Father inclusive practice in a parenting and early childhood organisation: The development and analysis of a staff survey

Aim: The successful embedding of father inclusive practice (FIP) in parenting and early childhood organisations is relatively new and therefore challenging to assess. The purpose of this study was to describe the process of adapting an existing tool, the Knowledge about fatherhood checklist (KAFC), to suit the parenting service context and apply the modified survey to establish a baseline of attitudes and practice of all staff at an established parenting and early childhood service in Western Australia, Ngala. Method: Following the application of the KAFC at Ngala in 2016, feedback provided by the staff led to a reflective and iterative process of review to adapt the KAFC. In 2018, all staff were asked to complete the adapted survey – the 23-item Father inclusive practice survey (FIP survey) – in order to assess the attitudes and behaviours of everyone in the organisation. The FIP survey covers aspects of competency as well as knowledge and attitudes in relation to fatherhood or father engagement. Results: Results indicated generally high levels of appreciation of the fathering role by Ngala staff. However, a number of areas for improvement in staff knowledge and attitudes were identified, including the benefit of reflecting on personal experiences of fathering, the awareness of the gendered stereotyped view of men, and the importance of the influence fathers can make in the context of attachment and breastfeeding. Conclusions: The implementation of this FIP survey informs improvements to staff orientation and training in FIP, and provides insights into staff attitudes, beliefs and practice regarding acknowledgement of the important contribution fathers make to the development and wellbeing of their children

Perinatal Risk Factors for Mild Motor Disability

The aetiology of mild motor disability (MMD) is a complex issue and as yet is poorly understood. The aim of this study was to identify the prevalence of perinatal risk factors in a cohort of 10-year-old boys and girls with (n = 362) and without (n = 1193) MMD. Among the males with MMD there was a higher prevalence of postpartum haemorrhage, caesarean section, low birth weight and stressful first year of life. Among the females with MMD, there was a higher prevalence of essential hypertension, anaemia and threatened pre-term. Multivariable logistic regression revealed gender(male), anaemia, threatened pre-term birth (if female) and hypertension (if female) weakly explained MMD at 10 years. These results underscore the importance of considering gender differences in order to better understand the multiple influences on motor development

Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study

Background: Approximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges negatively impacting on their mental health. The aim of this study was to investigate the prevalence of, and factors associated with, emotional and behavioural difficulties in children aged between 6 and 12 years living with HIV in Malawi. Methods: A random sample of 429 primary caregivers of children living with HIV drawn from the three main administrative regions of Malawi was recruited in a cross-sectional study. They completed a questionnaire about family socio-demographic characteristics, HIV disclosure, and child demographic and clinical characteristics, as well as the Strengths and Difficulties Questionnaire, Life Stress Scale, Support Function Scale, and Impact on Family Scale which were pre-tested and translated into the local Chichewa language. Data were analysed using descriptive statistics and logistic regression. Findings: Using the newer band categorisations of the Strengths and Difficulties Questionnaire, parent version, 31% of primary caregivers reported that their child had a slightly raised to very high level of total difficulties. Factors that were associated with difficulties were: primary caregivers' young age (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI]: 1.4-9.5); low level of education (aOR 2.6; 95% CI: 1.2-5.7); lack of employment (aOR 2.7; 95% CI: 1.2-5.9); the report of a substantial impact of the child's illness on the family (3.1; 95% CI: 1.5-6.5); and a low level of family functional support (aOR 2.0; 95% CI: 1.1-4.1). Neither non-disclosure of HIV status nor any of the child demographic or clinical factors were significant in multivariate analysis (p >.0.05). Conclusion: Close to one-third of children living with HIV in this study had high scores indicative of emotional and behavioural difficulties. Emotional and behavioural difficulties in children living with HIV were associated with family demographic and psychosocial factors, but not HIV disclosure. Effective policies and programs that promote the mental wellbeing of children living with HIV in Malawi are indicated

Need and acceptability of story books intended to help with the process of informing children about their HIV status in Malawi: a mixed methods study

The rate of disclosure of HIV status to children living with HIV in sub-Saharan Africa remains low despite the World Health Organisation’s recommendation that children should be told about their HIV status by the age of 12 years. Authors of previous studies have identified lack of disclosure materials as the main barrier to disclosure of HIV status. This study aimed to assess the need and acceptability of a series of age-appropriate children story books intended to help with informing children about their HIV status. Questionnaires, interviews, and focus group discussions were used to collect data from caregivers, healthcare workers, and school teachers, adolescents living with HIV, and community leaders across the three administrative regions of Malawi. Information about the need and acceptability of the story books and the sociodemographic characteristics of the participants was collected using reliable instruments. Quantitative data were tabulated while thematic analysis was used to analyse qualitative data. Almost 600 participants responded to the survey questionnaire, and 19 interviews and 12 focus groups were conducted with 106 participants. Ninety-eight per cent of participants supported the idea of developing the proposed series of story books and reported that they would use the books once they are developed. Most of the participants expressed that the books will help to improve their knowledge and understanding of HIV disclosure, increase their confidence on how to disclose and help to provide consistent information about HIV disclosure to children.The results of this study show a high acceptability rate of the story books. The process of HIV disclosure to children is a very complex issue that will require the development of guidelines and materials that are rigorously evaluated prior to dissemination

Socio-demographic, clinical, and psychosocial factors associated with primary caregivers’ decisions regarding HIV disclosure to their child aged between 6 and 12 years living with HIV in Malawi

The World Health Organisation (WHO) recommends that children living with HIV should be informed about their HIV status within the ages of 6 to 12 years using age-appropriate resources. The aim of this study was to assess the socio-demographic, clinical and psychosocial factors associated with primary caregivers’ decisions to disclose HIV to children living with HIV aged 6 to 12 years in Malawi. A cross-sectional study of 429 primary caregivers of children living with HIV were systematically recruited from all regions of the country. Information on HIV disclosure, family and child socio-demographic characteristics, child clinical characteristics, and child and family psychosocial characteristics was collected using validated instruments. Logistic regression was used to analyse data. The prevalence of nondisclosure of HIV status to children was 64 per cent. Concerns about the child’s inability to cope with the news (29%), a lack of knowledge on how to disclose HIV status (19%), and fear of stigma and discrimination (17%) were the main reasons for non-disclosure. On multivariate analysis, the odds of non-disclosure were higher among primary caregivers who were farmers (aOR 3.0; 95% CI: 1.1–8.4), in younger children (6–8 years) (aOR 4.1; 95% CI: 2.3–7.4), in children who were in WHO HIV clinical stage one (aOR 3.8; 95% CI: 1.4–10.2), and in children who were not asking why they were taking ARVs (aOR 2.9; 95% CI: 1.8–4.8). On the other hand, nondisclosure of HIV status was less likely in underweight children (aOR 0.6; 95% CI: 0.3–0.9). Many children living with HIV in Malawi are unaware of their HIV status. Non-disclosure is associated with a number of clinical and demographic characteristics. The findings highlight the need to provide guidance and support to primary caregivers to help them to effectively disclose HIV status to their children

Preadolescent children's perception of power imbalance in bullying: A thematic analysis

Bullying in schools is associated with an extensive public health burden. Bullying is intentional and goal oriented aggressive behavior in which the perpetrator exploits an imbalance of power to repeatedly dominate the victim. To differentiate bullying from aggressive behavior, assessment must include a valid measure of power imbalance as perceived by the victim. And yet, to date, there remains no agreement as to how to most accurately measure power imbalance among preadolescent children. This qualitative study explored children's (age 9 to 11) understanding of power imbalance through thematic analysis of focus group discussions. Subthemes that emerged as influencing power imbalance include: Age of victim, peer valued characteristics, and group membership and position. Subthemes of empathy and peer valued characteristics emerged as protecting against the negative impact of power imbalance

Parents' nonstandard work schedules and parents' perception of adolescent social and emotional wellbeing

Objective: We investigated the association between joint parents' work schedules and parent-reported adolescent mental health and test parental time for adolescents and parenting style as mediators. Background: Increasing evidence shows that parents' evening/night/irregular work schedules have a negative impact on children’s physical and mental health. Few studies examine adolescents and joint parental work schedules. Method: We analysed one wave of the Australian Raine Study data, focusing on adolescents who were followed up at ages 16-17 and lived in dual earner-households (N=607). Adolescent mental health was measured in the Child Behavioural Checklist (morbidity, internalising behaviour, externalising behaviour, anxiety/depression). Parental work schedules were defined as: both parents work standard daytime schedules (reference), both parents work evening/night/irregular shifts; fathers work evening/night/irregular shifts - mothers day schedules, mothers work evening/night/irregular shifts - fathers daytime schedules. We estimated a linear regression model with robust standard errors and log transformation of the dependent variables. Results: Compared to the reference group, when one or both parents worked evening/night/irregular schedules, there was a significant increase in parent-reported total morbidity, externalizing behaviour and anxiety/depression in adolescents. Fathers’ only evening/night/irregular schedules was associated with a significant increase in parent-reported total morbidity and externalizing behaviour. Inconsistent parenting partially mediated this association. Mothers’ only evening/night/irregular schedules was not significantly associated with parent-reported adolescent mental health. Conclusion: Our findings underscore the importance of fathers' work-family balance with implications for adolescent mental health

Perinatal risk factors for Developmental Coordination Disorder

The aetiology of mild motor disability (MMD) is a complex issue and as yet is poorly understood. The aim of this study was to identify the prevalence of perinatal risk factors in a cohort of 10-year-old boys and girls with (n = 362) and without (n = 1193) MMD. Among the males with MMD there was a higher prevalence of postpartum haemorrhage, caesarean section, low birth weight and stressful first year of life. Among the females with MMD, there was a higher prevalence of essential hypertension, anaemia, and threatened pre-term. Multivariable logistic regression revealed gender (male), anaemia, threatened pre-term birth (if female), and hypertension (if female) weakly explained MMD at 10 years. These results underscore the importance of considering gender differences in order to better understand the multiple influences on motor development