las interacciones padre-niño lactante y el nivel de interacciones, las similitudes y las diferencias en el seno de las dyadas madre-niño lactante y padre-niño lactante. Para medir las interacciones se utilizó un instrumento de observación standardizado de 73 elementos, la escala de medida Nursing Child Assessment Teaching Scale. Los resultados indican que aunque la mayoridad (69%) de las dyadas padre-niño lactante no demuestran comportamientos interactivos con riesgo, cerca de 31% de la muestra estaban desorganisados en sus interacciones. Además, los resultados demuestraron que aunque los dos padres eran sensibles y respondian a los señales de sus niños lactantes, las madres estaban más aptas que los padres a responder al desemparo de sus niños cuando los niños estaban más tranquilos y respondian mejor a los padres que a las madres. Con esta información, los clínicos y los investigadores pueden comprender mejor las interacciones en el seno del contexto familial y reforzar programas de intervención aspirando mantener y mejorar las interacciones padre-niño lactante

Maternal Psychological Absence and Toddlers' Social‐Emotional Development: Interpretations From the Perspective of Boundary Ambiguity Theory

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94745/1/famp1411.pd

Optimizing health services for young children in poverty: enhanced collaboration between Early Head Start and pediatric health care

Given the importance of health to educational outcomes, and education to concurrent and future health, cross-systems approaches, such as the Whole School, Whole Community, Whole Child (WSCC) framework, seek to enhance services typically in K-12 settings. A major gap exists in cross-systems links with early care and education serving children birth to age 5. Both pediatric health systems and early family and child support programs, such as Early Head Start (EHS) and Head Start (HS), seek to promote and optimize the health and wellbeing of infants, toddlers, preschoolers, and their families. Despite shared goals, both EHS/HS and pediatric health providers often experience challenges in reaching and serving the children most in need, and in addressing existing disparities and inequities in services. This paper focuses on infant/toddler services because high-quality services in the earliest years yield large and lasting developmental impacts. Stronger partnerships among pedicatric health systems and EHS programs serving infants and toddlers could better facilitate the health and wellbeing of young children and enhance family strengths and resilience through increased, more intentional collaboration. Specific strategies recommended include strengthening training and professional development across service platforms to increase shared knowledge and terminology, increasing access to screening and services, strengthening infrastructure and shared information, enhancing integration of services, acknowledging and disrupting racism, and accessing available funding and resources. Recommendations, including research-based examples, are offered to prompt innovations best fitting community needs and resources

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358http://deepblue.lib.umich.edu/bitstream/2027.42/112539/1/12889_2012_Article_4758.pd

Examining Long‐Term Effects Of An Infant Mental Health Home‐Based Early Head Start Program On Family Strengths And Resilience

Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home‐based Early Head Start (IMH‐HB EHS) program on family functioning. The sample includes 152 low‐income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH‐HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH‐HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH‐HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH‐HB EHS services are maintained after services cease.RESUMENLa meta de las intervenciones con base en la salud mental infantil es promover el desarrollo sano de infantes y bebés por medio de promover un funcionamiento familiar sano para adoptar relaciones de apoyo entre el pequeño niño y sus importantes cuidadores. Este estudio examinó el impacto que sobre el funcionamiento familiar tiene un programa “Early Head Start” de salud mental infantil con base en casa (IMH‐HB EHS). El grupo muestra lo componen 152 familias de bajos recursos del Medio Oeste de Estados Unidos, en espera de o ya criando a un niño menor de un año de edad, que fueron asignadas al azar para recibir los servicios de IMH‐HB EHS (n=75) o a una condición comparativa (n=77). Las madres que recibieron los servicios de IMH‐HB EHS reportaron un funcionamiento sicológico y familiar más saludable, resultados que son consistentes con el enfoque de IMH, cuando sus niños tenían entre 3 y 7 años de edad. Específicamente, las madres en el grupo IMH‐HB EHS reportaron un funcionamiento y relaciones familiares más saludables, mejores habilidades para arreglárselas que eran necesarias para abogar por sus familias, así como menos estrés en el papel de crianza al ser comparadas con aquellas madres en la condición comparativa. El estudio también examinó la manera de arreglárselas buscando apoyo, algunas de las cuales cambiaron diferentemente a través del tiempo con base en las asignaciones de grupo del programa. En general, los resultados sugieren que los aspectos positivos que las familias alcanzan como resultado de participar en los servicios de IMH‐HB EHS se mantienen después que los servicios terminan.RÉSUMÉLes interventions fondées sur la santé mentale ont pour but de promouvoir le développement sain des nourrissons et des jeunes enfants en promouvant le fonctionnement saind'une famille afin de favoriser des relations de soutien entre le jeune enfant et ceux qui s'occupent d'elle ou de lui. Cette étude a examiné les impacts d'un programme américain de Early Head Start focalisé sur la santé mentale du nourrisson (abrégé IMH‐HB EHS) sur le fonctionnement de la famille. L’échantillon a compris 152 familles de milieu défavorisé de la région centre des Etats‐Unis, attendant un enfant ou s'occupant d'un enfant de moins d'un an, a qui on a assigné au hasard les services IMH‐HB EHS (n=75) ou une condition de comparaison (n=77). Les mères ayant reçu les services IMH‐HB EHS ont fait état d'un meilleur fonctionnement psychologique et familial, des résultats qui correspondent à l'objectif de santé mentale du nourrisson, lorsque leurs enfants avaient entre 3 et 7 ans. Plus spécifiquement, les mères du groupe IMH‐HB EHS ont fait état d'un meilleur fonctionnement familial et de meilleurs relations familiales, de meilleures capacités à s'adapter nécessaires afin de se porter les avocates de leurs familles, et de moins de stress de parentage comparé à celles du groupe de comparaison. L’étude a aussi examiné l'adaptation liée à la quête de soutien, qui a en partie changé différemment au fil du temps, en fonction du groupe de placement. Au bout du compte les résultats suggèrent que les gains obtenus par les familles comme résultat de la participation aux services du IMH‐HB EHS se maintiennent après que les services cessent.ZUSAMMENFASSUNGInterventionen, die auf der mentalen Gesundheit von Säuglingen basieren, zielen darauf ab, die gesunde Entwicklung von Säuglingen und Kleinkindern zu verbessern, indem ein gesundes familiäres Funktionieren gefördert wird, um unterstützende Beziehungen zwischen dem Kleinkind und ihren/seinen wichtigsten Bezugspersonen zu begünstigen. Diese Studie untersuchte die Effekte eines Early Head Start‐Hausbesuchs‐Programms (IMH‐HB EHS) auf das familiäre Funktionieren. Die Stichprobe umfasst 152 Familien mit niedrigem Einkommen aus dem Mittleren Westen der USA. Es handelt sich bei der Stichprobe um werdende Eltern oder Eltern mit einem Kind unter einem Jahr, die randomisiert einer Dienstleistung zugewiesen wurden: zum IMH‐HB EHS‐Programm (n = 75) oder zu einer Vergleichsbedingung (n = 77). Mütter, die das IMH‐HB EHS‐Programm erhielten, berichteten von gesünderem psychologischem und familiärem Funktionieren, wenn ihre Kinder im Alter zwischen 3 und 7 Jahren waren. Dies sind Ergebnisse, die mit dem IMH Fokus übereinstimmen. Im Speziellen berichteten Mütter, die in der IMH‐HB EHS‐Gruppe waren, von gesünderem familiären Funktionieren und familiären Beziehungen, besseren Bewältigungsstrategien, um für ihre Familien einzustehen und von weniger Stress in der Elternrolle verglichen mit den Müttern der Vergleichsbedingung. Die Studie untersuchte auch unterstützungssuchende Bewältigungsstrategien, von denen sich einige basierend auf der Gruppenzugehörigkeit im Laufe der Zeit in unterschiedlicher Weise veränderten. Insgesamt deuten die Ergebnisse darauf hin, dass die Gewinne, die die Familien infolge der Teilnahme am IMH‐HB EHS‐Programm erzielten, nach Ende des Programms aufrechterhalten werden.抄録乳幼児精神保健に基づく介入は、幼い子どもとその重要な養育者との間の支持的な関係性を育てるという健康な家族機能の促進を通して、乳幼児の健康な発達を促進することを目的としている。この研究は、乳幼児精神保健在宅早期ヘッドスタートInfant Mental Health home‐based Early Head Start (IMH‐HB EHS)プログラムが、家族機能に与える影響を調査した。対象はアメリカ合衆国中西部の妊娠中か1歳以下の子どもを育てている152の低所得家族で、IMH‐HB EHSサービスを受ける(n=75)か、比較の条件か(n=77)に、ランダムに割り当てられた。IMH‐HB EHSサービスを受けた母親は、子どもが3歳から7歳の間に、より健康的な心理機能および家族機能を報告した。これはIMHの焦点と一致している結果だった。特に、IMH‐HB EHS群の母親は、比較条件の母親と比べ、より健康な家族機能と関係性、家族を擁護するのに必要なよりよい対処機能、そして親役割にストレスが少ないことを報告した。研究はまた、支援を求める対処についても調査した。その一部はプログラム群への割り当てに基づいて時間経過により異なって変化していた。全体として、IMH‐HB EHSサービスに参加した結果として家族が達成し獲得したものは、サービスが終了した後も、維持されている。摘要以幼兒心理健康為基礎的介入旨在通過健康的家庭運作去培養小童與其重要看護者間的支持性關係, 以此促進幼兒和學步兒的健康發展。本文探討一個幼兒心理健康家訪早期搶步計畫 (IMH‐HB‐EHS) 對家庭運作的影響。樣本包括一百五十二個在美國中西部低入息的家庭。這些家庭正待產或在養育一個少於一歲的小孩。參與家庭被隨機分派到接受IMH‐HB‐EHS服務 (n=75) 或一個比較環境 (n=77)。有接受IMH‐HB‐EHS服務的母親報告在孩兒三至七歲間有較健康的心理和家庭運作, 這結果與IMH的焦點相附合。具體來說, 在IMH‐HB‐EHS組的母親較在比較環境組的母親報告有健康些的家庭運作和關係, 有好些的因應技巧為家庭作鼓吹, 及在親職角色中有少些壓力。本文亦探討尋求支持的因應, 發現這會根據組別分派而有不同的隨時間改變。總體而言, 探討結果顯示家庭從參與IMH‐HB‐EHS服務所得的收益在服務停止後仍會維持。Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112230/1/imhj21518.pd

Cross- lagged associations between behaviour problems and obesity in head start preschoolers

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155893/1/ijpo12627_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155893/2/ijpo12627.pd

Routine Active Playtime With Fathers Is Associated With Self-Regulation in Early Childhood

In recent years, a literature has emerged describing contributions fathers make to the development of very young children. Scholars suggest that active play may be a specific area of parenting in which fathers are primary and, further, that this type of play helps children experience intense emotions and learn to regulate them. However, this hypothesis remains largely theoretical. The current study (N = 415) addresses this gap in fatherhood research by using a secondary analysis of data collected in the national Early Head Start Research and Evaluation Project (EHSREP) Fathering Substudy (Boller et al., 2006; Love et al., 2005) to examine relations between fathers’ active play (measured at children’s 36-month birthday-related assessment) and developmental outcomes (cognitive–social and emotion regulation) at the entry to kindergarten. Findings demonstrate that regular active physical play between fathers and young children is associated with improved developmental outcomes. However, findings support a curvilinear relationship such that moderate amounts of active play are associated with better outcomes for children, but too little or too much active play is associated with worse outcomes, especially for children with more reactive temperamental qualities. Importantly, these findings are not replicated in relation to other types of parenting activities in which fathers engage, such as reading to children or engaging at mealtime, suggesting there is a special relationship between this type of play and children’s development. Furthermore, findings demonstrate that children with high emotional reactivity may benefit the most from active playtime with their fathers. These results are discussed in the context of the influence of fathering processes on child and family outcomes in low-income families

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358</p

Externalizing behavior is prospectively associated with intake of added sugar and sodium among low socioeconomic status preschoolers in a sex-specific manner

Abstract Background High intake of added sugar and sodium is a public health concern for preschool-aged children living in the US. Externalizing behavior may predict higher consumption of added sugar and/or sodium; however, previous studies have mostly been cross-sectional. The aim was to evaluate whether externalizing behavior is prospectively related to added sugar and intake in a sex-specific manner among preschoolers. Methods This was a secondary analysis of 524 preschool children (48% male) from Michigan who participated in an obesity prevention trial that occurred during one school year from 2011 to 2015. Teacher-assessed externalizing behaviors and three 24-h dietary recalls were completed at baseline and follow-up. We used linear mixed effects regression to evaluate the association between externalizing behavior at baseline and added sugar (% of total Calories) and sodium intake (mg/1000 Calories) at follow-up. In adjusted analysis, we included baseline income-to-needs ratio, child race/ethnicity, and baseline overweight status. All models were adjusted for total energy intake and accounted for clustering by classroom. Results Baseline externalizing behavior was positively associated with added sugar intake at follow-up among boys; after adjustment for confounders, every 5 points lower externalizing T-score (corresponding to higher externalizing behavior) was associated with a 0.6 higher percentage of added sugar per total Calories (95% CI 0.2 to 1.1; P value = 0.004). In contrast, girls with higher levels of externalizing behavior had lower consumption of added sugars; after confounder adjustment, every 5 points lower externalizing T-score was related to 0.6 lower percentage intake (95% CI -1.0 to −0.1; P value = 0.01). Baseline externalizing behavior was inversely associated with sodium intake at follow-up among boys. After potential confounder adjustment, for every 5 points lower externalizing behavior T-score, there was a 22 mg/1000 Cal lower sodium intake (95% CI -45 to 1; P value = 0.06). In contrast, after adjustment for confounders, every 5 points lower externalizing T-score among girls was related to 24 mg/1000 Cal higher sodium intake (95% CI 1 to 46; P value = 0.04). Conclusions Externalizing behavior among preschool-aged children was prospectively related to added sugar and sodium intake in a sex-dependent manner. Trial registration NCT01398358 Registered 19 July 2011.https://deepblue.lib.umich.edu/bitstream/2027.42/138809/1/12966_2017_Article_591.pd